Nurse Annoyed at Being Told “You’re Smart Enough to Be a Doctor”

by Brian Carty, MD, MSPH

In a new book of essays by nurses, “Reflections on Doctors” (2008), nineteen essays show physicians as the corrupt, dishonest, homicidal misfits that they really are.  Not really; that’s a spoof.  The essays are intelligent and well written, but do address some important issues.

Doctor-Nurse Relationship is Like a Marriage         

The doctor-nurse relationship is in many ways a marriage writ large, with love, hate, mutual dependence, ambivalence, and uncertainties about power and responsibility.  As in many marriages, though, the two parties would sometimes like to take separate vacations and have separate checking accounts.

“Smart Enough Not to Be a Doctor”

One essay is titled “Smart Enough Not to Be a Doctor.”  The author, Pamela Gonzalez, RN, says that she has been told repeatedly throughout her career that she is “smart enough to be a doctor.”  She considers this an insult. 

Are Doctors Smarter Than Nurses?

Ms. Gonzalez complains that “This backward compliment suggests that choosing a professional path in the nursing field is for those with less intellectual abilities (sic) than those who choose to go to medical school.”   Ms. Gonzalez says that she wants to reply “Yes.  I was smart enough - and I chose not to be a doctor.” 

Ms. Gonzalez graduated from an Ivy League college and had good grades and test scores. She writes well and sounds like a very competent professional.  All of which suggest that she probably would have done well in medicine.

Some Aspects of Nursing Are More Appealing

So why didn’t she go to medical school?  Ms. Gonzalez gives some supposed advantages of being a nurse rather than a doctor, such as being more directly involved with patients.  She believes that patients will confide sensitive information to a nurse which they won’t disclose to a physician.  Still, it’s hard to imagine a relationship which requires more trust and disclosure than the doctor-patient relationship, so these arguments aren’t very convincing.  There may have been other reasons why she preferred nursing to medicine.  

In Some Ways Medicine Is Not So Appealing

According to Ms. Gonzalez, becoming a doctor requires spending years training before seeing patients, and HMOs often control the time physicians spend with patients.  Also, she wisely does not place much value on a high income.  These reasons seem a little closer to the mark.   I suspect, but cannot prove, that the reason Ms. Gonzalez didn’t go into medicine was the often extreme demands placed on physicians. 

Besides, what’s wrong with being a nurse?  Ms. Gonzalez must know that many physicians are unhappy with their pay and working conditions.  Whether medicine is still a wise career choice is a complicated issue which cannot be discussed here.  Ms. Gonzalez says she was “smart enough not to be a doctor.”  Perhaps many doctors now practicing wish they had been that smart.

There Is Something to Be Said for a Job Which Doesn’t Consume Your Life

My father was an engineer.  No weekend call, no 3 AM phone calls, no 80 hour work weeks.  He didn’t have the status, income, or maybe even the job satisfaction of a physician, but he went home every day at 5 o’clock, and then his time was his own.  I think there’s a lot to be said for that.


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