July 1 – bring on the Interns
July 1st always has this stigma of being the least safe day to be a patient in a hospital. July 1st marks the first day that newly minted physicians, bright eyed and bushy-tailed, not yet jaded by some of the nuances of medicine, are stepping out onto the wards to treat patients. New doctors should be feared – they were mere medical students a few weeks ago. They ARE here to help.
None of this is true. July 1st is like a Happy New Year celebration for the medical profession. To the new physicians – welcome to the club. You have joined the ranks of the rest of us who had sacrificed so much to earn the highest terminal medical degree – an MD or DO. You are now donning your long white coats for the first time and may feel clumsy in them. I know I did that first month. You will hear people call you “doctor”. It takes some getting used to (9 years later I still giggle when someone calls me doctor, I know I earned it but it still seems surreal).
Patients should not be scared that new physicians are rounding on the wards, setting foot into the operating room, beginning that first ER shift. They should be happy that there are new physicians eager to make a difference, fueled by that passion that drove them to medicine in the first place.
For the new doctors, here are a few bits of advice from a doctor of 9 years. I started on night float and when the clock struck midnight on Monday June 30, 2008 I felt my heart skip a beat. It was game time. There are some things to keep in mind and I hope this helps you.
- No one is beneath you. You are part of a health care team. Ask the overnight nurses how the patients under their care fared when making morning rounds. Interact with the respiratory therapists, physical/occupational therapists, nurse’s aides, speech therapists. Everyone is part of the team caring for the patient. Learn how to function as part of that team. Introduce yourself to the hospital staff. They will teach you if you are willing. Just because you have MD or DO on your white coat doesn’t mean you are above anyone. If you think you are above them, just wait until they page you every 15 minutes at night just to keep you from sleep.
- Doctor comes from Latin “docere” which means “to teach”, not “to preach”. Partner with your patients to help them find health. Explain your care plan to them and their loved ones. Yes, you will have times as a doctor when you grow frustrated and you want to just preach, but you get more bees with honey than vinegar. You have a degree that actually means to teach. “See one, do one, teach one”…remember that Mantra.
- You want patients to be compliant and not defiant. If your patient understands their care plan and medication changes, they are more likely to adhere to it. Be creative. I used dry erase boards in residency, in my outpatient practice, and now in urgent care I draw on exam table paper. Partner, don’t preach. Find a way to reach out to patients, but don’t be discouraged if they don’t heed your advice.
- Doctors are not gods, but God has given each of us a special gift and talent. How you use your talents and help others is your gift to God. I am a believer that I am guided by God’s hand in the practice of medicine. We don’t know everything. It is best to admit when you don’t know an answer. Patients will respect you more. The learning never ends.
- Don’t be an empty white coat. I spoke about this at a white coat ceremony in September 2014 (. Many patients see a white coat and see someone who can help them. At times, your long white coat will feel like a hero’s cape when you help a patient. Other times it will feel heavy like a lead apron when you have to deliver life altering news to a patient and their family. I have encountered many empty white coats in my time as a doctor. Work always to sharpen your people skills (in my video time 12:50). (see video link below or at youtube Sam Urick III under white coat speech)
- Become a doctor of people. (video 13:50) Becoming a doctor of people, “It takes more than brains, it takes heart. It takes patience and empathy”. Wisdom comes with experience. Fill the pockets of your white coats with empathy and sympathy, with confidence but not hubris. With friendship and wisdom, not just knowledge. Anyone can take an exam or in training exam, but a good score doesn’t make you a good doctor. If you are spiritual or religious, pray for your patients and the hand of God to guide you.
A bright smile and a hearty laugh are the best accessories to any white coat. Keep your patients’ spirits up, take time to sit on their bed, on the stool in the room. Get to know the person behind the gown.
As one of my favorite teaching attendings, Dr Terrence Philbin, taught us in residency: There are just some things you can’t learn in any textbook, but only in the book of life.
Welcome to the club new physicians! You have a clean slate. Your future is yours to write. There is no time like the present to prepare for your future.
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