I’m 3 years out of residency and while I thought I was a great resident, I find that I’m only an average attending. What happened and how can I take the next step to have the respect of my ED and hospital colleagues as a great physician?
Trying to Improve
Dear Trying to Improve,
I recently was in California wine country and was introduced to someone who has been called one of the best winemakers in the country. I was intrigued by what makes a great winemaker, particularly one who was under 40 years old. It turns out, as my grape growing friend advised me, that many of the same attributes that make a great winemaker can be found in a great physician—anal retentive behavior, an excellent knowledge base, a desire to learn new things and probably a little bit of luck.
For the patients, being a great physician is not all about knowledge. In fact, I’ve seen incredibly loyal patients of docs that I consider quacks. A patient expects the physician to manage the case correctly and frankly rarely knows if their workup is inappropriate. It’s bedside manner, keeping the patient informed and allaying fears that carry the day in the patient-physician interaction.
If I’m working a busy shift, I’m looking for someone who can move the ED efficiently as well as voluntarily take some of the tough cases and the undesirables – the sickies and the homeless drunks, for instance. As a chairman, I think it’s my responsibility to take every such case, but I love it when my colleague is a step ahead of me, taking care of the crashing 6 month old or the homeless guy who is here for the 15th time this month. I’ve worked with other really good docs who seem to slow down when they’re working with someone slower than them. We all know who can move the meat so it’s important to bring your “A” game everyday. Be a team player. Bringing something of value to the team every day is critical to being a clinical leader. Finally, giving a good and tight sign-out or staying over your shift to help us older guys learn to use ultrasound is just icing on the cake.
Core measures, efficiency, and achieving and exceeding the department goals and metrics are what keep this group smiling. Also, maintaining a minimal amount of complaints from patients, nurses, and the attending staff will make your chairman happy. A patient complaint or a missed pneumonia case takes me 20-40 minutes to review and officially respond to, including counseling the physician. The doc who doesn’t waste my time because they were in a rush and skipped a step or was rude is going to be my friend. Also, for the hospital administrator, getting patients into the right bed the first time, be it an ICU, observation or home, gets them the best financial bang for their buck.