Tuesday, November 30, 2010

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.