In a recent advisory calling attention to health care worker burnout, U.S. Surgeon General Vivek Murthy, MD, highlighted the broad response the situation calls for: “We must ensure that every health worker has access to affordable, confidential, and convenient mental health care.”
If finances are keeping you or someone you know from seeking treatment for depression, anxiety, substance use, or other conditions, the Texas Medical Association’s PBF Wellness Fund is here to help overcome that barrier.
Through the fund, physicians with a valid Texas medical license can receive financial support for treatment of conditions that impair their ability to practice medicine safely. In addition, qualifying physicians can receive financial support to cover their family’s living expenses while undergoing treatment.
In the surgeon general’s report, Addressing Health Worker Burnout, Dr. Murthy proposed a variety of approaches to aid the 35% to 54% of physicians and nurses, and 45% to 60% of medical students and residents, reporting symptoms of burnout. He called for individuals, health care organizations, academic institutions, government, and more to help address the problem.
Related to mental health, the advisory calls for such actions as:
Eliminating punitive policies for seeking care for mental health and substance-use disorder;
Normalizing conversations about mental health challenges, including suicide, in health care learning environments to foster a culture of support and awareness; and
Ensuring access to mental health services for health care workers and their families, including the use of telemedicine.
Contact TMA if you or someone you know could benefit from the PBF Wellness Fund. Email Chris Johnson, PBF director, or call her at (512) 370-1602 with questions. Or complete an application. TMA strives to protect the anonymity of fund recipients.
Contributions from physicians and their spouses support the fund. If you want to help, you can contribute via secure, online donation, or send a check to PBF Wellness Fund, Attn: TMA Finance Department, 401 W. 15th St., Austin, TX 78701-1680.
The PBF is a 501(c)(3) organization, so charitable contributions are tax-deductible to the full extent permitted by federal law.
By Hujefa Vora, MD, TCMS Publications Committee Chair
Last month, I wrote about choices. We all seem to encounter hundreds, if not thousands, of choices every day. And who really knows how the slightest choice affects the next set of choices that present themselves before us. Our choices at times can appear meaningless to us. As I prepare for my day, I choose my scrubs from my closet. Unconsciously, I make the decision to wear the blue ones. I decide to just grab a granola bar for breakfast as a matter of convenience on my way out the door rather than to sit down with my wife at the dining table for the coffee and omelet and communion I am truly craving. On my way to work, I decide to stop and fill up some gas, though my truck still has a quarter tank. The floor nurse messages me that my patient’s family has decided to try and meet with me around lunchtime today rather than meet me for my morning rounds. I let her know that I am not sure that this will work, as there are likely to be another few hundred choices that I have to make before I get there. I will try. That seems to be all I can do in any given situation. At any rate, I decide to go by and see the patient first this morning. This will give me a moment of clarity without the interference that sometimes follows families into a room. I make the choice to turn left rather than right—I will start my day in the ICU and make my way back to the orthopedic facility later. I know that I will make it to all of the patients before the end of my day. My choices thus far have been mundane rather than the life and death decisions which we are glorified with when others speak of our profession.
The choices I made that morning were not anything but ordinary. And yet, as we find sometimes, they guided me exactly to the place where I was needed most.
