The world exists for us by our senses, and theway we use our senses can bring us great pleasure,but sometimes it can also bring us greatpain. Let's look at some recent examples.
Janet Jackson got herself in a lot of trouble by lettingothers see something that they aren't supposed tosee in public. Showing off her bosom in public as shedid at this year's Super Bowl is socially taboo. It's apowerful act that engendered powerful consequences.She needed to think about that taboo before she (intentionallyor unintentionally, it doesn't matter) let herselfget in that situation.
Howard Stern got himself in trouble by letting hisaudience hear something that is considered sociallytaboo to hear over the airwaves. Again, there may benothing wrong with letting people hear such words inprivate settings, but there is a powerful social tabooabout letting people hear such words in the public settingin which Mr. Stern works.
It doesn't matter whether we personally enjoy listeningto Mr. Stern or looking at Ms. Jackson's bosom.We may not agree with these taboos, but we shouldknow that the taboos are there and that there may beconsequences for anyone (ourselves included) whochooses to violate them.
Fiscal Warning System
Why is this important for doctors? Certainly we allunderstand that if we felt the urge to say a swear wordin front of a patient, our warning system would turn onand we would restrain ourselves. And if we found ourselvestempted to disrobe at a New Year's Eve partybecause other people were doing so, our warning systemwould start flashing and ringing, and our commonsense would urge us to restrain ourselves. There areother areas of our lives that could do with a taboo ortwo, as the following stories illustrate.
A doctor I know was at a party. He had been drinkingand his tongue was well lubricated by liberal dosesof ethanol. He found himself having a great conversationwith a fellow he had just met. The guy was a greatlistener and seemed genuinely interested in the doctor.He laughed at the doctor's jokes and tapped the doctoron the shoulder at all the right moments in the conversationto maximize the developing male bonding. Thesubject inevitably turned to money.
The doctor bemoaned all the difficulties doctorswere having with poor reimbursement and high liabilityinsurance premiums. The guy was very sympathetic.Then the new friend started talking about the doctor'shigh taxes. By then, warning bells should have beengoing off and danger lights should have been flashing infront of the doctor's eyes. If they were, he wasn't payingattention. He started telling his new friend aboutthe neat accounting tricks he had discovered to avoidpaying those excessive taxes.
The doctor later found out that the friendlystranger was an IRS agent. Naturally, he got auditedand had to repay the government a lot of money. There needs to be a sort of socialtaboo that is ingrained in us to such an extent that ifwe find ourselves starting out on such a conversationin which we reveal private financial matters in public,danger lights start flashing, warning bells go off, andwe bring ourselves up short.
Another doctor left his personal accountingreports lying around on his desk for everyone to see.And his staff did indeed see those reports. One memberof his staff was so impressed with how rich thedoctor was that she felt compelled to relieve him ofsome of what she saw as excessive wealth. She beganan embezzlement spree that cost the doctor hundredsof thousands of dollars.
Another doctor had such a good time with his newprivate airplane that he put photos of it all over hisoffice, in the waiting room, in the exam rooms–everywhere.Then he wondered why his patients complainedso much when he raised his fees.
Still another doctor went on a month-long "cruiseof a lifetime." It was a life-changing experience, and hecouldn't help talking about it to everyone he met, especiallyhis office staff. The trouble was, he was about todo salary reviews with that same staff. He found it veryhard to hold the line on their raises when he had justbeen essentially bragging about all the money he spent.
Finally, one doctor, in a misguided attempt to bondwith the hospital nurses, couldn't help showing themthe photos of his new boat. They seemed so thrilled toshare in his happiness (he was a friendly doctor whothey liked) that he opened up to them about his financialconcerns. He complained about how he was beingsqueezed between declining reimbursements andincreasing expenses. They nodded agreement, but thenlater complained about how he was making so muchmore money than they were making, how much moresqueezed they were, and how it wasn't fair. One of thenurses shared this with her husband, who happened tobe a legislator. Guess how sympathetic the legislator-husbandwas when a bill came before him that wouldaffect doctors' reimbursements?
Curbing Your Enthusiasm
At this point you may be throwing up your hands inexasperation, saying, "Just what do you suggest that Ican do in public, and when and where can I just bemyself?" I'm not suggesting that you can't be yourself.I'm suggesting that there are social settings in which youshouldn't do or say certain things. We doctors need tolearn which social settings are the ones where we shouldn'tshow and tell about our personal financial lives.
We must think of these situations as having taboos.And while we may or may not agree with these taboos,just as in the cases of the above entertainers, we shouldbe aware that these taboos exist. In addition, we shouldtrain ourselves to get those bells ringing and warninglights flashing at the appropriate times so that we keepout of trouble. Following are some suggestions aboutwhat you might consider personal taboos:
After all, it's in our best interest to use commonsense when talking to other people about money issues,to be sensitive when discussing our financial well-beingwith those less financially fortunate than ourselves, andto be sensible when deciding where to keep our personalfinancial reports and information.
Louis L. Constan, a family practice physician inSaginaw, Mich, is the editor of the Saginaw CountyMedical Society Bulletin and Michigan FamilyPractice. He welcomes questions or comments at3350 Shattuck Road, Saginaw, MI 48603; 989-792-1899; or email@example.com.