Reflections on 33 Years of Practice at Northside Hospital
Reflections on 33 Years of Practice at Northside Hospital and Five Keys To An Excellent Practice
Over three decades of medical practice saw huge changes, but some tenets should remain the same.
I moved to St. Petersburg, Florida, in 1982 to begin a cardiology practice. Dr. David Kohl joined me in 1985, and we named it Bay Area Heart Center. Forty-one years later, the practice has evolved to 13 doctors, two ARNPs, 4 locations, and is now Bay Area Heart Cardiac, Vascular, and Vein Center.
As a physician, you may be acutely aware of how much medicine has evolved. But you may not appreciate what has not, and should never, change if you want to offer superior and excellent patient care. Regardless of your specialty, some guideposts should always be remembered.
You are the patient's advocate. You might work for a hospital, corporation, or insurance company. They write your checks and may dictate your schedule. However, your first and highest obligation is to the health and safety of your patients. Ignore this principle at your own risk and that of your patients. Admittedly, reconciling these two "masters" can be tricky, but if you want to be recognized as a great doctor, adhering to this principle will never fail you.
Hone the art of beside communication. Often called bedside manner, I prefer the word communication. You can render the best medical advice; however, if the patient does not trust or believe you, it will be for naught. Stop focusing on your computer or laptop while interacting with the patient. If this is impossible, type your notes after your visit, or insist your boss hire a medical scribe. Eye contact is essential and the key to trust and empathy.
Remember that guidelines are only that. Medical practice guidelines are just that and no more. They are not unbreakable rules. You will always be correct if you can honestly support and document your reasons for deviating from them. "Evidence-based medicine" is another slippery phrase and a moniker that ties you to "cookbook" medicine and not always the best patient care." Evidence and science change and evolves." How you practice must do the same.
Hire the best people available. No man or woman is an island. The days of the general practitioner who tries to run a medical office alone or with his spouse are long gone. There might be exceptions in rural America, but this is no longer true for most population centers. You will need nurses, nurse practitioners, physician assistants, and other administrators. Your practice administrator or manager is one of the keys to success. Bay Area Heart has had only two administrators (both women) in its 41 years. Ignore the trend to hire someone based on their gender, race, religion, or other categories. Be an advocate for restoring meritocracy to its deserving role when hiring.
Focus on medicine and not social change. The purpose of medicine has always been to prevent disease and heal the sick. Resist the temptation to use your power and position as a social warrior. If your mind insists you do so "for the greater good" of society, do it on your "off-time" and not out of your office or from your role as a doctor. I have a few strong political views, but I always tried to avoid sharing them with patients.
Adhering to these principles will serve you well. Sometimes you will feel like a salmon swimming upstream and against the tide. However, if you chose the practice of medicine to help and heal people, and hopefully you did, you will never fail by always applying them to your lives and your work.
