by David Markenson, MD, MBA
Featured in the November-December 2019 Colorado Medicine Colorado Medicine.
I am honored and humbled to be installed as president of the Colorado Medical Society at this challenging and exciting time in our profession. We fight for all Colorado physicians in the public and private sectors to help improve the practice of medicine and protect important patient safety and quality measures. While we will continue to address singular issues as they arise, what I think is most challenging to our profession at this current time and what I will focus on during my presidential year is the unique role of the physician, the role of the physician in society and the patient-physician relationship.
There is something very unique about the calling to be a physician. But when fighting the small battles, it is easy to forget the big picture of why we became physicians and why society traditionally has held physicians in a very special place. I want to reflect on that unique role.
Most people relate physicians to Hippocrates and the oath that many of us recited in some form when we graduated from medical school. Some of the things mentioned in the original Hippocratic oath are commitment to our art, our education, and our patients. If you think about it, this has been eroding. How often do you hear patients referred to as customers? Are they really customers shopping for products like at a high-end store they frequent? How many salespersons, after fitting a customer for a new coat, tossed in bed that night questioning whether they made the right color choice for that person? “Did I get the size right?” Conversely, how many of you have stayed up at night thinking about a patient or conferred with colleagues to ask if you did the right thing by your patient? While we have to provide excellent service in our interactions, they are not customers; they are patients and our relationship transcends a simple transaction.
We need to reinforce that there is a sacred bond given to us by the patient and received and returned by physicians that, as a result, makes us well suited to advocate for the things they need in society and the things society should present them.
And while many may think of Hippocrates, many of you who know me well know that I went to yeshiva and I have a real love of Judaism and medical ethics. So in addition to looking to Hippocrates for an example, I also look to a person named Maimonides.
Maimonides was most known as a Jewish philosopher in the middle ages, but he was also a physician, and while people often talk about the great Jewish studies he wrote, in actuality he wrote some of the most central books of Jewish law and about medicine. To me his writings illustrate the multiple roles a physician can have in society: an educator, a learned person, an advocate for society and an advocate for patients’ needs. He truly represented a unique nature. Maimonides had an oath himself and a prayer for physicians that I would like to share with you.
Here is an excerpt from the oath of Maimonides:
The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all time; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.
May I never see in the patient anything but a fellow creature in pain.
Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements.
Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today. Oh, God, Thou has appointed me to watch over the life and death of Thy creatures; here am I ready for my vocation and now I turn unto my calling.
The prayer is actually fairly long so I won’t print it in full but I think there are a few passages that we can reflect upon as we think about the message we want to give to society.
From the prayer of Maimonides:
Should those who are wiser than I wish to improve and instruct me, let my soul gratefully follow their guidance; for vast is the extent of our art. Should conceited fools, however, censure me, then let love for my profession steel me against them, so that I remain steadfast without regard for age, for reputation, or for honor, because surrender would bring to Thy creatures sickness and death.
Almighty God! Thou hast chosen me in Thy mercy to watch over the life and death of Thy creatures. I now apply myself to my profession. Support me in this great task so that it may benefit mankind, for without Thy help not even the least thing will succeed.
Even in his times, he thought about ethics and he combined them with medicine. He talked about the unique role of the physician, how one must be humble to continually seek knowledge, and how sacred the bond is between a physician and patients. What I always find amusing is that one of his books, when translated, has an exceptional title for physicians. It was known as “The Guide of the Perplexed,” which is how I often talk about medicine.
In all seriousness, what I find when I study Maimonides are truths of our profession: Always yearning to learn more, to advance ourselves, to speak on behalf of our patients and recognize that our calling is the care and life of patients above our own, and that our efforts and learning are directed for the betterment of patients and the unique role of the physician. As physicians we have many roles to use our heart and knowledge to advance society and to serve and to educate. If we protect these roles, then the singular issues we have to face flow easily.
Bringing the focus back to these things is my commitment to you as your president and the centralizing theme of my presidency. I appreciate all you have done and all that you do. Thank you for this honor to serve you.
MEET DR. MARKENSON
David Samuel Markenson, MD, MBA, is a health care physician executive, researcher, educator and advocate with more than 20 years of experience in leadership roles. His career has been dedicated to improving hospital and health system quality, improving the approach to pediatric care, disaster medicine and health care emergency management, and advancing EMS and emergency medicine. He currently serves as the chief medical officer of Red Cross Training Services and chair of the National Scientific Advisory Council for the American Red Cross.
Prior to his role as CMO with the American Red Cross, Markenson was divisional vice president of graduate medical education for the Continental, Mid-America and Mountain Divisions at Hospital Corporation of America Physician Services Group, which included over 30 hospitals covering seven states. Prior to that, he served as the chief medical officer at Sky Ridge Medical Center. Before joining Sky Ridge Medical Center, Markenson was based at New York Medical College (NYMC) and Westchester Medical Center Health Network (WMCHealth) as vice president and medical director for regional emergency services and director of partnership for patients, quality data and special projects. During the same period, Markenson held the titles of professor of pediatrics and clinical public health, and director of the Center for Disaster Medicine at NYMC.
Markenson received his MD from Albert Einstein College of Medicine and his MBA from the University of Massachusetts at Amherst. He completed his residency in general pediatrics followed by a pediatric chief resident year and fellowship training in both pediatric emergency medicine and pediatric critical care. He is board certified in Pediatrics, Pediatric Critical Care, Emergency Medical Services and Clinical Informatics.
In addition to medicine, he has had a love of aviation from a young age, sparked by his grandfather’s service in the U.S. Army Air Corps. He has his pilot’s license including an instrument rating and has over 3,000 flight hours.
Markenson is the son of Alicejane Lippner, MD, JD, a pediatric hemotologist/oncologist, and Joseph Markenson, MD, MACR, a rhematologist. He is married to Heidi Markenson, PhD, a brilliant research scientist, and together the couple have three children: Emily, Rachel and George.