THE DOCTOR'S DILEMMA: AN ENTRY POINT FOR DISCUSSIONS ABOUT PROFESSIONALISM FOR SURGERY AND GASTROENTEROLOGY TRAINEES
Hadi J. Minhas2, Elise Malecki*1
1Albany Stratton VA Medical Center, Albany, NY; 2Albany Medical College, Albany, NY
In many training programs, discussions of professionalism and ethics are outsourced to vendors of computer-based modules. We found an easily accessible work of fiction which can serve to facilitate these discussions even among physicians without a particular interest in the humanities. George Bernard Shaw's play The Doctor's Dilemma is a farce portraying outrageous behavior by physicians. It is as relevant today as it was when it was published at the turn of the 20th century, as the main plot revolves around the treatment of a respiratory infectious disease and the allocation of scarce resources. A subplot in ACT I about a surgeon who promotes and performs high volumes of an unnecessary operation is of particular interest for trainees in procedural specialties. The surgeon arguably fails in most of the Accreditation Council for Graduate Medical Education's Core Competencies: patient care, medical knowledge, professionalism, practice-based learning and improvement, and systems-based practice, though may have adequate interpersonal and communication skills. We will provide outlines of this and other frameworks, such as the Hippocratic Oath, human subjects research rules, and even state laws pertaining to physician licensure, with annotations from the play. As a product of its time, the play contains sexism and other forms of bigotry, which may be potential triggers for readers, but also may be a springboard for discussions of explicit and implicit bias. The play is freely available on the internet as it is in the public domain. Reading the play and discussion with attendings during procedural downtimes has been well-received by Gastroenterology fellows in our training program.
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