The developmental personality changes which result from
medical socialization, as now constituted, are not conducive to
preparing the doctor emotionally so that he can meet the needs of
dying patients and their families in the depersonalized hospital
setting. Little recognition currently exists among medical educators
that the doctor's role is more than that of gatekeeper of the nation's
health--that, in fact, he also presides over the death scene.
24 If he is
to fulfill the role which is increasingly expected of him, he must be
better prepared to deal with the subjective features of this poignant
For background information concerning the cultural roots of death
orientations in American society, see
Lidz ( 1967).
For a discussion of the competing demands inherent in the doctor's role,
Merton ( 1957), especially pp. 73-79.
The topic of death and dying was but one of many covered during the
interviews, which varied in length from 1.5 to 3 hours, depending on student
loquatiousness. More than 200 items of information were included in the recorded
questions and answers. Results of the larger study will soon be published in a book
entitled Students into Doctors: Professional Socialization in Medical School (by
R. H. Coombs
, in preparation).
Interviews were conducted on the West Coast before Dr. Powers accepted
her present position. The 13 physicians interviewed ranged in age from 30 to 57, with
a mean age of 41. Three were women, ten were men, and all but one, an
anesthesiologist, were currently in psychiatric training or in the private practice of
psychiatry. The physicians interviewed have a wide variety of experience. Eight were
in general practice prior to beginning psychiatric training; among these the average
length of general practice was 12 years, with a range of from 2 to 25 years. One
physician interviewed had been an anesthesiologist for 7 years. Two physicans who
took part in the study had been in the service after internship and prior to psychiatric
training. The two physicians remaining had gone directly through psychiatric
training. One of the physicians was a minister and one was a social worker prior to
going to medical school. Ten of the 13 physicians interviewed went to medical school
in the United States, and three were trained in foreign countries.
A further discussion on the topic of the medical center as a social system is
Bloom ( 1971).
An earlier report about the coping mechanisms utilized by seasoned
clinicians in stressful hospital situations is provided in
Goldman ( 1973).
This research, part of the larger study of medical socialization, was based upon
participant observation in an intensive care unit.
Kasper ( 1959) first emphasized that medical students are desensitized not to
death, but to the symbols of death.
For further discussion on this and other aspects of the desensitizing
Fox ( 1963) article.
Questia, a part of Gale, Cengage Learning. www.questia.com
Book title: Inside Doctoring:Stages and Outcomes in the Professional Development of Physicians.
Contributors: Robert H. Coombs - Editor, D. Scott May - Editor, Gary W. Small - Editor.
Place of publication: New York.
Publication year: 1986.
Page number: 277.
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