Residency Blogs

In the past few decades, the “patient revolution” has empowered patients to become informed, active participants in their own health care experiences. Strong patient-physician communication is at the heart of this revolution. Unfortunately, physicians may be inadvertently undermining this effort due to our underdeveloped communication skills.

In late August, I received an email from Duke Family Medicine Residency Program Director Viviana Martinez-Bianchi, M.D., FAAFP, inviting residents to apply as a World Health Organization (WHO) young leader to attend the WHO/UNICEF Global Conference on Primary Health Care in Astana, Kazakhstan.

While living in Argentina, back in 1978, I was 14 years old when my father, a vascular surgeon, showed me a newspaper article that highlighted the Declaration of Alma-Ata. “This,” my father said, citing the call to action to develop primary health care with an emphasis on health equity and health for all, “will make a difference in the health and lives of people of the world.”

Recently, a patient tearfully confided in me her disappointment when a neighbor reneged on a promise to include her when seeing a particular movie. My patient had saved money from her limited disability income in anticipation of the event; it had been years since she had gone to a movie.

For a group that prides itself on managing the health of others, physicians themselves lead some of the most unhealthy, unbalanced lives you will ever see. In medical school, we’re taught about the association between stress and chronic conditions like heart disease, anxiety and depression but no one ever teaches you how to manage a busy practice and a busy family.

I still remember my first month of intern year — waking up in the middle of the night to check patient charts, labs, vitals and online resources. The transition from medical student to doctor frightened me, and I spent many nights reading through charts moment by moment to reassure myself that my patients were all tucked away and doing well through the night.

My office moved three months ago, and I am now on “the social work hallway” where people pass my door (or wait outside of it) on the way to meet with our medical social workers. There is a constant stream of people, sometime in singles or couplets, other times in small groups. 

I took one step backward, started to lose my balance, and knew it was all over. I fell to the ground as squeals of delight and laughter filled the air. My right foot just could not reach the red circle, and my chance for Twister victory had evaporated.

As I look back on stressful times in my life, specifically in pharmacy school, I now think “that wasn’t so bad.” I think about how we can make situations we go through 1,000 times more stressful than what they really are and how it important it is to take care of ourselves during situations that are out of our control.

While in the emergency department a man was brought in by ambulance for agitation. After introducing myself, he told me his story. He witnessed his brother be shot to death by police. He now felt targeted, which is what prompted his visit to the emergency department.