As I arrive at the hospital, the cafeteria’s coffee machine calls my name. The granola bar wasn’t quite enough. I chose a decaf vanilla latte. Now the coffee machine is not that place, but it is certainly the place I needed most. Caffeine would make it better, but that goes without saying. My coffee and I meander onto the unit. The nurses are busy at their bedsides, assessing the patients at the start of their morning. As I walk toward the central nurses’ station, I note the rhythms of the telemetry monitors. Muffled underneath is the low hum of air flowing through endotracheal tubes. The aroma of the coffee hides the scent of hand sanitizer and bleach. Just the granola bar was a poor choice, but the choice of coffee from the cafeteria more than compensates for that. It is all entrancing, calming, and yet chaotic. The ICU has its own music. Occasionally, the better choice of words is controlled chaos. My moment is broken by a flourish from the room 20 feet in front of me. The rhythm is broken as a woman flies out of the room, hurtles towards me, and demands her nurse. For a moment, I hesitate. I then realize that the blue scrubs I chose this morning happen to be the same blues worn by our ICU nurses. I follow her into the room. The patient is bucking the ventilator. In his bed, he is strapped down, but from the spasms in his shoulders and neck, his arms look like they will try and pry loose. I hit the Code button on the hospital bed. The ICU machine is awakened by a cacophony of deafening alarm bells. Three nurses barrel into the room with a crash cart. A few simple, unplanned choices have guided me to this moment.
“The choices I made this morning were not anything but ordinary. And yet, as we find sometimes, they guided me exactly to the place where I was needed most.”
There were no decisions this morning prior to this moment that required my four years of college, four years of medical school, or three years of residency. And yet, they were a doctor’s decisions and choices. The next few choices were those of a seasoned physician with more than 20 years of working in hospitals and ICUs.
I don’t have any history, as this is not the room of the patient I have yet to visit this morning. All I have is the information the nurses start barraging me with. The patient is seizing, so IV benzodiazepines are administered. Another choice. The patient starts to calm, spasming muscles relaxing. Calm washes over the scene for a moment. Everyone, including the patient, pauses to breathe. The momentary silence is broken by the sobbing of the patient’s wife, I presume. She asks if the doctor has been called. Without skipping a beat, I reassure her that the intensivist is on his way. The wife stutters out a prayer, then thanks me for my actions. My choice in that moment is not to correct her, but rather affirm to her that we will take good care of her husband until the intensivist arrives. I remain in the room for several more minutes until the intensivist comes in to relieve me. He assesses the situation, thanks me for intervening while he was indisposed with another patient situation, and then allows me to walk back out of the room. As I leave, he pokes his head out of the glass door and shoves a cup into my hand. “Don’t forget your coffee.”
Every choice we make in our days is governed by several principles. I am about to speak in generalities, a choice I am making in this moment. We are physicians. Our lives revolve around this choice. Being a physician is not just a job, not simply some way to make money, but rather a life choice, because being a physician is not my job, but it is my Life. We are called upon, above all else, to do no harm—our choice is to take this oath and live by it. No matter the moment, the situation, the patient comes first, above all else. We apply our knowledge, our skills, and our hearts to every patient individually, understanding that it is our oath and the choices that have followed thereafter that define our most noble profession at its core. As a physician, it should always be my choices, and my patients’ choices, which guide me to those moments and through those moments when I am needed most. One might say that I am pro-choice. I choose to agree. My name is Hujefa Vora, and I choose the word “choice” as this, The Last Word.
This article was originally published in the May/June 2022 issue of the Tarrant County Physician. You can read find the full magazine here.
While the origin of this quote is debated, I find that it sets the scene perfectly. The point is that you need to be engaged to have a say in the process. I frequently use this phrase when discussing issues related to women’s health and LGBTQ care when government officials or other people in power try to dictate how I practice medicine. In less than a year, various entities in the Texas government have tried to dictate this at least three different times. There just is not enough space in my exam room for all of us. And sadly, I feel that they are only just getting started.
I consider practicing medicine to be a profound privilege, and it is one that is only obtained after many years of hard work, study, and usually a huge financial commitment. For those who do not know, I did not come to medicine straight out of college. I chose to pursue studies in ballet and pre-medical course work while getting my undergraduate degree, then followed my passion to an opportunity to teach and dance professionally. After a few years, I decided it was time to go back to the pursuit of a career in medicine. However, I did not get there the first try and had to make a further commitment to improve my application to get into medical school the second time. Having studied ballet in college, I definitely felt a little out of my element in medical school. I still recall a time when a professor in a small group learning session referred to me as the “lowest common denominator” due to my nontraditional background. Despite this, I continued in my studies to obtain the title of Doctor of Medicine. To practice medicine, however, you do not stop there; you must take the next road in the journey of medical education, and I went on to study obstetrics and gynecology in residency for another four years of training. So, in total, I have spent 12 years in education to become the doctor that I am today. That does not include the hundreds of hours of study that one must continue after residency to maintain the privilege of being a doctor as well as to provide the best and most up-to-date care to one’s patients. Despite all of that, for obstetricians and gynecologists, our field is continually under the microscope for various areas of the care we provide, and outside influences are always trying to tell us how to do our job.
