Throughout my career, I have always thought of myself as a physician first.  A physician who does surgery, then one who does reconstructive surgery, and now one that does palliative medicine.  That’s a bit different than seeing oneself as a primary care provider or a specialist.

The physician always keeps the big picture in mind and uses their full breadth of knowledge.  They don’t necessarily always stay in their lane.

Sometimes, this can get you in trouble- like when you are referred a patient and you discuss all options, not just the procedure the referring provider wanted you to do, (ex. because your patient with a complicated lower extremity open fracture needs to get back to work ASAP to support his family, and you explain to the patient that to attempt limb salvage will likely keep him off work for months) so he elects a course the referring provider hadn’t discussed.   I got yelled at several times for this.

Sometimes, it can take more time (which you may not feel you have to spare),  like when trying to interpret a confusing radiograph, you actually examine the patient to help understand what you are seeing (yes, I know radiologists that routinely examine patients, and they proudly wear their stethoscopes throughout their careers).

Starting in your first days as a resident, you will begin to form habits that will follow you throughout your career.

Remember your allegiance is to your patients.  Be present for your patients.  I was in private practice with a man who was chronically late- and not just a few minutes, sometimes more than an hour.  Drove our office and hospital crazy.  But when he entered each patient’s room, he sat down, made himself comfortable and he was theirs for however long they needed him.  He knew not only about their surgical issues, but he knew about their work, their family, you name it.  He was present.  And his patients loved him.  The hospital administrators didn’t always love how behind he was, and the medical records folks didn’t like how late his records were completed.  Somehow he even made it to many of his childrens’ school activities.

This is being a physician.  My belief is that you went into medicine to be a physician (if you didn’t that’s ok- then being a technician will work well for you), and if you fall into the path of technician, you will not have a fulfilling career because you are not using your full professional self.  My belief is that this contributes to job dissatisfaction, and leads providers to leave medicine before their time.  And ultimately all patients will suffer.

So take care as you go forward in your medical career and your life.  Don’t mindlessly fall down a path you don’t want to take.

—- your patients await!

*This letter was originally written with medical students in mind- but applies to all new graduates in any medical field.