Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St, Pomona, CA

Identity and Podiatric Medicine

I had an interesting experience recently. For the past year-and-a-half, my 6 year-old son, Lazarus, has been taking dance classes. Several months ago, he started "Company," which is the competitive side of dance. As a result, the number of classes he takes and the number of days per week has quadrupled. Previously, my wife would take care of driving him to and picking him up from his lessons, but with the birth of our daughter three months ago, things have become much more complicated. As a dutiful father and husband, I became very involved in the process and am now picking him up three to four nights per week and driving him as much as possible. As an obvious part of my involvement, I interact heavily with the administrative staff of the dance studio. The folks there are very nice, and are wonderful with my son.

But here's where it becomes interesting. Despite the fact that I see these people several times per week and know their names, they don't know mine nor ask for it. Generally, I'm referred to as "Lazarus' dad". This started me thinking about identity. I wonder about the importance of identity in the lives of medical professionals. How does career interact with our personal identities, and what is its significance in medicine in general?

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Identity

It was probably during residency that I started thinking of myself as a podiatric physician. It's pretty obvious how this would have occurred. I spent so many hours, days, and years training to become a physician, putting so much effort into this one pursuit, that I now identify so strongly with my job. Now, that's not to say I don't have other identities. Whether I'm a husband, father, son, or friend, each of these identities is a facet of who I am.

What fascinates me, though, in relation to my son's dance class, is the manner in which external forces can so easily add identities to our lives. Many people view themselves in relation to something external in their lives. For example, how many people do we see referring to themselves as a "cancer survivor?" Surviving this disease, terrible though it is, redefines the person in a fundamental way, altering their identity, or at the very least adding a new facet to it.

I can honestly say that prior to my son's dance class, I was never referred to as "Lazarus' dad." I was surprised by this at first, since my "daily" identity is as "Dr Shapiro" (obviously some ego involved as well). It took a little time to get used to it, but I did. At least my staff and students at the University don't refer to me as "Lazarus' dad" –not yet anyway!

The Bigger Picture

This rather plastic definition of who we are has ramifications for those of us in the health professions. My identity as a white, male physician is pretty common in the historical sense. But how does identity play into such ideas as the conflict between being a female physician and child rearing or being a younger physician with a different background from his elders (i.e. the generation gap), among others? These issues become much more important in the broader context. An interesting review article, for example, discusses gender roles in medical career choices.¹ Historically, we've seen a difference in the choice of career paths for women versus men, with less women choosing surgical professions, though this seems to be changing for the better. For example, most of my partners at Western University are female, and all are excellent physicians and surgeons.

The obvious confrontation of mother identity versus doctor identity must always be present, but hopefully is becoming less of an issue with the greater involvement of men in the home. This is the very conflict I had to work through with my son's dance class. My wife, of course, has no sympathy. Her response was, "Welcome to my world." Clearly, the increasing numbers of women in medicine in general has filtered into podiatry as well. Every female podiatric physician will have to deal with the balance between family and work. Which identity is dominant must be up to the individual.

Additionally, identity has an important role with changing generations. Many older physicians bemoan this change, complaining that younger doctors no longer want to work as many hours or put as much time and effort into their careers. It seems there is a definite change. Sanfey and colleagues examined the influences on surgical career choices of medical students.² They found that both gender and generation, with a more significant emphasis on family life by the younger generations, affected the choice of a surgical career. I find this a very positive trend for podiatric medicine as a whole. Our profession has always been known for its strong balance between family and work, and given some time and appropriate marketing, more high quality men and women will see that podiatry works beautifully with the new social norms.

What's your personal identity? Does your "personhood" come before your "doctorhood"?
What important influences in your life define who you are?

Keep writing in with your thoughts and comments. Better yet, post them in our eTalk forum.
Best wishes.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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References

Riska E. Gender and medical careers. Maturitas, 2011; 68: 264-237.
Sanfey H, et al. Influences on medical student career choices: Gender or generation? Archives of Surgery, Nov 2006; 141: 1086-1095.