Over the past two weeks, which also happened to be my final two weeks of clinical time before graduation, I have had the privilege to observe some of the physician members of the Miller-Coulson Academy. I elected to enroll in this rotation because I figured that there was likely no better way to end my time at Hopkins than by working alongside and learning from the institution’s best clinicians. What really set the tone for my experience was the fact that my first day coincided with the Miller-Coulson Academy’s 8th Annual Excellence in Patient Care Symposium. It was wonderful to be in the company of a standing-room only audience to witness ten physicians be inducted as new members of the academy. As each new member was introduced, a quote from a grateful patient was displayed on the screen behind him/her. I paid close attention to these quotes and recorded the terms that were most frequently used. As I now consider my full two-week experience, I think it is only fitting for me to use the words of the patients to guide my reflection of this elective experience.
The physicians of the Miller-Coulson Academy embodied compassion and empathy. I recognized this when Dr. Fetting asked each and every patient “How is your spirit?” with the same sincere demeanor as he asked about a patient’s pain, appetite, and the like. In one particular case, I was struck when Dr. Fetting, who has spent decades caring for women with breast cancer, admitted to me before a new patient encounter during which he would have to discuss a difficult diagnosis that “conversations like this never get easier.”
The physicians of the Miller-Coulson Academy are genuine. I witnessed this in the way that Dr. Sellmeyer described metabolic bone disease and its therapies to her patients in clear and understandable terms and in the way that she responded to the often-asked question, “Would you recommend this treatment to your mother?” I witnessed this too in the way that Dr. Kraus transitioned so skillfully from speaking gently with a young patient who is facing a second kidney transplant to speaking candidly with a patient who is not adhering to the prescribed immunosuppressive regimen.
The physicians of the Miller-Coulson Academy impart hope to patients and their families. On the days that I spent in clinic with Dr. Clarke, I could sense the comfort and support that Dr. Clarke provided to his patients, many of whom have spent years coping with complex gastrointestinal symptoms.
The physicians of the Miller-Coulson Academy are advocates for their patients. I witnessed this as Dr. Laheru devoted a substantial amount of time and effort to communicating with other providers not only within the Johns Hopkins network but at institutions across the country to ensure that his patients received outstanding, well-coordinated care. Moreover, I valued that Dr. Greenough advocated not only for the care of his individual patients but also for the improvement of health care delivery on a community and national level.
The physicians of the Miller-Coulson Academy are tireless. During one of my first days, Dr. Wolfe asked me, a fourth-year medical student, to provide her, a highly-respected internist, with feedback about her interactions with patients, how she conducted clinic visits, and the like. To me, this request represented just how much she, as well as every single one of the Miller-Coulson Academy physicians, strives to continually improve their practice of medicine. This sentiment emerged again as Dr. Ziegelstein remarked during last week’s Grand Rounds that “clinical excellence is not a coincidence.” Rather, it is a remarkable skill set that must be continually fostered and nurtured.
Finally, the physicians of the Miller-Coulson Academy are a gift. I heard the words “gratitude,” “thanks,” and “love” countless times over the past two weeks. The physicians of the Miller-Coulson Academy are a gift not only to their patients but also to our entire health care system. They are a gift to students and trainees like me who seek role models who exhibit clinical excellence on a daily basis.
Overall, my elective experience during the past two weeks served as an excellent conclusion to my medical school career. As I embark on the next stage of my education and training, I hope to be able to emulate the qualities and skills of the Miller-Coulson Academy physicians in the care that I provide to my patients, their families, and their communities.
- Bryn Carroll, MS IV