As mentioned earlier, there have been three times when the government of Texas has tried to dictate how I can practice medicine. On September 1, 2021, Senate Bill 8, prohibition of doing an abortion after a heartbeat is detectable, was implemented. This has led to many far-reaching consequences that do not have anything to do with abortion, such as concerns regarding management of ectopic pregnancy, management of premature rupture of membranes before viability, and lethal fetal anomalies not identified until 18–20 weeks.
“I consider practicing medicine to be a profound privilege, and it is one that is only obtained after many years of hard work, study, and usually a huge financial commitment.”
On December 2, 2021, Senate Bill 4 became effective, further placing non-evidence based restrictions on medication abortions as well as requiring physicians and healthcare facilities to report complications that occur from medically induced abortions. This essentially forces physicians and healthcare facilities to report our patients who are already going through a challenging time. In addition, we must justify the use of the same medications used for abortion when used for other medical reasons and sometimes delay the care for patients in the process.
On February 18, 2022, the attorney general of Texas wrote an opinion letter equating transgender care with child abuse. This was followed by a letter from the governor on February 22, 2022, to the Texas Department of Family and Protective Services, asking them to “conduct a prompt and thorough investigation of any reported instances of these abusive procedures in the state of Texas.” While these are officially opinions only, they have led the transgender community to fear seeking evidence-based care. Furthermore, some physicians and healthcare entities who provide this care have shut down or halted the care of these patients. These opinions have further isolated an already at-risk population from the care they need and deserve.
We have all trained, studied, and worked too hard to let those who have not done the same dictate the care we provide. Would we allow outside influences to decide who gets cancer treatment or cardiac care based on the opinion of a person without proper medical education and training? The truth is, no, we would not accept that. Unfortunately, when it comes to the issues of reproductive health and LGBTQ care, an attitude of “that does not affect my practice, so I do not need to say anything” is taken. Yet, there are far-reaching implications that we must consider. No matter your opinion on any of these issues, we as physicians need to fight back on these interferences in the patient-physician relationship. I will continue to provide the evidence-based and compassionate care that my patients deserve. I will also continue to bring myself to the table of advocacy, so that neither my practice nor my patients end up on the menu.
In his role as the Co-Advocacy Chair of AMA-MSS Region 3 that includes medical schools in Arkansas, Kansas, Louisiana, Mississippi, Oklahoma and Texas, the first-year medical student has helped organize nationwide campaigns for the organization.
“I was extremely honored to receive this award alongside other incredible leaders in AMA-MSS Region 3,” Singh said. “Receiving this award inspires me to continue growing my involvement in the AMA-MSS and be an advocate for medical students, physicians, and patients.”
Singh has been a part of the MSS Region 3 Resolution Review Committee, the Logistics and Resources committee for the AMA-MSS N-21 Conference and the Committee on Legislation and Advocacy (COLA) since 2021. He was also one of the authors on four different resolutions presented at the AMA N-21 Conference held in November 2021.
“Through the Texas Medical Association (TMA)-MSS, I was part of the Ad-Hoc Committee to review resolutions for TexMed 2022 and I was primary author for one resolution and helped draft two other resolutions,” Singh said.
