“Every American is entitled to a college education.” “Every American is entitled to quality healthcare.” “I am entitled to a special place because I am head of this or that organization.” “I am entitled to___ because it is owed to me.” Are we truly “entitled” to anything? To entitle is “to give a right or claim to something: to furnish with grounds for laying claim.”1 Why do we think we can claim something we did not earn or purchase? All our lives we are told we are “special” because of how we act or because of things we do or don’t do. As we get older, we play on teams where there are no winners because all are “special” and try hard. We go to schools where we can rarely fail, because we are “special,” and no one wants to make us feel like we are not. Through life we are treated as if we are entitled to things we have not earned. This entitlement mindset has resulted in a disaster for our country, and is even a major problem in healthcare.
Dr. Steven Dubovsky reviewed the entitlement issue in medical education, but his findings would hold true for any educational or professional endeavor. He found that medical students defined entitlement as “a technical term that describes a sense of being entitled to attention, care taking, love, success, income, or other benefits without having to give anything in return.”2 In other words, they believe everything in education and life should be handed to them without work or any other cost. The feeling is that “education must above all else be a feel-good process. Student stress, fatigue, or anxiety are to be avoided at all costs.”3 Everything should be handed to us on a silver platter with little or no cost, and certainly without stress or effort on our part! No one should have to spend too many hours working and studying; it might pose undue stress on the individual. Does that sound familiar?
Dubovsky identified 5 expectations of entitlement in medical students that seem to apply to all.2 1) Knowledge is a right and should be provided to the student with minimal exertion or effort on his part. 2) Others will provide all the necessary education. No additional study will be required by the student. 3) Learning problems are never the fault of the student; they reflect the inadequacies of the teacher, the course, or the system. 4) Everyone should receive equal recognition and reward despite differences in ability and effort. 5) When things are not as expected, everyone has the right to express their displeasure with the teachers or the system through demonstrations or other means of confrontation. Does anyone recognize any qualities of current attitudes on this list?
It is amazing that someone has identified this prevailing attitude with such accuracy. Unfortunately, this attitude is not seen only in education. It would be interesting if professional sports leagues worked on the above expectations. If so, everyone would be told they could play professional sports. No one would dare tell someone he was not good enough to play, because it might hurt his feelings. All one has to do is show up and play. Skill and work ethic have no influence on who gets to play. Since that is the case, why in the world would one want to waste time and effort on practicing? How long do you think that would last?
Unfortunately, this is the attitude encouraged by today’s world. It is the “it’s all about me” attitude.4 People who focus only on themselves and their own enjoyment and welfare, without concern for others, are the ones who will suffer the most from this “entitlement syndrome.” It is not reserved for any educational level, financial class, group, or profession. It can engulf anyone or any group not sincerely dedicated to serving others or larger ideals. As health care providers, we must fight this attitude of entitlement and continue to focus on the needs of others. If we do not, this sense of entitlement will consume and destroy us. However, there is one thing to which I think we are all entitled—to care about the needs of others.
1. Urdang L, Flexner SB, eds. The Random House Dictionary of the English Language, College Edition. Random House; New York, NY; 1968:441.
2. Dubovsky SL. Coping with entitlement in medical education. New Engl J Med. 1986;315(26):1672–1674.
3. Moulton R. Duty, trust, and the training of residents. J Trauma. 2000;49(4):575–579.
4. Treadwell T. Character—where has it gone? WOUNDS. 2012;24(2):A6.