Category Archives: Uncategorized

The Two-Way Patient-Doctor Relationship and Physician Resilience

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Johnny Tenegra, MD

So much of 21st century medicine can seem dehumanizing. Whether it is handling prior authorizations by insurances, signing hundreds of orders from pharmacies, or even spending hours in front of a computer screen clicking checkboxes on your electronic medical records, I think to myself that this is not why I entered medicine. As much as every day seems to come to routine, we can’t forget about the memorable moments that come with those special doctor-patient relationship encounters. I spent some time reflecting on my work in academic medicine and realized there have been many times that my patients have helped me be resilient.

Sometimes my patients have great suggestions. I had just finished precepting my last patient, but the clinic was supposed to be finished a half hour ago. I had had a busy afternoon, multitasking, handling phone messages, nursing issues, and even interviewing a resident applicant when I received a message about a patient needing some lab results (thank goodness they were normal!), and I had to call her with a message. I apologized that it was a busy week and for the length of time it took to respond to her, and she detected that I was tired. Realizing it was a late night, my patient then said, “Go home and get some dinner with your wife. I’ll be okay.”

Sometimes my patients are my coaches. Several months later, a couple of my patients noted I was running behind, and I sat down to thank them for being patient with me that day. They told me that I was a sweetheart for not making them feel rushed and that they appreciated my listening to their thoughts and suggestions. Feeling a boost of enthusiasm to get through the rest of my clinic, I gave them a couple hugs for the extra pat on the back.

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Now and Then

 

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Nancy J. Baker, MD

We travel
in two dimensions,
living in time and place
experiencing life and death.

Now and here
or then and there.
What about now and there
and then and here?

Pancreatic cancer
means then is now,
there is here
undeniably.

Old age
implies then, not now,
remote from here
and unimaginable.

What if we live
as if today is our last?
Is now forever
and there everywhere?

The paradox of
now there and then here.
Impermanence means
take nothing for granted.

Heaven on earth
now and then,
eternity
here and there.

The Joy In Family Medicine

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Anthony Tam, MD
University of Michigan FMR

When I look back and think about who I thought a doctor was when I was a kid, I imagined that person taking care of kids, adults, and even pregnant mothers. I saw them as a primary responder for minor injuries and illnesses or even for acute processes. And I looked up to these role models and hoped that, some day, I could be that doctor and role model for others. It wasn’t until medical school that I figured out the role model I looked up to was a family medicine physician.

After doing my clerkship rotation in family medicine, I knew this was the field I wanted to enter. A specific patient I had talked to at the clinic was “Mary”.  Mary had come in for a follow-up on her thyroid medication. Routinely, I went in before the resident I was working with to talk to “Mary” and discuss any issues she had. She suddenly burst into tears about how she has been feeling sad and giving up on life. However, after a long discussion about how much good she had done for her family, kids, and community, she came to the conclusion that she deserved to be alive and should continue helping others.  When my resident came in to review what we had discussed, the first thing “Mary” said was, “Will this be the doctor that will replace you when you are gone?  I felt so comfortable talking to him about my troubles in life and really hope that I can continue seeing him in the future for my care.”  It was this moment when I knew that family medicine was the career path for me. I wanted to be that doctor that builds trust in relationships and provides the care that any person needs, regardless of their economic or social situation.

Family physicians present themselves with great confidence, leadership, and sincerity.  They exude confidence by helping patients make informed decisions on preventive care.  They show true leadership in working with not only other doctors, but also the staff that helps run the clinic. And most importantly, they show true sincerity in making sure each patient feels as though they are being seen by a doctor that cares about them.

How do I know that I chose the right profession?  Fast forward now to my second year in a family medicine residency where I am looking forward to the days I have clinic so I can see the patients I started seeing as an intern. The staff I work with make me smile every day I’m here and I enjoy the time I spend in clinic.  I exit each room with my patients laughing and catching up with their lives as I walk them out to checkout.

The great, long-lasting relationships and trust developed with a patient and the continuity of care are priceless. I am so happy to have matched into an amazing family medicine residency that helps me become the doctor whose hand patients can hold in a time of sorrow, the one who encourages them to make the right lifestyle choices, or maybe even the one who takes care of an injured athlete on the field. I am more than eager to continue my time here with Michigan Medicine.