Singh is the current AMA delegate for the TCU School of Medicine. During National Advocacy week in October 2021, he helped organize a “Call Your Rep” event as well as social events to increase AMA engagement at the medical school. He also attends monthly Tarrant County Medical Society meetings to provide updates about the medical school, the AMA-MSS and TMA-MSS chapters he’s involved in.
“It really gives me the opportunity to connect and build relationships with local physicians in Fort Worth and all across North Texas,” said Singh. “I believe that there is power in a collective voice and organized medicine provides medical students and physicians the opportunity to advocate for change on a local, regional, and national level. This motivates me to work harder and give back by mentoring other students to find their voice through the AMA-MSS on healthcare advocacy topics they are passionate about.”
Statement from Texas Medical Association President Gary W. Floyd, MD:
The Uvalde, Texas, school shooting was shocking, and hit me at my very core as a pediatrician, father, and grandfather. I can’t put into words the emotions I felt at the time. But I can tell you the first action I took was to call my Texas Medical Association Board of Trustees colleagues and Michael Darrouzet, executive vice president of TMA, to say, “We have to do something for the Uvalde community. We need to take action to prevent these violent acts from ever happening in Texas again.” Ray Callas, MD, chair of the TMA Board of Trustees, did the same. Together we called for action.
I know you can relate to our reaction, because as physicians, we fix problems – we are trained to diagnose, treat, and heal. And that is exactly the approach TMA took in its response to the Uvalde crisis.
TMA went to work immediately to create the Mental Health Rapid Response Team, a coalition of 20 organizations ranging from state medical specialty societies, statewide leaders from community health centers, and social work and psychology organizations to state government resource leaders, such as the Texas Health and Human Services Commission (HHSC), Texas Child Mental Health Care Consortium (TCMHCC), Texas Division of Emergency Management, and Texas Department of Public Safety, to name a few. See the entire list of participants below. The coalition is co-chaired by Dr. Callas and me.
TMA already had its first meeting with the Mental Health Rapid Response Team to learn what resources are being deployed in Uvalde, what is needed, and how we can collectively help with the response without overwhelming the community or interfering with ongoing efforts by the state. We also started establishing short- and long-term goals for the coalition, focusing on the needs of the Uvalde community, first responders, communities all over Texas that also are dealing with this tragedy, and new legislation we can put before our legislators in January 2023. Being proactive is TMA’s primary goal, in the hope our efforts will prevent such situations from occurring again.
What we know: Uvalde currently is overwhelmed with offers to help with counseling. TMA’s goal will be to look longer-term, finding in-person counseling for Uvalde during the next year or two. HHSC has asked TMA to create a list of people who are willing to provide long-term counseling services in Uvalde. Eventually, we will need telemedicine services as well. TMA will soon publish information about how to get involved. Please keep an eye out for this.
TMA learned one valuable lesson from the COVID-19 pandemic: When we work together and learn from each other, we can be much more effective. We are taking that same approach now. This is not a problem we can fix quickly but one that will take time to properly diagnose, treat, and heal.
Please join TMA as we help the Uvalde community and our state to detect, prevent, and start fixing the many problems affecting our children and families in Texas.
