Editor’s Note: Keeping ’Em in Stitches

I’ve met hundreds of doctors over the years, and I like them a great deal. Sure, you can be a grumpy and even cynical bunch at times, but I don’t think anyone who really understands what physicians go through could hold that against you. The vast majority of physicians I speak with are passionate, dedicated, and, of course, very smart.

But to be honest, I think many of you would do well to lighten up a bit - not because your troubles aren’t real, or even because they aren’t getting worse, but only because you’d be happier regardless if you chose to see the humor sometimes.

I know: Easy for me to say, right?

But Stuart Silverstein is one physician who agrees with me. The one-time professional comic is a pediatrician in Stamford, Conn., who, after spending most of his career employed by hospitals, last year opened his own urgent-care practice and has since had his eyes opened very wide to the challenges of private practice.

“It’s a tough business, but there’s humor in it,” he told me. “I think humor is the only way to approach it. How can you not laugh when you’re called to an emergency C-section, and your claim is denied because you didn’t get the proper preauthorization?”

Silverstein didn’t always find medicine funny. In fact, as a resident he was so miserable he nearly quit practice to pursue his comedy career, which was doing nicely at the time. During the day he was unhappy and burned out in practice, he recalled, but at night he was making people laugh at local clubs and was achieving some notoriety for his act. It’s pretty common, I think, for young doctors to seriously consider a radical career shift, but less common for them to actually have a second career to fall back on.

Yet Silverstein is one physician who’s had a side job pretty much his entire career. Eventually he gave up smoky nightclubs for more-lucrative medical conference speaking gigs, then gave that up to publish “lighthearted” board-certification preparation books called “Laughing Your Way to Passing the Boards.” Can you imagine, say, a young neurologist studying for her boards with prep material based conceptually on the “Dummies” guides? I couldn’t, either, but it’s real - see them at passtheboards.com - and Silverstein says they’re selling well, thanks.

Perhaps having that secondary outlet is part of what helps him to take the rigors of practice in stride. Or maybe it just comes naturally for a man who puts his young patients at ease by telling them (when they ask “Is it gonna hurt?”), “Nah, I won’t feel a thing,” or by soothing parents nervously watching a procedure with, “Don’t worry, I’ve done this once before.”

He’s got a million of ’em: Jokes about fat cat insurance execs. About deciding not to go to law school because “I didn’t want to be self-loathing.” Even, yup, a rabbi joke or two. It’s all in good fun. But Silverstein is dead serious when he complains that physicians have been “brainwashed into thinking that we’re not good business people” and moreover, that physicians shouldn’t even want to be good businesspeople, by a healthcare system that’s happy to take advantage. Humor may help him cope with stress and surely it makes him a more engaging doctor, but being funny for money “has taught me a lot about business and marketing” that most of his colleagues don’t know.

Of course, that’s what we here at Physicians Practice are trying to change. No kidding.

Bob Keaveney is the executive editor of Physicians Practice. Tell him what you think at bkeaveney@physicianspractice.com.

This article originally appeared in the September 2008 issue of Physicians Practice.