It's the evening before I return to work, and my feelings are alternating between excited and distraught and absolutely terrified. It definitely feels like time to go back (there is almost nothing left on my to-do list), but at the same time I'm dreading the first day. I start with a busy clinic and I'm on home call for the first 12 days, so it won't be an easy return. But I can do this.
I'm hoping that, if I start off on the right foot, I can set myself up for long-term success. With that in mind, here are a few of the work habits that I hope to cultivate from the very beginning. For those of you who work in medicine, is there anything else you'd add? Any advice? (Or just reassurance that I will not in fact spontaneously combust during my first clinic tomorrow?)
Record Billing Information as it Happens:
This seems like a rather greedy thing to be thinking/talking about, but the reality is that I'll be paid fee-for-service, so if I don't bill for things, I don't get paid. While I have no intention of exaggerating my billings (I spent three minutes talking to the patient...so that counts as 30 minutes of counselling), I do want to get paid fairly for the work I do. The best way of achieving that is to document things as I go along so that I don't miss patient encounters or forget about things like phone calls and letters and family meetings.
Finish my Dictations Every Day:
So many of the other attendings (can I really say other?) have offices filled with charts and are constantly lamenting how far behind they are with dictations. Which means so much unnecessary stress! When I've been on clinic rotations in the past, I've been successful at keeping up with my dictations on a daily basis, and I plan to do the same as an attending. It just takes discipline, as well as remembering how much longer it takes to dictate on a patient I saw two weeks ago than on a patient I saw earlier in the day.
Devote Time and Energy to Teaching:
Most of my work will be in a teaching hospital, meaning that I'll have medical students and residents and fellows working with me most of the time. As a recent trainee, I know how frustrating it is to work hard and do all of the scut work without getting some teaching in return. Even though I find teaching challenging and sometimes stressful, I plan to make it a priority to do some of it every day that I have a learner on my service. I also plan to take on some of the teaching opportunities (small group sessions, lectures, etc.) that are always understaffed as a way of giving back to the medical school that got me to where I am today. The bonus of teaching is that it's a great way of keeping up my own skills (and getting some Continuing Medical Education credits so that I can keep my license).
Read for at Least Three Hours per Week:
Medicine changes. Every day, I get emails from journals about all of the articles that I should be reading. In order to keep up with at least part of the giant fire hose of medical knowledge, I plan to set aside three, one-hour reading sessions every week.
This is worthy of a post all its own. I don't even know what to say here. I have a few research projects that I'm interested in pursuing, but I have no funding, time, or salary to support research. Soooo.....we'll just have to see where this one ends up. I had hoped to have this figured out by the end of my vacation, but not so much.
Put Patient Care Above Other Considerations:
This is more a work philosophy than a habit, but I think it's important to always remember that my patients are real people, with hopes and fears and people who love them and lives outside of my clinic room. Their outcomes are more important than how much I bill or what time I leave work at the end of the day. While I do want to earn a good living (pay off debt!) and have a life outside of medicine, those goals can never be at the expense of providing good patient care.