Sincerely,
Gary W. Floyd, MD President Texas Medical Association
Mental Health Rapid Response Team
Association Participants
Child Psychiatry Access Network (CPAN is part of TCMHCC) – Laurel Williams, DO, CPAN medical director; Nhung “Noon” Tran, MD, Texas Pediatric Society liaison to CPAN and CPAN pediatric consultant; and Luanne Southern, TCMHCC executive director
Federation of Texas Psychiatry – Phillip Balfanz, MD; Eric Woomer, lobbyist and government affairs consultant; and Courtney Williamson
National Alliance for Mental Illness Texas – Greg Hansch, executive director
National Association of Social Workers Texas – Will Francis, executive director
Texas Academy of Family Physicians – Tom Banning, CEO/executive director
Texas Association of Community Health Centers – Jana Eubank, executive director
Texas Chapter of the American College of Physicians – Nicole Abbott, executive director
Texas Counseling Association – Jan Friese, executive director
Texas Hospital Association – John Hawkins, president/CEO; Steve Wohleb, general counsel; and Sara Gonzales, vice president, advocacy and public policy
Texas Medical Association – Gary Floyd, MD, president, and Ray Callas, MD, chair, board of trustees
Texas Nurses Association – Julia Menegay, interim CEO, and Dawn Webb, director of nursing practice and professional development
Texas Pediatric Society – Stacey Mather, executive director, and Clayton Travis, director of advocacy and health policy
Texas Psychological Association – Angie Guy, interim executive director
State Participants
Office of the Governor – Heather Fleming, advisor
Texas Child Mental Health Care Consortium – David Lakey, MD, chair
Texas Department of Public Safety – Steven McCraw, executive director/colonel, and Lt. Charles Havard
Texas Department of State Health Services – John Hellerstedt, MD, executive commissioner, and David Gruber, associate commissioner, regional and local health operations
Texas Division of Emergency Management – Nim Kidd, Chief
Texas Health and Human Services Commission – Cecile Young, executive commissioner, and Sonja Gaines, deputy executive commissioner for intellectual and developmental disability and behavioral health services
WHAT: Fort Worth residents of all ages are encouraged to lace up their walking shoes and join medical students and faculty from Texas College of Osteopathic Medicine for Fort Worth’s first anniversary Walk with a Future Doc (WWAFD) Texas event.
WHEN: Saturday, June 11, at 8:30 am (recurring monthly every second Saturday)
WHERE: LVTRise – 8201 Calmont Ave Fort Worth, Texas 76116 (Meet at the outdoor area behind the facility)
WHO: Dr. Maria Crompton, medical students, and any community members interested in participating
WHY: Walking is one of the simplest, best things people can do to live a long, high-quality life. WWAFD makes it easy by providing the time, place, motivation (a brief health information talk), and fellow participants for a fun walking experience.
TheWalk with a Future Doc concept is simple: Physicians and medical stduents organize walks in their communities and invite their patients, their patients’ families, and community members to join them. Walkers will enjoy a refreshing and invigorating walk with Dr. Crompton and other health care professionals, who will provide support to participants and answer questions during the walk.Walk with a Doc Texas is overseen by a national nonprofit organization to get people active and healthy, and is backed by the Texas Medical Association (TMA) in Texas.
This is a FREE program, and preregistration is not required. Information about future walks will be announced on this chapter’s Walk with a Doc website.
Walk with a Doc is a nonprofit organization whose mission is to inspire communities through movement and conversation with physician-led walking groups. Walk with a Doc was started in 2005 by David Sabgir, MD, a board-certified cardiologist in Columbus, Ohio. To learn more, visit theWalk with a Doc website.
“Rebecca” wasn’t looking for a miracle – she just needed to see a gynecologist. The 47-year-old mother of three was suffering from abnormal uterine bleeding. Her problem eventually became so severe that she had to quit her full-time job as a phone salesperson because she was drained emotionally and physically.
“I suffered a lot,” Rebecca says. “I was in a very dark place . . . I could not even drive because I was not well in all aspects of my life.”
But in spite of her clear need, between her financial limitations and immigration status, Rebecca was faced with a resounding chorus of “Nos” as she struggling to find the help that could turn her life around.
“I was crying all of the time because I could not find anyone to help me,” she says. “I was having constant bleeding that would last months. All I wanted was help and to be treated like a human.”
Eventually, she was able to receive mental health support through Health Services of North Texas. Through this program she was connected to a psychiatrist who began helping Rebecca manage her anxiety and depression. They also referred her to Project Access.
Dr. Carolyn Quist, a Project Access volunteer, agreed to take Rebecca’s case. After finding numerous cysts on both of Rebecca’s ovaries, she determined that they needed to be removed. She performed the surgery at Baylor Surgicare in Fort Worth, and anesthesia was provided by U.S. Anesthesia Partners.
