Practice of medicine: Six things to remember in your practice in 2019

Last updated on March 15, 2019

There are small moments of reflection that pop up in any given day that can affect how we approach our practice of medicine.

Something at home affecting us at work, or vice versa.

Like a Venn diagram, the two circles overlapping by just that slight amount at the center. One such recent intersection for me occurred during an unexpected moment – the mundane household task of doing the laundry.

It was a weekend, of course, or I wouldn’t have been home. I loaded the dirty clothes into the washer and reached up to the shelf for the detergent, when something new drew my focus.

Something that didn’t belong.

A sentence, written on the front of the washing machine, in one of our kids’ handwriting, right next to the dial—in permanent Sharpie pen. My first reaction, as a parent, was not a happy one. (Dare I admit here this is not the first place in our house to fall victim to the Sharpie marker…?)

Then I peered closer, and read the words.

Remember the soap.

My irritation dissipated, and a smile played across my face.

In those three words, an entire story is told.

I didn’t try to remove the writing (is that even possible? really, if you know the trick to removing Sharpie ink please let me know…), and it remains on the washer, to bring back a smile whenever I see it.

Now before you lose patience, and ask what on earth does laundry have to do with the practice of medicine, I promise, a point is coming.

We embark this month on a new year,

and it occurred to me today as I did the laundry, this little sentence reminds us of several important things in life and our practice of medicine.

Here are a few:

Remember the basics of your task.
Don’t skip the first step.
It’s okay to write yourself reminders (although I might suggest using the memo function on your smartphone rather than the Sharpie pen technique favored by my children).

I thought about how we might use this humble sentence as physicians. Here is what I came up with:

1. Remember the patient

There are few challenges in practice that cannot be solved by following this charge.

(Please note, this means first and foremost that we practice patient centered care, not insurance-centered care. See also #3).

2. Remember yourself

How many articles about physician burnout were published in 2018?

Two of my favorites are these:

3. Remember the prior authorization

(Although you might like to forget…)

But the reality is the year 2018 saw an unprecedented rise in the need for the “prior authorization” to accomplish any care for our patients.

We, the physicians, need to continue to speak up about the delays in care and, in some cases, actual harm, these unnecessarily burdensome regulatory steps can cause.

4. Remember the profession

The practice of medicine is not just a job, it’s a profession; and I say, still a noble one.

5. Remember the art

Medicine remains as much an art as a science. Let 2019 be the year you renew your inner Art of Medicine.

6. Remember the mystery

Medicine is not a cookie-cutter science. The longer I practice, the more I see things I cannot explain. Be open to the mystery. It’s what makes—and keeps— us human. I recommend this blog post, Glimpse of a Deeper Order, by Rachel Naomi Remen.

In summary,

if you will allow me to stretch the laundry metaphor just a bit further…

The practice of medicine without any one of these six things (well, with the exception of #3), is like doing the load of laundry without the soap—at first glance, it might look the same, but one whiff and we know the difference.

What’s your best advice or story from your practice? Remember the __________. How would you complete the sentence? Respond in the comments section. Can’t wait to learn from you!

Originally published on Doximity’s Opmed on 1/18/19