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Crack in the Armor

David Epstein, MD, MS, FAAP shares the insecurities we have in medicine as physicians and how protecting ourselves from these insecurities or self-doubt may not be the best thing.
There are very few people who are supremely confident in their abilities in medicine. Most people have some insecurity about their medical knowledge, procedural prowess, clinical judgment, interpersonal interactions, and other skills that are required in the field of healthcare. Nobody is perfect and most of us are keenly aware that we are only human.
Call it imposter syndrome. Call it self-doubt. Call it a lack of self-assurance. Whatever the name attached to the feeling, these feelings will surface under the right circumstances.
In medicine, we must exhibit some degree of confidence while managing and treating patients. If we don’t exhibit confidence in our knowledge and skills, the patients won’t have confidence in us treating them. So, we walk around with armor to protect us and allow us to perform our medical duties without interference from our feelings of inadequacy. The health and even the lives of our patients depend upon the unhindered execution of our practice of medicine.
However, sometimes, a crack in our armor is found that allows a comment from a patient, the look of a parent of a child in our care, or an identified medical error to penetrate our armor to ignite the flame of insecurity that spreads throughout our soul like wildfire. It is at that time which we find ourselves facing our worst enemy.
Our worst enemy is our self-constructed perception that we are infallible and do the best for our patients 100% of the time. This is the armor that we wear to shield us from self-doubt and insecurity. An argument can be made that we need it to function in a profession with so much at stake for patients and their families. However, it deprives us of connecting with feelings that we should be familiar with, as any penetration through a crack in that armor will cause a chain reaction that we may not be practiced at dealing with and can cause great inner pain.
Maybe we need to be more vulnerable and not don our armor too often, so we know how to deal with the inevitable failings that occur while we practice medicine. We need to allow ourselves to have grace and kindness toward ourselves because we are only human. In medicine, our intentions are to heal and to do good. But, sometimes things don’t go the right way, no matter how hard we try. Supreme confidence is not a characteristic that most people in medicine possess. It is not because we don’t want complete confidence in what we do, but because we are human and imperfect.
Reminding ourselves of our imperfections will likely make us better physicians because this allows for inspired growth and development. Our shortcomings should not be considered limitations, but opportunities to hone our skills and inspire us to do better. By practicing medicine with the intention to be a better physician by all definitions, we become more resilient to the things that would trigger our insecurities and prevent us from putting on the armor of invincibility as often.
How do you manage your self-doubt and insecurities in medicine?

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