“She took really good care of me, and she always asked how I was doing emotionally, which I believe she did not have to do, but she still asked,” says Rebecca of Dr. Quist. “She is not only an amazing doctor, but she is also a wonderful person. She explained everything to me thoroughly and patiently. I will never be able to repay all of the help she has given me.”
Currently, Rebecca is still gaining strength as her body heals, but her overall health is much improved. She has hope for the future, and gratitude for those who said “Yes” to her when she needed it most.
“Project Access is an awesome team, and I will always be thankful for their help,” she says. “Knowing that they offer help for people like me makes me so happy.”
By Catherine Colquitt, Tarrant County Public Health Medical Director
This article was originally published in the May/June 2022 issue of the Tarrant County Physician. You can read find the full magazine here.
Tarrant County Public Health (TCPH), with its long history of providing vaccinations and testing in response to outbreaks and exposures, is rapidly expanding mobile operations to meet more testing, vaccination, treatment, screening, surveillance, contact tracing, and risk reduction education needs in our rapidly growing county.
TCPH staff and leadership have learned much during the COVID-19 response about taking services “local.” We have benefitted greatly from working with such partners as county, regional, state, and federal government agencies, as well as first responders, municipalities, the Tarrant County Medical Society, school districts, colleges and universities, primary and secondary private schools, preschools, childcare facilities, places of worship, and municipal and state emergency management and preparedness experts.
Responding to the need for mobile services with COVID-19 has reshaped healthcare delivery and has redefined preventive risk reduction and early/expedited treatment strategies for communicable diseases. It may also help us to move closer to the health equity we wish to achieve in our county and beyond. The COVID-19 pandemic has exposed disparities in access to vaccines, testing, accurate COVID-19 information, and expert advice regarding COVID-19 risk reduction strategies (masking, social distancing, practicing cough and hand hygiene, self-isolating when ill, quarantining after COVID-19 exposure, and vaccination).
As of March 24, 2022, some 2,894,773 COVID-19 vaccinations have been administered in Tarrant County, with 1,338,110 people (66.24 percent of eligible Tarrant County residents) having received one dose, and 1,179,080 people (58.37 percent of eligible Tarrant County residents) being considered fully vaccinated with one Johnson and Johnson vaccine or two doses of mRNA vaccines.1
Essential clinical services offered by TCPH include immunizations; HIV testing, prevention, and treatment; STD screening and treatment; tuberculosis treatment; screening and contact investigations; drug treatment for latent tuberculosis infection; travel medicine clinics for advice; and vaccinations essential for safe international travel. We believe that a hybrid approach to the delivery of these services is vital to addressing health equity and access issues that could otherwise interfere with our objective of safeguarding the public’s health. We continue to operate our brick and mortar clinics across the county, but we must be nimble to serve communities which can’t easily access services in our fixed locations. We have a highly visible VaxMobile (an articulated city bus provided by our Fort Worth Transportation Authority partners), and we have purchased five mobile immunization trailers customized for the purpose. We have also purchased a 26-foot-long mobile van in which we can see clients for education, testing, and treatment.
We are ready, willing, and coming soon to your neighborhood. Remember, “Public Health is Where You Are”!
Physicians from JPS Health Network are offering free sports physicals for Fort Worth ISD student athletes on Saturday, May 21.
Fifty JPS physicians, including seven Sports Medicine Program fellows, Sports Medicine Program faculty members, and physicians in the Family Medicine Residency Program, will perform the exams. A comprehensive sports physical exam is required for Fort Worth ISD students to participate in athletics in the new school year. The free event is a convenient opportunity for students to get a checkup.
Also volunteering their time are more than 30 others, including JPS nurses, EMTs, and students from Texas College of Osteopathic Medicine, who will take vital signs. Other JPS team members have been enlisted to direct the students to various stations.
