How to doctor - a thread.
So I am closing my practice shortly. I thought I would make a short thread about how I practice medicine with the thought it may be helpful to others.
1. Be an expert AND know what you don't know
Read, experience, practice, simulate, reflect. See what is happening to pts. Learn from sources that work for you - conferences, social media, UTD
Most importantly, know what you don't know - seek experts for your pts in those areas.
Read, experience, practice, simulate, reflect. See what is happening to pts. Learn from sources that work for you - conferences, social media, UTD
Most importantly, know what you don't know - seek experts for your pts in those areas.
2. Be available
It is a hard balance and I've struggled with this. I try hard to be available when patients are sick. It may mess things up a bit for your life. Balance being available & not being a martyr.
Institutions that make systems that support sick pts should be lauded.
It is a hard balance and I've struggled with this. I try hard to be available when patients are sick. It may mess things up a bit for your life. Balance being available & not being a martyr.
Institutions that make systems that support sick pts should be lauded.
3. Be kind
Pts are sick and feel like crap sometimes. NO ONE likes to wait - I hate waiting. Pts and families will often be scared or not in the best of moods. It comes with the territory. It is almost always not personal even though it may feel like it is.
Be kind.
Pts are sick and feel like crap sometimes. NO ONE likes to wait - I hate waiting. Pts and families will often be scared or not in the best of moods. It comes with the territory. It is almost always not personal even though it may feel like it is.
Be kind.
4. Go the extra mile
One of my friends in 2008 when I was shocked I wasn't getting a job I was promised, took me on a road trip of America to reflect.
He told me Harry Truman had a "The Buck Stops Here" sign on his desk. Of course I had to get it from Independence MO.
One of my friends in 2008 when I was shocked I wasn't getting a job I was promised, took me on a road trip of America to reflect.
He told me Harry Truman had a "The Buck Stops Here" sign on his desk. Of course I had to get it from Independence MO.
4.1 Really go the extra mile
We have so much power as physicians to do good. Little things make a huge difference. You can put a smile on a pt's face with a silly joke.
And sometimes you can make life-changing diagnoses by working and thinking hard.
The Buck Stops Here.
We have so much power as physicians to do good. Little things make a huge difference. You can put a smile on a pt's face with a silly joke.
And sometimes you can make life-changing diagnoses by working and thinking hard.
The Buck Stops Here.
5. Call families yourself when if your patient gets sick or has a change in disposition or crashes and they can't talk to them. Give updates. Do it in a timely fashion.
They are worried.
They want to hear from the doctor.
That's you.
They are worried.
They want to hear from the doctor.
That's you.
6. Be good to colleagues and juniors
Treat everyone with respect. Especially the nurses and the staff you work with daily. You are all working together for the same goals - making health better.
There are precious few more noble teams.
Treat everyone with respect. Especially the nurses and the staff you work with daily. You are all working together for the same goals - making health better.
There are precious few more noble teams.
7. Learn from your learners
You teach them but man you can learn so much from them too.
Learners will have different values and that's cool. I'm end-Gen X and never understood millennial culture... but then I waited and I fit in so well with Gen Z @rishibansalMD.
You teach them but man you can learn so much from them too.
Learners will have different values and that's cool. I'm end-Gen X and never understood millennial culture... but then I waited and I fit in so well with Gen Z @rishibansalMD.
@rishibansalMD 8. Support patients during their special times - weddings, kids. They'll appreciate it.
Don't go to funerals.
This is tough because you may want to. Peter Kopplin taught me this. Families remember the doctor as part of sad times/illness.
They want to remember the happy times.
Don't go to funerals.
This is tough because you may want to. Peter Kopplin taught me this. Families remember the doctor as part of sad times/illness.
They want to remember the happy times.
@rishibansalMD 9. Send handwritten notes on occasion. And send Christmas gifts.
To the nurses and admins.
To referring docs who you appreciate.
A letter to colleagues who achieve a special landmark.
Flowers for funerals.
It is so special to get something like this.
To the nurses and admins.
To referring docs who you appreciate.
A letter to colleagues who achieve a special landmark.
Flowers for funerals.
