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  • They told me that I'm a traitor to my own profession,

  • that I should be fired,

  • have my medical license taken away,

  • that I should go back to my own country.

  • My email got hacked.

  • In a discussion forum for other doctors,

  • someone took credit for "Twitter-bombing" my account.

  • Now, I didn't know if this was a good or bad thing,

  • but then came the response:

  • "Too bad it wasn't a real bomb."

  • I never thought that I would do something

  • that would provoke this level of anger among other doctors.

  • Becoming a doctor was my dream.

  • I grew up in China,

  • and my earliest memories are of being rushed to the hospital

  • because I had such bad asthma that I was there nearly every week.

  • I had this one doctor, Dr. Sam, who always took care of me.

  • She was about the same age as my mother.

  • She had this wild, curly hair,

  • and she always wore these bright yellow flowery dresses.

  • She was one of those doctors who,

  • if you fell and you broke your arm,

  • she would ask you why you weren't laughing

  • because it's your humerus. Get it?

  • See, you'd groan,

  • but she'd always make you feel better after having seen her.

  • Well, we all have that childhood hero

  • that we want to grow up to be just like, right?

  • Well, I wanted to be just like Dr. Sam.

  • When I was eight, my parents and I moved to the U.S.,

  • and ours became the typical immigrant narrative.

  • My parents cleaned hotel rooms and washed dishes and pumped gas

  • so that I could pursue my dream.

  • Well, eventually I learned enough English,

  • and my parents were so happy

  • the day that I got into medical school and took my oath of healing and service.

  • But then one day, everything changed.

  • My mother called me to tell me that she wasn't feeling well,

  • she had a cough that wouldn't go away, she was short of breath and tired.

  • Well, I knew that my mother was someone who never complained about anything.

  • For her to tell me that something was the matter,

  • I knew something had to be really wrong.

  • And it was:

  • We found out that she had stage IV breast cancer,

  • cancer that by then had spread to her lungs, her bones, and her brain.

  • My mother was brave, though, and she had hope.

  • She went through surgery and radiation,

  • and was on her third round of chemotherapy

  • when she lost her address book.

  • She tried to look up her oncologist's phone number on the Internet

  • and she found it, but she found something else too.

  • On several websites,

  • he was listed as a highly paid speaker to a drug company,

  • and in fact often spoke on behalf

  • of the same chemo regimen that he had prescribed her.

  • She called me in a panic,

  • and I didn't know what to believe.

  • Maybe this was the right chemo regimen for her,

  • but maybe it wasn't.

  • It made her scared and it made her doubt.

  • When it comes to medicine,

  • having that trust is a must,

  • and when that trust is gone, then all that's left is fear.

  • There's another side to this fear.

  • As a medical student, I was taking care of this 19-year-old

  • who was biking back to his dorm

  • when he got struck and hit,

  • run over by an SUV.

  • He had seven broken ribs,

  • shattered hip bones,

  • and he was bleeding inside his belly and inside his brain.

  • Now, imagine being his parents

  • who flew in from Seattle, 2,000 miles away,

  • to find their son in a coma.

  • I mean, you'd want to find out what's going on with him, right?

  • They asked to attend our bedside rounds

  • where we discussed his condition and his plan,

  • which I thought was a reasonable request,

  • and also would give us a chance to show them

  • how much we were trying and how much we cared.

  • The head doctor, though, said no.

  • He gave all kinds of reasons.

  • Maybe they'll get in the nurse's way.

  • Maybe they'll stop students from asking questions.

  • He even said,

  • "What if they see mistakes and sue us?"

  • What I saw behind every excuse was deep fear,

  • and what I learned was that to become a doctor,

  • we have to put on our white coats,

  • put up a wall, and hide behind it.

  • There's a hidden epidemic in medicine.

  • Of course, patients are scared when they come to the doctor.

  • Imagine you wake up with this terrible bellyache,

  • you go to the hospital,

  • you're lying in this strange place, you're on this hospital gurney,

  • you're wearing this flimsy gown,

  • strangers are coming to poke and prod at you.

  • You don't know what's going to happen.

  • You don't even know if you're going to get the blanket you asked for 30 minutes ago.

  • But it's not just patients who are scared;

  • doctors are scared too.

  • We're scared of patients finding out who we are

  • and what medicine is all about.

  • And so what do we do?

  • We put on our white coats and we hide behind them.

  • Of course, the more we hide,

  • the more people want to know what it is that we're hiding.

  • The more fear then spirals into mistrust and poor medical care.

  • We don't just have a fear of sickness,

  • we have a sickness of fear.

