I’ve never been a small-talk doc. My therapist calls me “the Dr. Kevorkian of medical taboos.” I’m most comfortable discussing the uncomfortable—topics that scare most physicians. In my TED talk, I bust through three taboos: human sexuality, physician-patient intimacy, and doctor suicides.
Taboo #1: Sexuality. Americans are oversexualized and sexually repressed. And that’s not healthy. Because I’m at ease with my sexuality, patients are free to express theirs. I care for polyamorous couples, sex workers—even married virgins. Why would patients disclose such intimate details they’ve never shared with other doctors? I’m nonjudgmental and accepting, so patients allow me to see who they really are. That’s healthy. And fun. Yes, I even offer Pap parties (find out why in my TED talk):
Taboo #2: Intimacy. So why aren’t more doctors and patients having fun? Frankly, they’re scared. Intimacy means in-to-me-see. When doctors fear patients, patients fear doctors. Fear begets fear. So let’s face it: our fear-driven disease management billing system is ill equipped to deliver health or care. Maybe that’s why our doctors feel so, well . . . unwell.
Taboo #3: Suicide. Doctors are beyond frightened. Many docs (and med students) are burned out, depressed—even suicidal. The fact is: nearly one million Americans will lose their doctors to suicide in 2014. When would be a good time to discuss the hundreds of doctors and medical students who die each year by suicide? With more than 100,000 views, my TED talk would suggest the time is now.
In many cultures, those who travel into forbidden territory are ostracized. But sometimes, the public demands—even craves—the truth. My TED talk is more than a truth-telling sermon. When I was invited to deliver a TED talk, I was instructed to change the world in less than 18 minutes with one, new, big idea. So I introduced the world to America’s ideal medical care movement—a grassroots revolution in which citizens are opening ideal clinics where patients and doctors can be comfortable, connected, and happy. The public excitement is palpable. And the media is abuzz.
The Washington Post asked to publish my physician suicide blog in their print newspaper and online with my TED talk embedded. When doctors commit suicide, it’s often hushed up was the third most read national news story that day. Due to high readership, The Washington Post asked me to write another article. Huffington Post invited me to contribute Why I Kiss My Patients. The Daily Beast showcased the ideal medical care movement and my TED talk. A Reader’s Digest article is coming in November. And Time Magazine just interviewed me for a feature.
The reaction in medical circles is equally inspiring. After reposting my blog, Physician Suicide Letters , the editor responded: “We have never had comments of that magnitude and it is utterly eye-opening for me.” I am now the #1 top-trending author on KevinMD and my talk is listed the #1 TED talk that all medical students should watch.
Can a big idea get any bigger? Yes.
The producer of America Tonight discovered my TED talk and sent a crew from DC to film me for two days. An excellent 11-minute program on ideal medical care as the solution to the physician suicide crisis aired on prime time national TV with portions of my TED talk replayed! Though not accessible online, here’s a much abbreviated print version of that story.
I thought my idea was just for Americans until I was featured in the UK and then named New Zealand’s Compassion Hero. I’ve been contacted by citizens from Nigeria to Singapore, Kenya to Iceland. Suicidal physicians, medical students and their family members from all over the world have reached out for help after viewing my talk. Doctors have thanked me saving their lives. Patients have thanked me for helping them develop healing relationships with their doctors.
I’m a small-town doc with a big idea. People think I have a PR team. I do not. My TED talk has spread one inspired person at a time. In less than six months since my talk was uploaded, it has gone global. And this proves to me that one TED talk can change the world of medicine.
Pamela Wible, M.D., is a family physician who pioneered the first medical clinic designed by patients. Photos by Wind Home and GeVe.
how many medical students kill themselves….I cant find good statistics…
One of the problems is that the data is not tracked. It’s hidden.
I almost did. I think about it daily. I regret the decision to practice medicine, every day I try to find a way out. Most days I wished I had just done it. I would have been happier.
hi, i am an authority on suicide and addiction / recovery… there is a “recovery pharmicutical industrial complex…we all know it if we think …there is a book i was giong to write…”Chasing the Scream ” that puts all other recovery thoughts to shame…
and no professional i know, no user ive met and no family member had heard of it…Russel rand does an interview that tells the story…why is infomation guarded and docs FEARFUL to EXPLORE new ideas..because they are complacent and too busy…
my granfather was a gp…he talked with his patients…a stomch ace was more orten a family matter ,,, a diagnostician,,his parrents , his wifes parrents and three children live in a row home on broad street philadelphia…and in the 70s i saw accupuncture in their dining room…navey yard workers said it worked on their pain…if the doc said lets give this a try it was sure…he was often paid with food…home repairs ,,,coctails at a saloon…they live well…
medicine became a business..not to serve and heal but a trade..not to dis the trades..
when he died he said it was an honor to be a doctor in this time in america and the profession is a mess…that was around the late 80s…its messier…
how many young med students are driven into medicin by parental egos…make us prowd and are guiltridden over the expensive eduication they have been pushed into…
some sane people commit suicide over situational depression and pressure..a statistic wouldnt even scracth this…
sorry im on a chrome book and i cant do spell check…in the name or triage i felt sharing was more important,,,
thanks , hope this rings true…
do you think outside the box ?
i never thought there was any sort of box…that is what the study of humanities and medicine should be and is…
bill carroll
haddonwmc@gmail.com
Dr. Wible, how do you think that the topics of intimacy and sexuality are impacted by the increasing use of chaperones by some doctors, or when the patient must first disclose all areas of concern to both a receptionist and a medical assistant? It seems to me that the former shows a lack of trust, and the latter causes a separation between doctor and patient. I can’t see how either can be helpful to forming an intimate relationship with one’s physician, but I am curious as to your thoughts.