“We want to be involved in our community. We want kids to be able to participate in sports because it provides so many positives for our youth today,” said Sports Medicine Fellowship Program Director Michele Kirk, MD.
The mass physicals event has not taken place since 2019 due to the COVID-19 pandemic. Kirk noted that at past events JPS physicians have identified serious health problems in some teens while checking students’ readiness for sports. Athletes are referred to the appropriate physician providers for further evaluation and treatment in these situations.
JPS Sports Medicine physicians serve as team physicians for many high schools in Fort Worth ISD and Arlington ISD as well as being the team physicians for Texas Christian University, Texas Wesleyan University, and Southwest Assemblies of God University. They specialize in preventing, diagnosing, and treating injuries related to athletics and physical activities. To find out more about the JPS Sports Medicine program, visit jpshealthnet.org/get-care/services/orthopaedics.
Physical examination and medical history forms must be completed and signed by a parent or legal guardian by Wednesday, May 18. All FWISD athletes wanting to participate must go through their school and athletic trainer. Parents will not be allowed to bring their children in for the physicals themselves.
This article was originally published in the May/June 2022 issue of the Tarrant County Physician. You can read find the full magazine here.
“Cranial nerves two through twelve intact. Sensation is absent to light touch in right C5 and C6. Strength five out of five in bilateral upper and lower extremities. Bilateral hyperreflexia noted in patellar reflexes. No gait abnormalities,” I recite to my neurology preceptor. I quickly tap my right foot in nervous anticipation of disseminating the physical examination findings and their implications to the patient.
Context is everything. One year ago, abnormal neurological findings on an Objective Structured Clinical Examination (OSCE) would excite me. It was a free space to explore various pathologies in depth without fear of harming the patient. But this is not an OSCE. Gone are the days when hired actors pretended to be patients with medical cases. This is the real world with patients experiencing debilitating symptoms presenting to clinics. Now, abnormalities are not just an opportunity to see topics I learned in class or in a textbook last year come to life. Rather, abnormal physical exam findings in the real world can have devastating effects on individuals’ lives and on their overall wellbeing.
Informing patients about abnormal findings that warrant further imaging is not an easy task. I take a deep breath and knock on the door. I calmly deliver the news that his neck pain, hyperreflexia, as well as his numbness and pain in the middle and pinky fingers necessitates an MRI of the cervical spine for evaluation of possible cervical degenerative disc disease.
“So, I won’t know if I have that disease until I get the MRI?” asks the patient.
“Yes, that’s correct. Imaging is a tool we can use to confirm our clinical findings,” I reply.
The patient’s body starts to reflect the stress he feels from this information. Sweat beads form on his forehead. His brows furrow. His lips quiver.
“But it won’t be until a couple of weeks that I can get the MRI and have the results back,” he worriedly says.
I sense his uncertainty, and I spend twenty extra minutes with him. I calmly explain that it is normal to feel anxious about the unknown. I further explain that imaging is a helpful tool we can use to confirm our clinical findings. I reassure him that physical exam findings and imaging results together will allow us to formulate an efficacious treatment plan to fulfill his goal of improving his symptoms.
Our job as healthcare professionals transcends purely applying medical knowledge to real-life settings. The quality of the medical information we give patients is valuable only if it is delivered in an understandable manner that takes into consideration how that information affects their daily lives. If the pathology is prioritized over the patient, medical care will not suffer, but the patient will. Given that our primary duty is to ensure the wellbeing of patients, patient encounters are more fruitful when extra time is spent explaining the importance and relevance of the information. It takes years to fully master medical topics for medical students who spend all day studying and are constantly immersed in the material. It is not a fair expectation to assume that patients will recognize the significance of and be able to apply health recommendations without a clear and thorough explanation by the caregiver. Patients are real people, and this recent encounter reminded me that entering medical settings is a vulnerable situation that requires physicians to acknowledge their experiences with care and compassion.
Tarrant County Physician Online 