Inhabiting the Medicine You Preach

Halfway through my family medicine rotation back at my Californian home, the medical group in the Bay has really shown me the diversity and uniquely individualized ways that each physician can practice medicine. The breadth of family medicine is as vast as the mind can stretch, serving patients of all ages with all sorts of problems. Despite each 20 or 40 minute time-slot scheduled, it is impossible for physicians to cover all the ailments, complaints, preventative instruction, and social coverage that each patient may need. Instead, it is imperative for each physician to sort through the priorities for each patient’s acute needs and plan for future directives that can be planned for.

What’s enlightening to me is the emphasis that each physician places on their agenda for their patient. It is also educational to me that this is also heavily dependent on the population served and their unique needs. At my institution, many of the patients we see are of the misrepresented populus with numerous, complex medical and socioeconomic issues that require lots of teasing and deciphering. It is thus expected that discussing preventative measures such as smoking cessation, exercise, and appropriate diet are much lower on the priority list relative to their acute complaints. When queried, the attendings tell me that while it’s not the ideal situation patching up a lot of sequelae instead of treating the root of the problem, it’s hard to align both patient and physician’s interests when there are so many barriers in place. It’s lamentable, but it’s the reality of medicine.

My brief two weeks at my local clinic has amazed me with the persistence and dedication to lifestyle modification and education that my attending preceptor has demonstrated with each patient encounter. No matter the reason for the visit, he always makes a point to discuss diet and exercise regimen with each of his patients and get on the same page for improvements or appraisal. What was more inspiring to me was the way he not only preached healthy living, but he also lived through example. His firm belief in serving as a role model of health as a primary physician was what I had imagined doctoring to be - leading through example. Having experienced years of stressful medical education pursuit and working alongside sleep-deprived residents, I have long become disillusioned by the idea of a healthy and stress-managed physician. It’s not uncommon for me to hear residents and students joke about “sacrificing our healths for the health of our patients”, but observing my attending preceptors live devotedly by example has shown me that it is not an impossible task. While it may not be achievable at every stage of the physician-forming process, it is definitely a principle of priorities in the career of a fully fledged physician.

Starting my third week at another local clinic today, I have again been shown the unique ways that each family physician chooses to practice medicine. Being able to speak Mandarin, the attending physician I followed was able to converse casually and personally with each patient, discussing alternative therapeutic options such as acupuncture of Chinese massage therapy to older patients. It’s amazing how rapidly and how deeply the rapoire is struck with this simple cultural understanding shared between physician and patient. These connections allow physicians to make more suitable and more personalized plans for patients while boosting patient compliance. Each physician brings their personal flare to create a unique haven for his/her patient, tailored to the specific population and needs.

Having completed most of my rotations for the third year of medical school, I have begun to reflect internally on what kind of physician I would like to grow into. Not only as a physician of a specific specialty or otherwise, but also as the traits of a healer that I desire.