Still a doctor first

Tuesdays are typically the least predictable day of the week for me, randomly filled with meetings, teaching, and touring.  Since our hospital, outpatient Family Health Centers (FHCs), and medical school are not on the same physical site, my travel time back and forth among these places also plays a role.

For example, when I woke up today, my schedule looked like this:

7:30-8:15 breakfast meeting with our residency recruitment coordinator
8:15-8:45 travel time to my office (in one of our FHCs)
8:45-10:45  administrative time - answer e-mails, check EHR in-box, work on new QI curriculum
10:45-11:00  travel time to the hospital
11:00-11:15 review residency applicant files for afternoon tour
11:15-11:30 discuss a CME proposal with CME coordinator
11:30-1:00 facilitate a patient communication session for our residents on breaking bad news
1:00-1:30 grab lunch, check e-mails
1:30-3:30 tour residency applicants to our outpatient FHCs
3:30-4:00 meet with hospital communications director re: eVisit implementation
4:00-4:15 travel back to office
4:15-5:30ish assist with finishing up afternoon precepting, follow up on EHR in-box

When I arrived to my office after my breakfast meeting this morning and logged into my e-mail, I was greeted with an automated admission notification for one of my patients.  My patient was not admitted to our hospital but to another in the system.  The admission diagnosis: cardiac arrest.

Needless to say, I spent the next half-hour contacting the nursing unit, speaking with the intensivist, learning what happened: arrest at home, CPR by family members, "successfully" resuscitated in the Emergency Department.  Now on pressors and intubated.  I provided the intensivist with my patient's medical history and had my staff send over records.

All of those other things on today's schedule paled in importance with what I had to do, now, for my patient.  Calling the family.  Telling my office staff.  This afternoon, I was able to carve out enough time to drive over and visit my patient.  I don't have privileges at this hospital but was glad to be greeted warmly by staff and physicians there. 

I love being an academic family doc.  The variety of my day-to-day life, the opportunity to indulge in multiple interests throughout the week - it all energizes and inspires me.  I only spend about 30% of my week in direct care of my own patient panel.  Have no doubt, though, that that 30% supersedes everything else that I do.

True, I am also a teacher, preceptor, writer, tour guide/recruiter, researcher, EHR implementer, hospital CME committee member, health center administrator.  Whether they are my current patients or our residents' and students' future ones, though, ultimately everything circles back to the patients. 

I am still a doctor first.

When your Sunday brunch server is also your patient

My husband and I went to brunch yesterday at restaurant close to our home.  We had just picked up our menus when our server came to greet us and, just as I recognized her as one of my patients, she proclaimed, "you're my doctor!"

"Doctor mode" instantly switched on, quite avolitionally.  "Hi!" I heard myself say. "It's great to see you.  How are things?"

Just as if we were in the office, our server/my patient comfortably launched into an update on her recent medical issues.

And then, she caught herself and switched gears.  "Oh, I'm sorry.  What would you like to drink?"

I'm sure that this scenario is a common one for many family docs.  For me, though, as a suburban dweller working in an urban family health center, I rarely encounter my patients outside of the clinical setting.  My neighborhood haunts are several miles away from theirs.  I don't typically shop in their grocery store or walk on their streets...or run into them at a restaurant.

So, this scenario was a bit awkward for me.  I worried about my patient - will she feel extra concern about taking care of us as customers?  She might have thought that this bit of role reversal was somewhat odd.  

I worried about myself, too.  Better be on my best behavior, be extra polite, and leave a good tip.  After all, she might judge my multiple buffet trips - filling my plates with eggs, bacon, french toast, prime rib, and bread pudding - when she's heard me counsel her about healthy lifestyles!

These thoughts were fleeting, though.  "Doctor mode" somehow turned right off at the sight of that buffet, and my husband and I chatted airily about our Thanksgiving travels and the morning's church service.

When our server/my patient brought the check, I offered that I'd be happy to see her in the office to discuss her issues.  She seemed pleased, and the encounter ended on an upbeat note.

And, yes, we did leave a very good tip.

Welcome!

As an academic family physician, the daily workings of my career are a mystery to many of my family, friends, and even my private practice colleagues.  Shows like "Gray's Anatomy" give a sensationalized (albeit entertaining!) account of the US medical education system, carefully altered to appeal to the masses.

The realities of my day-to-day life are alternatively more mundane and thrilling than any TV show has yet managed to capture.

In this blog, I'll share tales of my patient care, teaching, research, advising, testing, recruiting, QI-ing, problem-solving, and assistant Family Health Center directing.  I probably won't be able to resist commenting upon some non-medical topics as well.

So, follow along as I describe life as junior faculty in a family medicine residency program!  Given the unpredictability of my life, I'm not comfortable committing to a regular post every day/week/whenever, though, so keep an eye out on your blog reader for updates (and I'll tweet when there's something new as well: @SingingPenDrJen).

Thanks for stopping by!

(N.B. I will take the utmost care to preserve the anonymity of my patients, learners, and colleagues along the way.)