Leave Medicine Better Than You Found It

My grandfather taught me many unforgettable and important life lessons, but one that rang (and rings) true in every circumstance of my life is the idea that you should “leave something better than you found it.” 

The origin of the adage is from a camping organization; it refers to respecting others, their property, and nature. My grandfather was my greatest exemplar of the concept and he applied it throughout his life. When I was growing up, I joined many different sports teams, academic groups, and volunteer crews. My grandfather frequently reminded me to work hard to ensure that when a job was complete, the group (or team or project) would be better than it was originally. 

During my undergraduate education, my grandfather again reminded me to make sure I left the university better than I found it. Whenever I felt discouraged, I reflected on my grandfather’s wisdom. By applying it, my discouragements transformed into motivations and solutions. Living the concept allowed me to improve everything that might otherwise have been only a struggle.

During college, I noticed that it was difficult for pre-medical students to publish research in areas in which faculty members were few. The solution that I found was to create a perpetual program that allows students to publish multiple quality research papers before applying to medical school. The program matches pre-med students with faculty advisors with the aim of bringing them together to design an efficient study at an accelerated rate. The goal is to give the student experience being a first author. The following year, the student then becomes a principal co-investigator; taking in a leadership role within the research.

As a business owner, I valued employees who had my grandfather’s “improvement mentality” (and the resulting productivity such a mentality generates). A company filled with teammates unified by a shared mentality meant increased success and productivity, which resulted in positive longevity. As employees retired or moved on to other opportunities, the most important legacy they left behind was in training new people and instilling our company’s approach.

My grandfather’s concept continued to resonate in medical school, and still resonates in residency. I remember as a student, there were aspects of the curriculum that felt outdated or inefficient. I distinctly remember a moment when I was studying in the library and realized I could either do nothing or make an effort to improve the curriculum. I joined the Curriculum Committee to represent the student voice and I was ultimately able to contribute to a project that streamlined an innovative curriculum for future classes. 

Now, post-college and med school, I often reflect on my life to ensure I am still living this important principle. The future of medicine is bright, but it’s approaching a pivotal moment in history. It is extremely vital that all medical professionals internalize the mentality that we must leave medicine better than we found it. Health care is a unique animal. While there are multiple strong opinions about all vital issues in medicine, one general point of commonality is that the health care system needs to improve.

“Leaving something better than you found it” requires taking individual responsibility to clean up after yourself. My heart breaks when I see a medical professional in the news that has made a decision that damages the reputation of the entire medical community. We have all taken the same oath and promised to “do no harm.” Although the oath is focused on patient care, I believe that the idea of “do no harm” is also applicable to reputation. The decisions and actions of one medical professional often affect the reputation, trust, and success of the entire community.

But cleaning up our own mess is not the end of our responsibility. There are many players in the health care system besides doctors, all of whom influence medicine. Although we are not responsible for their influence, we, on the front lines of medicine, should make an effort to be more involved in creating solutions to problems. The more passive physicians are, the more self-restricting we become. The worst thing we can do is lose control of the future of medicine — if we want to leave the profession better than when we found it, we must be active in advocating in arenas beyond those that are strictly medical (e.g., in our communities).

As I prepared to apply to medical school, I shadowed 18 different physicians in many different specialties. I was shocked to discover the vast differences in opinions regarding the future of medicine. I always ended my shadowing experience by asking each physician if they believed medicine was still worth pursuing. I received an array of answers (none of which correlated to the responders’ ages, specialties, or incomes). As I have progressed through medical school and residency, I have come to understand that motivation — as well as happiness and optimism — is not exclusive to any one specialty. Everyone in medicine can improve its future. The future is only as bright as we strive to make it.

Tyson Schwab, MD, MS is a clinician at Intermountain Healthcare. He practices at Utah Valley Hospital as part of the Utah Valley Family Medicine Residency program. His medical interests includes primary care, innovation, technology, health policy, and improving medical quality. Dr. Schwab is a 2019-2020 Doximity Fellow.

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