Are you really that exceptional?

Being exceptional means different things to different people and societies.

American exceptionalism implies that, for some reason, we are different than the rest of the countries in the world and deserving of special standing.

Medical science exceptionalism means that we can cure dreadful diseases by investing in high-tech medical research, and our belief that each patient in our trust deserves the best care in the world. These once-unshakable principles now seem far less secure, as we critically survey our biomedical enterprise and ask whether it has overpromised and underdelivered.

Medical system exceptionalism is driven by the notion that we, above others, favor individual freedom over government intervention.

Physician exceptionalism means 1) one specific doctor is better than another, like who is the "Best Doctor"?, or 2) being a doctor reflects your personal exceptionalism and achievements , and, therefore, entitles you to special treatment or social status.

• Personal exceptionalism means you, personally, are more worthy and better than everyone else. The average annual wage was?$53,383?in the U.S. in 2021, according to the Social Security Administration. If you make more, are you exceptional? What about if you have a college degree? In 2020, about?37.5 percent?of the U.S. population who were aged 25 and above had graduated from college or another higher education institution. This is a significant increase from 1960, when only 7.7 percent of the U.S. population had graduated from college.

Here's what it means to live paycheck to paycheck: All of your income goes to paying your monthly expenses. There isn't any money left after you pay the bills.

• Around 64% of Americans are living paycheck to paycheck, according to a May 2022?LendingClub?survey.

But, doctor, are you really that exceptional?

1. What does the evidence say about your performance and outcomes?
2. How much of where you are now is due to dumb luck?
3. Did you win the ovary lottery?
4. Did you benefit from how society values dysfunctional behavior?
5. How much of your status is due to just good marketing?
6. Were you accepted to medical school for the wrong reasons?
7. How is your exceptionalism resulting in the diversity of outcomes?
8. How does "picking the best and brightest" contribute to the dark underbelly of medical culture?
9. Has exceptionalism conributed to busted trust?
10. What happens when you realize you are just like everyone else?
11. Are you the only person on a Zoom call that puts their credentials (MD, MBA, JD, FACS, etc) after your name ?
12. Do you insist on talking in public on your cell phone that annoys everyone around you?
13. Is your inability to come down off the mountain getting in the way of accepting that you don't know what you don't know?
14. Do you have an entitlement mindset?
15. Do you think society owes you debt of gratitude because you chose to be a doctor?

Things change. People adapt. So should doctors. Complaining about the state of medicine, how much hospital administrators make, and how hard it is being a doctor when everyone seems to be moving your cheese will fall on deaf ears.

Fortunately, medical educators are starting to teach medical students "things we're not supposed to say".

Those working from home may be concerned about pressure to return to the office, but there is another threat lurking on the horizon. If high-paying white collar jobs can be done remotely, outsourcing them to cheaper areas could save organizations money, Fortune writes. Experts have predicted a post-COVID surge in so-called "telemigration." But recent data also show the highest-paying jobs are often the ones most easily done remotely. With the biggest gains in WFH going to knowledge workers during the pandemic, the threat may loom largest for them now

I take exception to exceptionalism. I've been there and it's not what it's cranked up to be.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs

Updated 2/2023