White Coat and the Black Belt

A Martial Arts Journey in Medicine

I was in my early 20s when one of my mentors, Grandmaster Jhoon Rhee, provided me with this bit of wisdom, “The purpose in life is to be happy!”     

Finding that happiness still resonates for me today, particularly when it comes to practicing medicine. It dawned on me that my medical career and those who have transitioned to direct care medicine mimics that of a martial arts journey.  

In the world of martial arts, the white belt symbolizes a blank slate, a canvas upon which our journey begins. It represents our innocence, our lack of knowledge, and the untamed potential within us. As time goes on, the belt starts to darken from sweat, dirt, hard work and wear.  Eventually, this produces a black belt.  The years of effort and toil darken the belt.  Ironically, as the years pass, the black belt begins to show signs of wear and tear. It frays at the edges, fades in color, and gradually reveals its white core.  The martial artist goes from a white belt to a black belt back to a white belt.  

It’s not just the belt that changes; the martial artist’s experience mirrors this journey.  With experience, we come full circle, returning to the essence of the white belt within us. But this time, it’s not the innocence of inexperience; it’s the wisdom born of years of dedication. We realize that true mastery isn’t a static state but an ever-evolving process.

The Parallel Journey

In medicine, I remember in school getting to wear the short white coat while we were in medical school rotating through clinics.  It symbolized our stage in training, our lack of knowledge, and the untamed potential within us. Graduating medical school and moving on to residency, I now got to wear the long white coat. Brimming with theoretical knowledge and a genuine desire to heal, like all my colleagues at that stage, I was open to various approaches to medicine and ready to learn from every attending and patient I encountered. The medical journey started with the innocence of a white belt mentality. 

Just as martial artists progress from white to black belts through rigorous training, I, too, went through an intensive training phase earning that black belt during residency. In those years after postgraduate training, I continued the black belt curriculum by being employed and becoming a part of the insurance-based healthcare system.

In the world of insurance-based medicine, the black belt represents expertise, experience, and an understanding of the system’s intricacies. I learned to navigate a complex web of insurance codes, pre-authorization procedures, and the often perplexing bureaucracy of healthcare. I was no longer the wide-eyed white belt; I became a seasoned practitioner.

Constraints of the Black Belt

The black belt, often seen as the pinnacle of martial arts achievement, symbolizes mastery and expertise. However the teaching responsibilities of a specified curriculum, competition, and mastering more forms within a specific style could sometimes restrict the ability to work freely on basics for yourself or the ability to learn new things.  

Completing residency, landing a job, getting on insurance panels, and opening a practice – this was where I gained clinical experience, became respected in my field, and earned my patients trust.  But, there was a catch. 

True wisdom lies not within being a black belt but in the lessons learned during that journey.  You begin to realize that you don’t know everything and that you must always be willing to learn, to grow, and to be humble.  This helped me in medicine as well because I realized as my career unfolded, there were things that I did not understand that were impacting my practice.  I needed to learn and grow.  I began to realize that the system had its own rules and regulations that didn’t always align with what I believed was best for my patients. I found myself bogged down spending more time dealing with paperwork and insurance approvals than actually practicing medicine. 

And then came a turning point in my career, a moment that echoed the essence of returning to the white belt. I discovered the world of direct care medicine.

Direct care medicine is a paradigm shift, a return to the roots of medicine, much like how a martial artist revisits the basics of their art. It’s a practice that operates outside the constraints of insurance companies and their complex regulations. Instead, it’s about direct, patient-centered care.

Searching for Freedom and Flexibility

A white belt is free from the constraints of pre-existing techniques.  They are not married to a “style” of martial arts with both its limitations and strengths.  Their challenge is to gain competence in an organized and structured way.  

My insurance based practice was like a style of martial arts that was too restrictive.  I needed the freedom and flexibility of the white belt – free to take my competence and skills and redirect them in a way that was best for my patients. In direct care medicine, I found the freedom to practice medicine in a way that truly puts the patient first.  

Direct care medicine allows me to tailor treatment plans based on individual needs, not insurance guidelines.  I had the skills and knowledge of a black belt.  Direct care medicine gave me the freedom and flexibility of the white belt that I needed.  

I can spend more time with my patients, getting to know them personally and addressing their concerns comprehensively. This return to the “white belt” mentality has been liberating, both for me and my patients. It’s a reawakening of the core principles of medicine, where healing and patient care are the top priorities.

A Never-Ending Journey

Much like a martial artist’s journey, my transition from insurance-based medicine to cash-based care has been a continuous process of growth and self-discovery. I’ve come to realize that expertise isn’t stagnant; it’s an ever-evolving journey.

Just as martial artists don’t forget the techniques they’ve learned on their way to becoming a black belt, I haven’t discarded my expertise gained in insurance-based medicine. Instead, I’ve integrated it into my practice, using it as a foundation upon which to build a more patient-centric approach.

I didn’t change how I practice medicine, I changed how I interacted with the system.

My journey in medicine has been a fascinating parallel to the progression of a martial artist from white belt to black belt and back to white. It’s a journey of continuous growth, adaptability, and a return to the core principles of healing.

While the black belt signifies expertise, the transformation of that belt to white represents a renewal of commitment and a reminder that true mastery lies in the ability to provide compassionate, patient-centered care. Just as in martial arts, the journey in medicine never truly ends; it’s an ever-evolving process of self-improvement and discovery.

So, whether you’re a physician, a martial artist, or simply someone on their life journey, remember the lessons from the white belt to black and back to white. It’s not about the color of the belt but the wisdom gained along the way that truly defines our expertise and our ability to make a positive impact on the world.

In his later years, Master Rhee would sign his letters, “In TBL” representative for Truth, Beauty, Love.  He said, “When you are truthful, you are beautiful in the heart. When you are beautiful in the heart, everybody loves you. When everybody loves you, you are happy.”