The Doctor is In!

Ramblings From Practice

Last month, I returned to the practice of medicine.  I feel fortunate as it is so very fulfilling for me.  The part I like best is the “human” side of medicine.  Once you have been in medicine for a while, it becomes relatively easy. You can diagnose a patient fairly quickly and then make time to build a relationship and establish trust.  The story behind the patient and the little things that happen from day to day are what keep me going.

Here are some ramblings from practice preserving patient confidentiality of course.  I think you will find that practicing medicine and building a community is not too different from blogging and building an online community.

Go the extra mile.

A gentleman came in needing final clearance to work.  He was going to be fighting the fires in Eastern Arizona.  Surely by now all of you have heard of the fires even if you are an expat? An initial test showed something questionable so he was referred out for additional testing. Unfortunately, that test results had not made it back into his chart. Without the results, I couldn’t clear him. And unfortunately for this patient he had already been waiting several weeks.

Through a comedy of errors, I spent 2 hours calling for results from the WRONG medical institution.  Some members of the staff started saying that the man was probably lying about ever having the test done.  My gut told me that the patient was not lying. I persevered and found out where he had the test done. This was all the while seeing other patients. After 3 hours, I had the results in hand and could clear this gentleman to work.

He was grateful and I did not mind.  It is just what I normally would do.  Yes, this was an  an administrative job.  However, it is a team effort and I am accustomed to pitching in until the job gets done.   I was later told that the usual protocol is to have the patient sign a medical release and to have him come back in 1-2 weeks.  Can you imagine what a disservice this would have been?

So set your standards higher and go the extra mile.  It pays off in relationships formed in the office and online.

How much to share?

This has been a matter of much debate online and in the office.  How much does one share about themselves and their personal lives?  I feel it is a matter of preference.  Certainly as a physician you wouldn’t unload your problems onto your patients.  That would be role reversal.  There is a fine line.  I read a nice post written by a general surgeon, Dr Michael A. Zadeh who summarizes this emotional aspect of medicine very well.

I never really thought about what I would and wouldn’t share until one day in my first year of practice I saw a patient struggling emotionally over an event I cannot even recall.  I shared just a little from my life in regard to the fact that I have hit stumbling blocks along the way as well.  This sharing was reflexive not intentional but was all it took. The patient felt relieved that she was not alone.

Several weeks ago, a mother came in with her toddler son after having had his leg cast removed after 9 weeks.   The child had not yet had the opportunity to walk yet.   The little boy was also about the same age as my daughter who had gotten her leg cast off just 3 months prior.

I told the mom not to worry if he didn’t walk immediately after cast removal.  Then shared how long my daughter didn’t walk after her cast was removed; 8 days and how long she limped; 1 month!  The mom looked as if a weight had been lifted off her shoulders; relieved!  It is these little things that make the difference.

Can you make a difference one person at a time?

While I was being oriented to my new position, a colleague, he said, “You are not going to make a difference.  These people are in another world. Just do your job.”  He was referring to the high incidence of drug and alcohol abuse within the population.

After working for 2 weeks, I couldn’t help but disagree.  One patient said: “ I have come in many times for this problem and no one has ever explained anything to me.”  To her, I had made the difference.

So like the classic “starfish story“,  make the difference one person at a time.  Very similar to how your online community is built.

Discussion

Did you enjoy the first post in my new series?  The series will highlight all the great stories and insights I have come across during practice.  It will be regular in that I will write more than once per year but as inspired. I want to give you guys the good stuff (and not feel obligated to write any old thing)  as it has been what has kept me in the game for so long!  Like chicken soup for the doctor’s soul!  I only wished I would have written down all the stories since 1994 when I first started medical school.  So if you see the title “The Doctor is In and the photo of the medical bag then you will know it is part of this series in the future.

How do you go the extra mile? How much do you choose to Share? Or how do you make a difference in your work whether it be online or otherwise.