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In reply—Dissatisfaction as a Unifying Force for Social Action

      Dr Volpintesta raises a number of interesting points, particularly with respect to how one’s early medical education might set his or her trajectory for future engagement in broader public policy conversations. Not only may medical schools not teach the importance or content of professionalism especially well, as Dr Volpintesta suggests, they may actually impart the wrong messages through forces such as the hidden curriculum.
      • Hafler J.P.
      • Ownby A.R.
      • Thompson B.M.
      • et al.
      Decoding the learning environment of medical education: a hidden curriculum perspective for faculty development.
      Our study does not address these issues directly. However, our finding that dissatisfaction was significantly associated with disengagement in policy conversations may illustrate the converse of the ideal Dr Volpintesta articulates, that dissatisfied physicians might be individually motivated to come together around health policy reform. It is intriguing to hypothesize whether dissatisfaction and burnout from the beginning of medical school contribute to decreased professionalism and professional engagement throughout one’s career, as others have suggested.
      • Dyrbye L.N.
      • Shanafelt T.D.
      Physician burnout: a potential threat to successful health care reform.
      In addition, whether dissatisfaction can be converted into a motivator of engagement and change is unknown. These questions highlight the need for further consideration of how professionalism in medicine may best be promoted from the earliest stages of professional development.

      References

        • Hafler J.P.
        • Ownby A.R.
        • Thompson B.M.
        • et al.
        Decoding the learning environment of medical education: a hidden curriculum perspective for faculty development.
        Acad Med. 2011; 86: 440-444
        • Dyrbye L.N.
        • Shanafelt T.D.
        Physician burnout: a potential threat to successful health care reform.
        JAMA. 2011; 305: 2009-2010

      Linked Article

      • Dissatisfaction as a Unifying Force for Social Action
        Mayo Clinic ProceedingsVol. 90Issue 5
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          In their article published in the February 2015 issue of Mayo Clinic Proceedings, O’Donnell et al1 are right to mention dissatisfaction with the practice of medicine as a major factor that generates physicians’ lackluster interest in addressing health policy issues. However, there is another factor that must be mentioned, the fact that most medical students do not learn the importance of defending medicine’s ideals in medical school or in residency. They are too busy learning the basics of being doctors, and once they are in practice, the importance of participating in medical affairs seems like a waste of time compared with the demands of practice, personal life, and continuing medical education.
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