Page 6 - Mecklenburg_Medicine_March-2018

President’s Letter

Docere — “To Teach”

(Latin root for the word “doctor”)

By Scott L. Furney, MD

N o one will ever confuse me with a morning person. Asia 40 years ago. They are not bound by the short appointments
My internal clock is wired for late nights, not early and diagnostic biases that familiarity can produce. Enough excuses,
mornings. After battling with my alarm clock(s) though; these are some really smart people we get to train. I learn as
and attempting to negotiate with the snooze button, much from them as they do from me.

I begrudgingly admit defeat and find some coffee. Mondays are There seems to be a consistent theme I am hearing in my first
few months leading this organization. My articles are in response to
particularly challenging after indulging my circadian rhythms during this angst. As much as I have found time with patients to be a potent
antidote to burnout, learners can be, as well. While I could attempt
the weekend. to remind you of the Hippocratic Oath and our duty to teach the
next generation, that is not the reason to teach. The real reason is
This particular Monday started out as any other — in clinic with that it brings diversity to our clinical experience — another antidote
against fatigue in the midst of repetition. Whether pharyngitis or
my patients and with a medical student to precept. The list was filled another common illness, we are more engaged mentally when we
have to explain our approach. For some, the act of teaching is a
with the usual suspects, selfish pleasure. You might find your patients enjoy it, too. True or
not, when my patients see me teaching another, they likely infer
As much as I have found and I thought my someone thinks I am smart enough to do so. I add to that enjoyment
time with patients to student would benefit by deeming my patients “Professor” after they have taught at least
from a complex patient three of my medical students. You should see them smile!

be a potent antidote to on a return visit for a For those who might have their interest piqued, you are in luck.
burnout, learners can vertebral insufficiency There are so many opportunities now in Mecklenburg County
fracture. I will spare that you will not have to look very hard. CHS has residencies and
medical students, Novant has a new family medicine residency,
be, as well. While I could you the details, but his Campbell has medical students who need placement, and there are
attempt to remind you medical history affords innumerable physician assistant and nurse practitioner programs
that as a risk. I was needing preceptors. There are simple tools I will share to build clinic
templates for teaching and quick tips for ambulatory precepting.
of the Hippocratic Oath worried about him, And, you have an open offer from me to give you a pep talk.
and our duty to teach though. He was losing
weight and “failing to I know some of you will dismiss this, and some are just not built
to teach anyone but patients and staff. For those who are on the
the next generation, thrive” over the last fence and do not know how to get started, please connect with me.
that is not the reason few months, all for You will find those few minutes a worthwhile investment in a tool
unclear reasons. The that will rejuvenate the practice of medicine for you. Being scooped
by my medical student certainly gives me a morning dose of
to teach. fracture added misery catecholamines, in a very good way. I still am not a morning person,
to his long problem list. but my students make sure I am fully awake.

My student returned In humble service,

from the room to go over the case, and his conclusion barely P.S. The patient did not have Pott’s Disease, but it still was a
really good thought!
registered in my morning fog. “I wonder if he has Pott’s Disease of

the spine?” the student suggested. I suddenly was wide awake and

have to admit, a little shocked. My brain quickly went through the

Kübler-Ross stages, adapted for medical teaching:

• Denial. No way the patient could have that!

• Anger (at myself). How could I not have thought of that!

• Bargaining. This is where you hedge a bit as a teacher, trying

to decide whether or not to admit your own inadequacy and

compliment the student.

• Depression. Admit you did not think of it, and the third-year

medical student did.

• Acceptance. Celebrate the fact that the patient benefits from two

smart people in his care, and you benefit from another dose of

humble pie.

In reality, no one should be surprised that novices with ample time

can come up with a broad differential diagnosis and have time to

explore it cognitively. That is, after all, why they are there. They can

elicit the patient’s long-lost military history and positive PPD test in

6 | March 2018 • Mecklenburg Medicine