Agree with you. Too many cooks in the kitchen ruins the stew. How many people do you need in your bedroom with your spouse? Receptionist? CPA? Insurance agent? It’s a bit ludicrous. We’e not talking about a lung transplant. Hangnails, bronchitis, Pap smears do not require a “team” approach. We’ve taken something simple and made it beyond complex. Now nobody is thinking clearly and the sacred relationship between doc & patient is lost in the chaos.
the sacred relationship is not there…you do not have a confidential relationship…you do not have the rights of a priest or lawyer…in a court of law you must disclose all or lie to the judge…even if you hurt your patient..
Thanks, and I agree completely.
What’s funny is I see a PA who works at a medical clinic, which is very much into the “team approach”. However, her MA only takes vitals, weight, etc., and that’s it. She never asks for specifics on issues that I have, leaving that for the PA. This seems to reflect her attitude. I have only seen this PA a few times, but, we chat about things that I would never discuss with most anyone else. She asks about sexual practices without hesitation, and then explains why its important for her to know. Were anyone else to do that, especially for those that do not pertain to me, I would probably blush, be offended, and end the conversation. With her, we just chat as if we were talking about the weather!
Were she to adhere to the “team approach run amok”, I doubt that I would ever have achieved this level of comfort with her.
Very nice talk, Pamela.
I’ve been running just such a clinic since 1971. Nice to see others doing the same. I’ve also written a book: The Real Drama: Incredible Medicine
Anyone know a publisher? I could self-publish, but rather have a “real” publisher. I mentioned my Burnout Powerpoint on your other site. If you want it, e-mail me.
PG
I decided against going with a “real” publisher and chose to be my own publisher. 🙂 Since my book is about medical disintermediation (removing the middle man), it seemed counterintuitive to then invite the middle man back in to publish the book about how I removed the middle man. 🙂
Dr. Pam, Thoroughly enjoyed your Ted Talk. Thank you for being “real” and alive.
What occurs to me is if and when Doctors reclaim their lives as Human Beings and not the assembly line worker they have become then we will need to make Medical School over as well. That is because we will need more Doctors since the 1 to ___ ratio will decrease in actual Practices.
It is one thing to reclaim your life and another to decide to pursue Medicine.
Nurse Practitioners and the advancement of automation will flow into the service gaps along the way but a bottom up disintermediation will benefit the most people with Education founded upon this fundamental . A well defined “Problem” contains the seeds of it’s ” Solution”. Listening is the only real way to download all the vitals.
Ps: Your Play on word “In to me See” is exactly what many words come from….Sentences. The Phonetic characteristics of different languages are
the accent which varies but the Sound itself holds true for milleniums.
Spirit two all… in harmony combines as one again. Listing back and forth
like a ship on the waves ,we listen .
Self Publishing has become far more easy and productive. The “Author ity”
of a published “Author” is said to be the best Business card possible. The Norse God THOR lends his power to mortals by the written word. The Aesirs lost the political spin battle when no one wanted to be an ASS. The sound clips keep evolving but stay similarly the same. Athena would disagree by asserting her domain over knowledge
and say rightfully so that she had original ownership. I was suggesting the ACADEMY must change.
Interestingly, if we actually started providing REAL health care and getting to the root of patients’ problems (rather than churning people through for 7-minute visits and throwing a prescription at them), we would have more than enough doctors now. We can never have enough docs when we don’t solve people’s problems and make them beg and beg and bag and call over and over again trapped on phone trees in a disease billing management system. What we have now is not health care. Surprise! Wordplay again!
The Speach of Pamela Wible MD was excelent
I feel so relieved by this talk. It is just what I have felt and what I have been saying to all my colleagues.. for the past 15 years. I am a body-centered creative arts somatic psychotherapist. I have sat in my office for the past 35 years and listened to the inner world of many many people.. from war trauma to sexual abuse to developmental neglect to all categories of trauma and loss. I myself grew up in a very challenging but also meaningful environment with a mother who was hospitalized when I was 8 years old and a father who was very busy inventing computers and a very charismatic brother who ended up so neglected and used and sacrificed that he had to utilize crack cocaine to feel energy and create some self esteem however false it helped him show up for family events.. I am appalled at how much shame and stigma still exists.. today in 2016.. I am also appalled at all the psychology conferences that I go to where physicians and therapists and psychoanalysts talk about topics of meaning and value but never really disclose what is going on for them and why they chose this profession and what their wounds are.. Really how would we then be there for our clients/patients.. It’s a complete set up as I see it now. I never did heal from depression and anxiety and ongoing PTSD and terror in the office of therapist. I trained with the famous and the best of th best.. They have written books and they have created institutes and training programs but they themselves are not naked and they themselves are also running a business.. which is fine.. but then why should I be scapegoated by my teachers because I want to speak about what is forbidden. The one who is in the seat of authority might actually have a problem but that has to be hidden.. I could say more and more and more.. about this process.. I speak up now.. and maybe one day.. when I can manage my rage and grief and my arrogance I will be able to speak publicly.
You hit the nail on the head. We are perpetuating this by not healing ourselves first. Then we put ourselves out there as experts. We need to first do no harm to ourselves and our colleagues. Everyone in human services needs mental health care on the job.