Four Things I Don’t Plan To Change

Here’s another great post from Waco family physician and friend Tim Martindale:

I hear constantly we are in a new world of medicine, and things cannot stay the same. We must make some adjustments, they say, to survive and cope in this new environment. Well I don’t want to be an ostrich with my head in the sand, and I am very involved with reading articles, attending meetings, and wrestling constantly with this new, changing world. I am active in my county medical society, my local specialty society, and my hospital staff. But there are some things the conventional wisdom says have to, or already have, changed, and I don’t agree.

1. I want to focus on listening to, looking at, and examining the patient. This affects decisions on how many patients I see, how to use my electronic medical record, and how I prioritize my time in the exam room. There is no substitute for the gestalt I get when I see, listen to, review history, examine the patient, then talk it over with them. So I see less numbers, find ways to not be boxed in or directed by my EMR, and make the patient my partner in their care.

2. I want to remain a patient advocate. Insurance, government, employers, drug companies, etc. all want me to consider their agendas, and put obstacles, checklists, prior authorizations, peer to peer reviews, endless paperwork, and threats of lower reimbursement or being branded as a lesser quality doc in my way. But my first priority is the health interests of my patient, and I’ll wade through all that nonsense tirelessly to meet that goal. My staff has the same vision and the perseverance of a bulldog.

3. I want to do complete, continuous, comprehensive, efficient care for my patient. I still do all my own hospital work, as well as nursing home and home visits. By doing this, I maintain the commitment to comprehensive and continuous care, the desire to be there for my patients at their most difficult times, the need for someone who knows the patient best to serve as the coordinator of care, the goal to keep my skills at maximum and not narrow my scope of practice, the pleasure and challenge of complicated hospital acute illness management, the camaraderie with the specialists as we work together, the desire to be a leader in hospital and community medical issues, and the widening of my knowledge base as I work with challenging cases alongside specialists. Yes, I do work harder, but I’m more happy and fulfilled. I should note that I respect physicians who have chosen otherwise, and hospitalists today are excellent.

4. I will continue to make my physical, emotional and spiritual health and wholeness a priority, as well as that of my physician partner and clinic staff. That means I think about it, plan for it, make sacrifices for it, and talk about it regularly with those alongside me. We can’t be victims of this relentless pressure and paperwork so that we push ourselves to the point of disqualification where we can no longer serve our communities in such a powerful way because we have forgotten about ourselves.

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