It is so special to get something like this.
@rishibansalMD 10. It's ok to laugh and to cry
Medicine is happy a lot and sad a lot.
It's ok to show emotions.
I laugh all the time. And cry sometimes.
Medicine is happy a lot and sad a lot.
It's ok to show emotions.
I laugh all the time. And cry sometimes.
@rishibansalMD 11. Remember the strength of your reach is beyond the pt encounter.
The CanMEDS @Royal_College roles are really really legit.
Advocacy - you have SOOO much reach @KashPrime taught me this
Science - @laura_targownik pretends to be ersatz but she's the real
Education - Admin -
The CanMEDS @Royal_College roles are really really legit.
Advocacy - you have SOOO much reach @KashPrime taught me this
Science - @laura_targownik pretends to be ersatz but she's the real
Education - Admin -
@rishibansalMD @Royal_College @KashPrime @laura_targownik 11.1 You can do so much more with a degree, systems, connections, other education, talent stacking, & tech we have now.
Especially if you are young and have energy - flex your brain as much as you can.
The impacts on health may exponentially ++ more than just ind'l encounters.
Especially if you are young and have energy - flex your brain as much as you can.
The impacts on health may exponentially ++ more than just ind'l encounters.
12. Work-life balance is critical
My wife taught me this.
It makes you happier.
It makes you a better doctor.
No one will look out for you more than yourself. It's not a cliche. It is super real.
Find a way to do it e.g. I budget the time off in my calendar.
My wife taught me this.
It makes you happier.
It makes you a better doctor.
No one will look out for you more than yourself. It's not a cliche. It is super real.
Find a way to do it e.g. I budget the time off in my calendar.
12.1 The dude who does this is my colleague Jeff Baker.
Tells me to work less, gets in later, leaves earlier.
But it paid off.
he has the NEJM article not me. He's in better shape at 30 yrs older. His pts are as well taken care of as mine.
It's ok to put your feet up.
Tells me to work less, gets in later, leaves earlier.
But it paid off.
he has the NEJM article not me. He's in better shape at 30 yrs older. His pts are as well taken care of as mine.
It's ok to put your feet up.
13. Inspire.
The man who taught me this was my pediatrician, Dr. David Huot, who retired recently - the MOST inspirational dude I've met.
1:1 is a unique opportunity to inspire. Connect with your pts. Be interested.
He says it way better than me here:
academic.oup.com
The man who taught me this was my pediatrician, Dr. David Huot, who retired recently - the MOST inspirational dude I've met.
1:1 is a unique opportunity to inspire. Connect with your pts. Be interested.
He says it way better than me here:
academic.oup.com
14. Finally be thankful
We are in a unique situation where we do the most rewarding things in the world - to help, advocate, and educate - every day.
And get paid by society to be able to live a good life.
Ignore the peccadilloes.
Be thankful we get to do this. /end for now
We are in a unique situation where we do the most rewarding things in the world - to help, advocate, and educate - every day.
And get paid by society to be able to live a good life.
Ignore the peccadilloes.
Be thankful we get to do this. /end for now
for advocacy I'll also shout out Dr. Amrita Sethi @drsethinyc who I fanboyed for yrs but just met this weekend.
In addition to being almost otherworldly prescient in endoscopy, Dr. Sethi along with @UzmaSiddiquiMD @DCharabaty & other superstars set up @WomeninEndo - to advocate.
In addition to being almost otherworldly prescient in endoscopy, Dr. Sethi along with @UzmaSiddiquiMD @DCharabaty & other superstars set up @WomeninEndo - to advocate.
@drsethinyc @UzmaSiddiquiMD @DCharabaty @WomeninEndo Endoscopy is such a male dominated subspecialty - and organizations like @WomeninEndo make it overt that male supporters should help a priori for women to be selected/empowered/supported.
At my institution - @natalia_calo @KM_Pawlak - two of the best I've ever known in the field
At my institution - @natalia_calo @KM_Pawlak - two of the best I've ever known in the field
@drsethinyc @UzmaSiddiquiMD @DCharabaty @WomeninEndo I forgot the pic with @JasonSamarasena - my brother from another mother
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