  • Can we bridge this disconnect

  • between what patients need and what doctors do?

  • Can we overcome the sickness of fear?

  • Let me ask you differently:

  • If hiding isn't the answer, what if we did the opposite?

  • What if doctors were to become totally transparent with their patients?

  • Last fall, I conducted a research study to find out

  • what it is that people want to know about their healthcare.

  • I didn't just want to study patients in a hospital,

  • but everyday people.

  • So my two medical students, Suhavi Tucker and Laura Johns,

  • literally took their research to the streets.

  • They went to banks, coffee shops, senior centers,

  • Chinese restaurants and train stations.

  • What did they find?

  • Well, when we asked people,

  • "What do you want to know about your healthcare?"

  • people responded with what they want to know about their doctors,

  • because people understand health care

  • to be the individual interaction between them and their doctors.

  • When we asked, "What do you want to know about your doctors?"

  • people gave three different answers.

  • Some want to know that their doctor is competent

  • and certified to practice medicine.

  • Some want to be sure that their doctor is unbiased

  • and is making decisions based on evidence and science,

  • not on who pays them.

  • Surprisingly to us,

  • many people want to know something else about their doctors.

  • Jonathan, a 28-year-old law student,

  • says he wants to find someone who is comfortable with LGBTQ patients

  • and specializes in LGBT health.

  • Serena, a 32-year-old accountant,

  • says that it's important to her for her doctor to share her values

  • when it comes to reproductive choice and women's rights.

  • Frank, a 59-year-old hardware store owner,

  • doesn't even like going to the doctor

  • and wants to find someone who believes in prevention first,

  • but who is comfortable with alternative treatments.

  • One after another, our respondents told us

  • that that doctor-patient relationship is a deeply intimate one

  • that to show their doctors their bodies

  • and tell them their deepest secrets,

  • they want to first understand their doctor's values.

  • Just because doctors have to see every patient

  • doesn't mean that patients have to see every doctor.

  • People want to know about their doctors first

  • so that they can make an informed choice.

  • As a result of this, I formed a campaign,

  • Who's My Doctor?

  • that calls for total transparency in medicine.

  • Participating doctors voluntarily disclose

  • on a public website

  • not just information about where we went to medical school

  • and what specialty we're in,

  • but also our conflicts of interest.

  • We go beyond the Government in the Sunshine Act

  • about drug company affiliations,

  • and we talk about how we're paid.

  • Incentives matter.

  • If you go to your doctor because of back pain,

  • you might want to know he's getting paid 5,000 dollars to perform spine surgery

  • versus 25 dollars to refer you to see a physical therapist,

  • or if he's getting paid the same thing no matter what he recommends.

  • Then, we go one step further.

  • We add our values when it comes to women's health,

  • LGBT health, alternative medicine,

  • preventive health, and end-of-life decisions.

  • We pledge to our patients that we are here to serve you,

  • so you have a right to know who we are.

  • We believe that transparency can be the cure for fear.

  • I thought some doctors would sign on and others wouldn't,

  • but I had no idea of the huge backlash that would ensue.

  • Within one week of starting Who's My Doctor?

  • Medscape's public forum

  • and several online doctors' communities

  • had thousands of posts about this topic.

  • Here are a few.

  • From a gastroenterologist in Portland:

  • "I devoted 12 years of my life to being a slave.

  • I have loans and mortgages.

  • I depend on lunches from drug companies to serve patients."

  • Well, times may be hard for everyone,

  • but try telling your patient

  • making 35,000 dollars a year to serve a family of four

  • that you need the free lunch.

  • From an orthopedic surgeon in Charlotte:

  • "I find it an invasion of my privacy to disclose where my income comes from.

  • My patients don't disclose their incomes to me."

  • But your patients' sources of income don't affect your health.

  • From a psychiatrist in New York City:

  • "Pretty soon we will have to disclose whether we prefer cats to dogs,

  • what model of car we drive,

  • and what toilet paper we use."

  • Well, how you feel about Toyotas or Cottonelle

  • won't affect your patients' health,

  • but your views on a woman's right to choose

  • and preventive medicine and end-of-life decisions just might.

  • And my favorite, from a Kansas City cardiologist:

  • "More government-mandated stuff?

  • Dr. Wen needs to move back to her own country."

  • Well, two pieces of good news.

  • First of all, this is meant to be voluntary and not mandatory,

  • and second of all, I'm American and I'm already here.

  • (Laughter) (Applause)

  • Within a month, my employers were getting calls

  • asking for me to be fired.

  • I received mail at my undisclosed home address

  • with threats to contact the medical board to sanction me.

