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A Reverence for Pediatrics

pdnews@elsevier.com

One of my plans for this year is to read more widely and think more deeply. As part of that plan I read a column by New York Times columnist David Brooks. In it he refers to “On Thinking Institutionally (On Politics)” (Boulder, Colo.: Paradigm, 2008)—a book by political scientist Hugh Heclo.

According to Mr. Heclo, we are all shaped by the institutions through which we navigate our lives. In this broad sense institutions include our family, the schools we attend, and eventually our profession.

The extent to which we internalize the rules and traditions of those institutions defines us as either an institutionalist or an individualist.

Those of us who revere the ones who preceded us and accumulated the rules that support the institution are thinking institutionally. According to Mr. Heclo, institutionalists “see themselves as debtors who owe something, not creditors to whom something is owed.”

You don't have to look very far to see that currently our society is tilting toward individualism. Chest-thumping end zone performances by egocentric professional football players and former senators who don't think paying taxes is important are all part of a phenomenon that has spilled over from the Me generation.

But, there remain a few high-profile figures who still revere the institutions in which they have thrived.

Mr. Brooks and Mr. Heclo quote Ryne Sandberg on the occasion of his induction into the Baseball Hall of Fame: “I didn't play the game right because I saw a reward at the end of the tunnel. I played it right because that's what you're supposed to do, play it right and with respect.…

“If this validates anything, it's that guys who taught me the game … did what they were supposed to do.”

Now it's time to start thinking more deeply. Do you see yourself more as an individualist or an institutionalist? What about your fellow physicians? Do they treat the practice of medicine with reverence? You may want to ask yourself, “What are the institutional values that define medicine?” Is it the Hippocratic oath? And, who were your physician models?

Ironically, it was probably the 10 years I was in solo practice that injected me with a reverence for the institution of pediatrics. Parents had other choices. They could have trusted the health, and on rare occasions, the lives of their children to someone else. But because I had adopted a set of skills and attitudes from the instructors in my training programs and through the mentorship of my former partner, and because I conformed to what parents viewed as the principles of the institution of pediatrics, they chose me.

Among my role models were two older surgeons. These gentlemen dressed in a manner that respected the sensibilities of their patients.

They introduced themselves with a handshake. They were instantly available when they were on call and never sounded as though my call for help was an imposition. There was never a hint that profit was a motive in their decisions to operate. They were classy and professional physicians who revered their profession.

Fortunately, there is room for creative thinking and action in most institutions. Great institutions like pediatrics not only tolerate but encourage their members to think outside the institutional box. And, luckily we have chosen a profession that still deserves our reverence. I hope you agree that we owe pediatrics far more than it owes us.

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pdnews@elsevier.com

One of my plans for this year is to read more widely and think more deeply. As part of that plan I read a column by New York Times columnist David Brooks. In it he refers to “On Thinking Institutionally (On Politics)” (Boulder, Colo.: Paradigm, 2008)—a book by political scientist Hugh Heclo.

According to Mr. Heclo, we are all shaped by the institutions through which we navigate our lives. In this broad sense institutions include our family, the schools we attend, and eventually our profession.

The extent to which we internalize the rules and traditions of those institutions defines us as either an institutionalist or an individualist.

Those of us who revere the ones who preceded us and accumulated the rules that support the institution are thinking institutionally. According to Mr. Heclo, institutionalists “see themselves as debtors who owe something, not creditors to whom something is owed.”

You don't have to look very far to see that currently our society is tilting toward individualism. Chest-thumping end zone performances by egocentric professional football players and former senators who don't think paying taxes is important are all part of a phenomenon that has spilled over from the Me generation.

But, there remain a few high-profile figures who still revere the institutions in which they have thrived.

Mr. Brooks and Mr. Heclo quote Ryne Sandberg on the occasion of his induction into the Baseball Hall of Fame: “I didn't play the game right because I saw a reward at the end of the tunnel. I played it right because that's what you're supposed to do, play it right and with respect.…

“If this validates anything, it's that guys who taught me the game … did what they were supposed to do.”

