How Do You Know If You Are A ‘Good Doctor’?

My brother retired from a major corporation as a project manager last year at the young age of 60. That’s what working in a large company can do for you. All of his life, he has had a passion for horticulture so he found a new gig in, of all things, spraying trees. He loves it.

In the tonier section of his city, he entered a client’s backyard to begin the treatment and noticed the homeowner. After some pleasantries, my brother asked what he did for a living. The guy said he was a retired doctor. Naturally, my brother asked what kind and the gentleman answered without blinking: “A good doctor.” Eventually, it came out that he had been a neurologist.

My brother told me the story. He didn’t make any comments about the doctor’s response. That’s my job now.

I don’t know how to define what makes “a good doctor” nor would I have the chutzpah to even say if I am a good doctor, at least so far.

What constitutes being a good doctor?

• Is it not being sued? Count me out from this one.
• Is it never having a postoperative infection? Been there, done that.
• How about charts not being audited? This has happened a few times.
• Never being accused of not being a real doctor? The opposite.
• Many saying “thank you”? Few.
• Never having other complications? You’ve got to be kidding me.
• Not worrying about a patient? When do I stop?
• Trying to do the best every time? You bet.
• Keeping up to date with the literature? Constantly.
• Remembering that the foot and ankle are attached to someone who is in pain, scared and hopeful? Every case.
• Realizing the privilege it is to treat someone? Over 35 years’ worth.
• Being in awe of how the foot works and all that anatomy? Since the first year of school.
• Hating every minute of it? Podiatry was never work but an avocation although I do hate all the nonsense associated with medicine today.
• Knowing that a lot of what I do is maybe too much of an art and not a science because some things of the body are still not understood? Yes.
• Trying to train residents so they become highly competent? Have trained over 50 and counting.

I could go on and on trying to see if I measure up to being a “good doctor.” You could also but we know it is not a scorecard.

Maybe that neurologist had it easier. A few things we encounter include delayed unions, nonunions, people ambulating when they shouldn’t and telling someone tonight he or she will lose part of the foot. What does the neurologist do that is comparable?

Maybe the “good pilot” is not the one who keeps the autopilot on but the one who flies it to the finish and has his or her share of near misses. Perhaps the good pilot gets out of these near misses and learns from each one. Does each complication make us a better doctor? I don’t know but complications sure keep me thinking.

Even though I’m still pondering that neurologist’s answer and trying to rationalize whether I’m a “good doctor” with this brief column, I still have trouble mouthing the words and believing them, at least not now. Is whether you’re a good doctor something you can only say in retrospect and not concurrently? Did that neurologist realize he was good during his practice?

Don’t forget. We are in the practice of foot and ankle care/surgery. When do we get in the game? Maybe the game occurs when the career is over and we have time to reflect on our work and accomplishments. Then we may be able answer whether we were good doctors or not.

I will find out if my brother still sprays the neurologist’s trees and see if he would be willing to ask the doctor: a) why he said he was a good doctor and b) what criteria did he use to say it.

Maybe when I go visit my brother, I could go over and interview the doctor. I am sure it would make for an interesting article. Does my brother have something similar to the Health Insurance Portability and Accountability Act regarding his clients? Would I need to sign a waiver and ensure my hepatitis B status is up to date?

If you can answer whether you are a good doctor the same way my brother’s client answered, I tip my hat to you. Tell me what I am missing. There is an elephant in the room. I was raised that the cup is always half empty. Does that make the question harder to answer from the get-go?

Dr. Wallace is the Director of the Podiatry Service and the Medical Director of Ambulatory Care Services at University Hospital in Newark, N.J.