Obsessive-compulsive behaviour in American medicine

There is a hard-work role in American medicine, known to the public and to the medical profession, at least implicitly, that may be responsible for much of what is both good and bad in American medicine. The name of the role, ‘obsessive-compulsive’, suggests the duality. On the one hand, the physician who follows its dictates is committed to high standards and to the service ideal; on the other hand, his workaholism, combined as it is with a highly technological approach to medical practice, may lead to over-diagnosis, over-treatment, and an inflationary medical bill. The role has implications for the health of the physician, as well as for that of the patient, since the former, in a vain attempt to be the perfect (i.e. omniscient and omnipotent) physician may lapse into alcoholism and drug addiction or so neglect his family that he becomes another divorce statistic. While the physician learns this role as a part of his professional socialization and as a reaction to the work situation, his personality type may predispose him to accept role demands; Type A personalities are particularly susceptible. The obsessive-compulsive role has an uncertain future in the American medical profession. The question is can a new role be constructed from the old that will promise a productive, yet healthy life for the physician, a lesser risk of iatrogenic illness for the patient, and a lower medical bill for society?