  • My friends and family urged me to quit this campaign.

  • After the bomb threat, I was done.

  • But then I heard from patients.

  • Over social media, a TweetChat,

  • which I'd learned what that was by then,

  • generated 4.3 million impressions,

  • and thousands of people wrote to encourage me to continue.

  • They wrote with things like,

  • "If doctors are doing something they're that ashamed of,

  • they shouldn't be doing it."

  • "Elected officials have to disclose campaign contributions.

  • Lawyers have to disclose conflicts of interests.

  • Why shouldn't doctors?"

  • And finally, many people wrote and said,

  • "Let us patients decide

  • what's important when we're choosing a doctor."

  • In our initial trial,

  • over 300 doctors have taken the total transparency pledge.

  • What a crazy new idea, right?

  • But actually, this is not that new of a concept at all.

  • Remember Dr. Sam, my doctor in China,

  • with the goofy jokes and the wild hair?

  • Well, she was my doctor,

  • but she was also our neighbor

  • who lived in the building across the street.

  • I went to the same school as her daughter.

  • My parents and I trusted her

  • because we knew who she was and what she stood for,

  • and she had no need to hide from us.

  • Just one generation ago, this was the norm in the U.S. as well.

  • You knew that your family doctor was the father of two teenage boys,

  • that he quit smoking a few years ago,

  • that he says he's a regular churchgoer,

  • but you see him twice a year: once at Easter

  • and once when his mother-in-law comes to town.

  • You knew what he was about,

  • and he had no need to hide from you.

  • But the sickness of fear has taken over,

  • and patients suffer the consequences.

  • I know this firsthand.

  • My mother fought her cancer for eight years.

  • She was a planner,

  • and she thought a lot about how she wanted to live

  • and how she wanted to die.

  • Not only did she sign advance directives,

  • she wrote a 12-page document about how she had suffered enough,

  • how it was time for her to go.

  • One day, when I was a resident physician,

  • I got a call to say that she was in the intensive care unit.

  • By the time I got there, she was about to be intubated

  • and put on a breathing machine.

  • "But this is not what she wants," I said, "and we have documents."

  • The ICU doctor looked at me in the eye,

  • pointed at my then 16-year-old sister, and said,

  • "Do you remember when you were that age?

  • How would you have liked to grow up without your mother?"

  • Her oncologist was there too, and said,

  • "This is your mother.

  • Can you really face yourself for the rest of your life

  • if you don't do everything for her?"

  • I knew my mother so well.

  • I understood what her directives meant so well,

  • but I was a physician.

  • That was the single hardest decision I ever made,

  • to let her die in peace,

  • and I carry those words of those doctors with me

  • every single day.

  • We can bridge the disconnect

  • between what doctors do and what patients need.

  • We can get there, because we've been there before,

  • and we know that transparency gets us to that trust.

  • Research has shown us that openness also helps doctors,

  • that having open medical records,

  • being willing to talk about medical errors,

  • will increase patient trust,

  • improve health outcomes,

  • and reduce malpractice.

  • That openness, that trust,

  • is only going to be more important

  • as we move from the infectious to the behavioral model of disease.

  • Bacteria may not care so much about trust and intimacy,

  • but for people to tackle the hard lifestyle choices,

  • to address issues like smoking cessation,

  • blood-pressure management and diabetes control,

  • well, that requires us to establish trust.

  • Here's what other transparent doctors have said.

  • Brandon Combs, an internist in Denver:

  • "This has brought me closer to my patients.

  • The type of relationship I've developed

  • that's why I entered medicine."

  • Aaron Stupple, an internist in Denver:

  • "I tell my patients that I am totally open with them.

  • I don't hide anything from them.

  • This is me. Now tell me about you.

  • We're in this together."

  • May Nguyen, a family physician in Houston:

  • "My colleagues are astounded by what I'm doing.

  • They ask me how I could be so brave.

  • I said, I'm not being brave,

  • it's my job."

  • I leave you today with a final thought.

  • Being totally transparent is scary.

  • You feel naked, exposed and vulnerable,

  • but that vulnerability, that humility,

  • it can be an extraordinary benefit to the practice of medicine.

  • When doctors are willing to step off our pedestals,

  • take off our white coats,

  • and show our patients who we are and what medicine is all about,

  • that's when we begin to overcome the sickness of fear.

  • That's when we establish trust.

  • That's when we change the paradigm of medicine

  • from one of secrecy and hiding

  • to one that is fully open and engaged

  • for our patients.

  • Thank you.

  • (Applause)

They told me that I'm a traitor to my own profession,

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