This past week, I’ve had the fortune of working with several members of the Miller-Coulson Academy – Johns Hopkins faculty physicians who have been recognized, through a very stringent and selective review process, to be masterful clinicians in their respective fields.
As I end a year of rotations – the bulk of my clinical time in medical school – this has been a valuable time for me to pause and reflect on what exactly it means to be “clinically excellent.” I’ve always been diplomatic in assuming that different people might define this phrase differently. That, for example, what an excellent primary care provider finds gratifying or empowering about his or her work, an excellent surgeon or sub-specialist might find tedious or unfulfilling. And that may be true to an extent.
But what has struck me above all else, this week, is the remarkable degree of similarity between these diverse practitioners. I laughed when I heard, for the third time in a week, a faculty member tell me apologetically, “I bet the other Academy folks are more efficient than me!” “Well, not exactly,” I didn’t have the heart to reply. But they were all incredibly dedicated to their patients – listening intently (electronic medical record off to the side, or not at all), responding earnestly to concerns, and counseling carefully. Even for a single morning or afternoon, they were wonderful educators and mentors, introducing me warmly to their patients, and taking time out of busy patient encounters (this was true of a surgeon I shadowed in the OR as well) to teach me about their work.
Uniting all of this was an unabashed sense of joy in practicing clinical medicine. A profound sense of fulfillment and reciprocal gratitude for being able to bring one’s knowledge and training to bear in a meaningful, human way. “Come with me,” was the unspoken message I got when I stepped into the room with excellent clinicians. “I have some wonderful people for you to meet. They might have medical issues. Thankfully, I’ve been trained for these sorts of situations. We’re going to take care of them, and we’re going to have a great time.” If “efficiency” was on these clinicians’ minds, it certainly did not let it impact the care that was provided. It was heartening to watch.
Two other thoughts:
- One clinician opened an interview by asking the patient, “Tell me what you’re looking for in a doctor.” I think the patient and I had identical expressions – of pleasant surprise. As an almost-doctor-in-training, this is a question that I’d like to adopt for my own work. After all, who better to shape and improve our clinical identity than the people we serve?
- To fellow JH med students: if the medical school curriculum were cable TV, and the core rotations a bit like channel-flipping, then these two weeks for me have been the equivalent of stumbling onto a great late-night documentary on National Geographic. By which I mean, throughout the week, I kept having a sensation of watching a threatened species doing what it does best in its natural habitat – except instead of being mercilessly subjected to the forces of nature, these clinicians have been recognized by a highly selective panel and celebrated for their work. I’ve been ending my days feeling mystified, intrigued – and glad for the experience.
Jonathan Yeh, MS4
Jonathan is a 4th-year medical student at Johns Hopkins who is interested in geriatrics, oncology, and end-of-life care. He and his high school prom date (now a doctoral candidate at the Bloomberg School of Public Health) live in Baltimore City with their two cats.