This essay looks at a very difficult and important topic – Practicing Medicine Without a Swagger

It was hard not to feel entitled when working 36 hours straight as a medical resident. By the end of my shift, I found myself interrupting conversations and being rude to co-workers and even patients. After all, I had been up all night.

But it was not only long call nights that allowed physicians to rule the roost. For decades, doctors enjoyed privileges and perquisites that made colleagues alternately envious and furious. But these days, doctors are less likely to be treated like royalty than – egads! – like employees. How are we dealing with this?

During my career, I have seen physicians who (as the Outkasts sang) think their s*** does not stink! As a student I saw a chief surgical resident throw a knife at the wall during an operation (right after he had cut a ureter).

Some specialties seem to attract those prone to arrogance. You see few family MDs or general internists who are arrogant. You see many neurosurgeons and CV surgeons with that attitude.

But even as a general internist, I run the risk of arrogance. Even in 2005, patients remain deferential, as do nurses, clerks, and everyone else in the hospital or the office. When we really help someone, we naturally start to believe our own press clippings.

But then are we any different from successful lawyers, business men (or women), athletes or entertainers? We all run the risk of forgetting that we are human beings who have a particular skill, but otherwise we should never take ourselves too seriously.

I have always socialized with non-physicians who are more interested in my ideas than my titles. I play golf with businessmen, lawyers, and no physicians. They worry more about more golf score than my title.

Now they do ask me medical questions from time to time, just like I ask them questions related to their business. I am flattered that they ask me, and am always glad to try to help them.

But I do worry about acquiring physician arrogance. We must all work to avoid that slippery slope.