A Medical Career Providing for Others

Posted in GUMC Stories

Given his resume, one would think that Professor Sir Michael Rawlins, MD, carefully planned his meteoric career. He rose from a consultant physician in Newcastle, England, to chairman of the National Institute for Health and Clinical Excellence (NICE) — overseeing the U.K.’s nationalized health care system — and then took over the reins of The Royal Society of Medicine. Oh, and he was knighted in 1999 by Queen Elizabeth.

And, given that Sir Michael is Georgetown School of Medicine’s 2013 commencement speaker, the 197 graduating physicians seated before him might hope to hear pearls of insight and wisdom to ensure their medical careers will be equally illustrious.

But Sir Michael will be inclined to tell the newly minted physicians that they need to be flexible, as he was. He sought opportunities, as they came along, that worked out in some cases, but not in others. “It is important for these physicians to know that they will have disappointments — we all do.”

The guiding light in Sir Michael’s career was his need to help patients receive just, equitable and kind care, he said in an interview. And from that credo, everything else followed.

One of his proudest moments was when he, as a physician and professor of clinical pharmacology at the University of Newcastle, was able to ease the depression and suffering of a man in his 60s dying of lung cancer. He had been part of the Queen Mother’s protection squad and was upset that the reputation of this group of guards was damaged due to recent malfeasance on the part of the group’s boss. The patient felt his lifelong work in the service of the royals was, by extension, destroyed, Sir Michael says.

Hearing this, Sir Michael managed to contact the assistant to the Queen Mother to tell her the former security guard was not well.

“The next time the patient came in, he said the most wonderful thing had happened to him,” Sir Michael continues. “He said he had a letter from the Queen Mother in her own handwriting, and that he was very happy. The last weeks that he lived, he clutched that letter to himself.”

The story is an example of one physician’s power, he says. “With a bit of imagination, you can help people in ways that count for more than memorizing the entire textbook of medicine.”

In fact, everything doctors do in their careers must come from the recognition that “being a physician is a huge privilege because you share people’s lives at their most vulnerable point.”

That is what Sir Michael always kept in mind as he moved to positions where he held great sway over the practice of medicine in Great Britain.

Voices of physicians get lost in cacophony

Physicians in the U.S. are also in a great position to hold their own sway over how patients will be treated in the future, Sir Michael says.

“Physicians need to be ready for, and part of, the future to come,” he says.

The practice of medicine will certainly change, he says. “Looking back on the sorts of drugs we used, the operations we did when I was a young man, it all has completely and utterly changed, and it will change again. I don’t know how, nor does anyone else,” Sir Michael says.

And in the U.S., delivery of medicine is in flux. “Physicians here can help guide how medical care can change,” he says. “They must use their voice in many different ways for the benefit and support of the patients they are responsible for. If they don’t do it, someone else will.

“This is why I will tell the medical students not to try to plan their careers too precisely. If they are flexible, open to change and dedicated to patient care, they can be future leaders.”

“Sir Michael represents a physician, a health care leader and a policy person all in one,” says Howard J. Federoff, MD, PhD, executive vice president for health sciences at Georgetown University Medical Center and executive dean of Georgetown School of Medicine. “His career is inspiring because he has made a choice to make a difference in so many ways that impact the lives of patients.

“I completely agree with him that physicians voices often get lost in the cacophony of others, including policy makers and politicians, who may, or may not, see health care in the same way that doctors do,” Federoff says.

Medical students — and new physicians — need to be thinking about the right model of health care for the U.S., Dr. Federoff says. “They need to be asking questions not just of themselves but of those with whom they work, other clinicians, other health care providers, other hospital or private practice leaders, of their elected officials. This is a very important and critical time in this nation’s history with regard to health care.”

Federoff and Sir Michael have gotten to know each other over the last several years, and they served together on a panel on global healthcare in London in April, part of the annual John Carroll Weekend, an annual event hosted by the Georgetown University Alumni Association.

“Sir Michael is extremely articulate, very passionate and engaging,” says Federoff. “His story — how someone trained as a physician winds up taking on the roles he has — will be very interesting to our students.”

Rawlins says he is pleased to be part of the Georgetown School of Medicine commencement — only the second medical school graduation in the U.S. at which he has agreed to speak. He admires the cura personalis mission of Georgetown, saying such devotion to the needs of others provides the right model for health care in America.

“Keeping cura personalis in mind will help guide these graduates,” Rawlins says. “It’s the best piece of advice I can give.”

By Renee Twombly, GUMC Communications

(Published May 20, 2013)