Now it's time to start thinking more deeply. Do you see yourself more as an individualist or an institutionalist? What about your fellow physicians? Do they treat the practice of medicine with reverence? You may want to ask yourself, “What are the institutional values that define medicine?” Is it the Hippocratic oath? And, who were your physician models?

Ironically, it was probably the 10 years I was in solo practice that injected me with a reverence for the institution of pediatrics. Parents had other choices. They could have trusted the health, and on rare occasions, the lives of their children to someone else. But because I had adopted a set of skills and attitudes from the instructors in my training programs and through the mentorship of my former partner, and because I conformed to what parents viewed as the principles of the institution of pediatrics, they chose me.

Among my role models were two older surgeons. These gentlemen dressed in a manner that respected the sensibilities of their patients.

They introduced themselves with a handshake. They were instantly available when they were on call and never sounded as though my call for help was an imposition. There was never a hint that profit was a motive in their decisions to operate. They were classy and professional physicians who revered their profession.

Fortunately, there is room for creative thinking and action in most institutions. Great institutions like pediatrics not only tolerate but encourage their members to think outside the institutional box. And, luckily we have chosen a profession that still deserves our reverence. I hope you agree that we owe pediatrics far more than it owes us.

pdnews@elsevier.com

One of my plans for this year is to read more widely and think more deeply. As part of that plan I read a column by New York Times columnist David Brooks. In it he refers to “On Thinking Institutionally (On Politics)” (Boulder, Colo.: Paradigm, 2008)—a book by political scientist Hugh Heclo.

According to Mr. Heclo, we are all shaped by the institutions through which we navigate our lives. In this broad sense institutions include our family, the schools we attend, and eventually our profession.

The extent to which we internalize the rules and traditions of those institutions defines us as either an institutionalist or an individualist.

Those of us who revere the ones who preceded us and accumulated the rules that support the institution are thinking institutionally. According to Mr. Heclo, institutionalists “see themselves as debtors who owe something, not creditors to whom something is owed.”

You don't have to look very far to see that currently our society is tilting toward individualism. Chest-thumping end zone performances by egocentric professional football players and former senators who don't think paying taxes is important are all part of a phenomenon that has spilled over from the Me generation.

But, there remain a few high-profile figures who still revere the institutions in which they have thrived.

Mr. Brooks and Mr. Heclo quote Ryne Sandberg on the occasion of his induction into the Baseball Hall of Fame: “I didn't play the game right because I saw a reward at the end of the tunnel. I played it right because that's what you're supposed to do, play it right and with respect.…

“If this validates anything, it's that guys who taught me the game … did what they were supposed to do.”

Now it's time to start thinking more deeply. Do you see yourself more as an individualist or an institutionalist? What about your fellow physicians? Do they treat the practice of medicine with reverence? You may want to ask yourself, “What are the institutional values that define medicine?” Is it the Hippocratic oath? And, who were your physician models?

Ironically, it was probably the 10 years I was in solo practice that injected me with a reverence for the institution of pediatrics. Parents had other choices. They could have trusted the health, and on rare occasions, the lives of their children to someone else. But because I had adopted a set of skills and attitudes from the instructors in my training programs and through the mentorship of my former partner, and because I conformed to what parents viewed as the principles of the institution of pediatrics, they chose me.

Among my role models were two older surgeons. These gentlemen dressed in a manner that respected the sensibilities of their patients.

They introduced themselves with a handshake. They were instantly available when they were on call and never sounded as though my call for help was an imposition. There was never a hint that profit was a motive in their decisions to operate. They were classy and professional physicians who revered their profession.

Fortunately, there is room for creative thinking and action in most institutions. Great institutions like pediatrics not only tolerate but encourage their members to think outside the institutional box. And, luckily we have chosen a profession that still deserves our reverence. I hope you agree that we owe pediatrics far more than it owes us.

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