Sunday, November 25, 2012

Me and My Shadow, Part 7

I host medical students from time to time at my practice, although I haven't been doing so as much in the past 2 years. The reason is because it takes extra time/work to teach, demonstrate, observe, supervise, and come up with jobs for the students to do, and then critique them. However, I couldn't say no to Kevo because his older brother rotated through my office 6 years ago.

Unlike my previous medical students, Kevo wrote his essay about working in my office before I got a chance to ask him to. But like my other students, he agreed to let me publish his thoughts here in my blog about his 5 week experience spent working at my little micropractice:

As I near the end of my Family Medicine Clerkship I have nothing but great things to say about my experience. Throughout the first two years of medical school I was fortunate to have mentors that were family medicine physicians as well as other mentors from different primary care specialties. Through talking to these mentors I had an idea of what working in a primary care clinic had to offer, but after having gone through this rotation my experience was even better and more enjoyable than I expected it to be. 
The reason my experience was so enjoyable had to do with several variables, however, the most valuable variable was the opportunity to work with Dr. S. Dr. S runs a very unique type of Family Medicine clinic. Dr. S used to work for Kaiser for many years and as a result of their medical system, he used to only get a very short time with patients on average and felt that this was not optimal for himself as the physician and was not optimal for his patients either. That is why he started what is called an “Ideal Medical Practice.” 
There is a small but growing community of physicians who are a part of these “IMPs” and Dr. S was one of the first physicians to pioneer this type of medical care delivery system. The whole concept behind this type of practice is to offer patients a very individualized, personal, high quality system of healthcare. Dr. S spends a lot of time with his patients, which allows him to get to know the specific needs of each one of them and allows him to build a strong rapport with them as well. The effect this has seems to be immeasurable in my estimation, as it has allowed Dr. S to have an extremely cohesive relationship with his patients. Dr. S’s patients know that he is willing to take extra time for their office visits, and he even accommodates the busy schedules of his patient by allowing same day scheduling of appointments. Such accommodation of patients by a physician seems to be a very rare trait in today’s medical climate and Dr. S’s patients definitely recognize this. 
There were several occasions throughout my rotation where a new patient would present for their first visit with Dr. S and when asked how they heard about the practice the patient would always reply by saying that they were persuaded to come see Dr. S by a current patient of the practice who had raved about the intimate, personal care they have received from Dr. S. 
One particular example comes to mind. A middle-aged gentleman who had recently moved from the Central Valley came in to the office. The patient had heard about Dr. S from a neighbor and came in for a physical exam. During this visit, Dr. S took the time to meticulously go through the patient’s past medical problems, medications, social history and a plethora of other topics that the patient wanted to discuss. It was especially nice to see Dr. S show great compassion when the patient discussed the recent death of his brother. Dr. S ended up spending almost two hours with the patient and it was obvious that such attention to detail towards the patient’s medical issues and the genuine empathy expressed was not lost on the patient. Observing that type of care is what I think sets Dr. S’s practice apart and why my experience was so valuable during these past several weeks. It was extremely refreshing to see that patients could have a doctor who cared for them as a person and not just a number. 
I am positive that there are many hard working, compassionate and dedicated physicians practicing medicine today but in my opinion the current medical environment does not always allow these physicians to spend as much time with their patient as they want, which is a shame. This is a concern for me as I go through my medical training. I may be an idealist, but I think spending more time with patients is a part of medical care that should not be sacrificed. Spending time with Dr. S helped me see that there are still doctors that go to great lengths to give their patients the time that they deserve, and that gives me hope for the future. I know that there is a huge possibility that I will not be able to run a practice similar to Dr. S’s in the future, but the fact that practices like this exist and the fact that more and more “IMP” practices are popping up I think is a great thing. 
Kevo Hindoyan
Class of 2014
Keck School of Medicine

Thank you, Kevo, for sharing your thoughts about the IMP model, and for your hard work spent working at my office. I know I made you super nervous when I went into "fly on the wall" mode to observe you in action talking with and examining patients, but I was impressed by your growth, humanity and confidence in your interactions with patients. I know you will become a great physician as long as you remember to be true to yourself. 

Which is also true for just about every doctor. If only we had the time and resources to be true to ourselves, and were allowed to do what we have been trained to do, without third-party interference, our healthcare system would be much better off than it is now.