Category: resident clinic

Talking Medicine

There’s something very gratifying about talking medicine with trainees. Regardless of their level of expertise, there’s always some wisdom to be shared.  1st year medical students are completely a blank slate and any  simple clinical discussion greatly augments their expertise.  Clinical discussions with 3rd year medical students are also extremely enriching considering how their heads are usually buried in textbooks for almost 2 years. The conversations about diagnosing and treating actual patients are both challenging and invigorating.  As interns and residents in internal medicine, the conversations about patients start to get deeper. It’s no longer just about diagnosis and treatment, but understanding and applying clinical evidence towards the best course of action in patients they are completely responsible for. This is also the time where we as medical educators who spent countless hours “talking medicine” with our trainees need to start talking about the most difficult questions facing healthcare today.

These difficult questions are aren’t about arcane diseases or curious physical exam maneuvers. We are beginning to ask about how our patients function within our broken healthcare system  For example, instead of simply talking about the different treatment options for a ganglion cyst, we challenge our trainees to ask and think about why a mother would take her daughter to the ER for that same ganglion cyst; a routine outpatient problem. We delve deeper into a patient’s day-to-day existence by trying to understand the myriad of medical and psycho-social reasons behind an elderly lady’s 3 hospital admissions within 2 months in order to identify solutions that will reduce health care expenditures and protect her from the dangers of hospitalization. Instead of simply prescribing medicines that lower blood sugars, we also talk about the cultural basis of an individual’s diet to better tackle the nutritional aspects of diabetes.

These types of issues which have no obvious answer are unfortunately the exact types of questions our trainees are least prepared to tackle. We’ve created a medical education system that emphasizes building knowledge and understanding of healthcare in terms of multiple choice questions and the absoluteness that comes with selecting a one true answer. Part of my goal as a medical educator is to deconstruct this black or white approach to thinking by asking the difficult questions and exposing how truly grey the world of healthcare is. From there, I hope some are inspired to reject the status quo and pursue careers that aim to provide great patient care, while also tackling the most complex systems issues in healthcare. This is just one of the many gratifying and important aspects of talking medicine today.

Advertisements

Learning, food and great memories

I had a few minutes so I thought I’d try and collect some of the many pictures taken at my last job that capture the spirit of learning combined with the fun and joy of eating together like a family.

At least a couple of times a month, we would hold pot lucks at our clinic while we did our Friday afternoon outpatient noon conference. They often a had a theme such as “Pi day”where we all made/bought some form of a pie.

The work we did in that clinic was often quite difficult but small events like these really made the work and learning process so wonderful!

Lot’s of great memories and I miss all of you!

Endings and Beginnings

It’s been a while since my last post. I’ve been busy and life has been changing.

For one, we had our third baby! She’s beautiful and certainly takes up a significant amount of our time (disproportionately at night!)

I’m also moving. After a lifetime of calling myself a New Yorker, we’re packing up and moving to Dallas, Texas.
I will always be a New Yorker and the emotions regarding this change are far too complex to discuss on this post.

But with this move ends a tremendous chapter of my medical life. Much of my posts on this blog were based on stories and experiences from these past 5 years.

We go into medicine because of the patients. The patients and their stories will always be the crux of my life in medicine. They will always inspire me to write and keep practicing medicine.

But these past 5 years have been about more than patients. I also took care of a different group of people. I got to be a caretaker of some pretty incredible internal medicine and med-peds residents.

They inspired me, taught me, challenged me, tested  me, made me laugh but most importantly made me proud to be a medical educator.

As doctors we love making patients better. As medical educators we love making patients better and making doctors better. It’s an incredibly fun and gratifying career path.

So with that, a sincere thank you and good bye to my trainees past and present. I hope your interactions with me were as meaningful to you as it was for me. I can’t wait for our paths to cross again as professional colleagues.

To my new patients, I can’ t wait to meet you all and take care of you

To my new trainees, I can’t wait to meet you all!. Let’s get to work to make healthcare better and change medicine!