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Remembering Who We are

Building compassion in medicine is the first thing a doctor should pay attention to

By Matthew Welzenbach

As your resume builds and you go further along in your medical training, it is easy to become ‘jaded’ with the medical profession. In medical school, USMLE exams are these monsters that everyone is simply trying to overcome. However, the knowledge will come, there is no need to be fearful of that. After a few shifts in the ICU, you will feel like you know everything there is to know about medicine. However, we must never forget who we are first and foremost.

As physicians, our duty is to our patient. This much seems obvious. Yet everyone has those difficult patients that simply make you want to pull your hair out. My advice in these situations is to think of who that patient is. Where I work in Denver, there is a large underserved population, whether that be indigenous Americans, undocumented immigrants, HIV or hepatitis C infected individuals, or polysubstance uses. And by no means are any of those categories mutually exclusive. My role as a primary care physician working in an underserved community is to help them navigate that system.

I have a few words of wisdom towards that end. Firstly is to never assume. It happens so frequently that we brush off alcoholics as simply people with no self control. However, often times these very people are homeless as well, and the only way they can manage any amount of sleep at night is to drink. Or they are a Vietnam veteran with untreated PTSD because the wait to get into the VA is four months long, and so they turn to any means possible to manage their condition.

Secondly, look for the underlying cause for your patients’ medical and psychiatric issues. As stated above, these problems often go hand in hand and it is important to recognize that. Psychiatric illness especially is rampant and often untreated due to the attached stigma.

Thirdly, and most importantly, advocate for your patients. You have met them in a vulnerable spot, and you are in a position to make a difference. This is the often forgotten part of what a physician is, but it is essential when performing patient-centered care. Trust is frequently a barrier to care. Many patients hold extreme biases against physicians, partly from the monetary expense of getting medical care, and also from long-standing cultural superstitions. Even convincing patients to have a flu shot can be a ten minute ordeal due to the innate scepticism permeating our society.

So while you prepare for your next step in medicine, study your textbooks and learn all that you can. It may seem far away but the knowledge and expertise will come, and with the help of tutoring services, that goal will come much sooner. But never forget who we are as physicians and the type of lives our patients go back to once they leave our clinic.

You are at an exciting time in your career, and I would love to help you reach that next step whatever it may be for you. Medicine is a versatile field that allows you to find the skillset that you are best at and put that to use. It is our jobs as tutors to help you along that journey and to traverse the many obstacles in the way (not least of which being the dreaded USMLE exams). However again I must stress that you do not forget who you are and why you are in this field. There will certainly be difficult times ahead, but just remember that our duty is to our patients in whatever form that may be.

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