They Don't Make Residents Like They Used To - Fair Enough

Hesham A. Hassaballa: This is Healthcare Musings. I'm your host, Dr. Hashem Hasabala. Welcome to Healthcare Musings, everybody. Happy to have you with me. I wanted to take this time to reflect over the episode I had with Dr. Kumel Hussein, who is a third year family medicine resident with whom I worked in the Midwest. was great resident, one of the my favorites really over the years, who wants to be a hospitalist and I hope he becomes a hospitalist. I think he'll be a great hospitalist and I hope he joins our group. He'll be a fantastic addition. You know, like I said, I've been I'm the curmudgeon now saying that I, you know, went uphill both ways and it was ten feet of snow and you guys Or don't know how good you have it and you're being s and and I do still think, or I mean I s I still kind of feel that the training sometimes is not up to the task when it comes to the job, because the job is still hard. and I just worry that the training doesn't prepare people for the job. And at the same time, you know what I kept saying? And I kept hearing myself saying at the end, you know, a a lot when Dr. was with with speaking with Dr. Hussein was fair enough. I kept saying, fair enough. And he had a lot of good points, you know, that and it's and I I I was I was thinking about, well, I mean, are we just salty because we had it really tough? And Our training was difficult and therefore if we went through that pain and suffering, then the people behind us need to also go through the go through that pain and suffering. And I kept saying I'm not saying that what I went through was right. I'm not saying being screamed at and brutalized by our attendings was right. I'm not saying that going home post call at four in the afternoon and not remembering how you got home was right. I completely agree. And I I again I kept saying fair enough. And you know, the one thing that he said that really stumped me and I and I'm I confess I had a hard time giving a a a cogent answer was when he asked me this. Take a listen.

Kumail Hussain: Even though there's days where you're on postcall, you're coming in the next day, as a resident, especially when you're working these these grueling hours, do you feel like you were at a hundred percent? So when a patient is relying on you on life or death situations, do you eat do you think the the previous generation who worked all these hours, who had all these responsibilities, they were bringing forth their best self? The patient got a doctor at his hundred percent and got the kit got the best care that they could possibly deliver. On minimal sleep, on all this stress and all these unnecessary tasks on top of them. Do you feel like that is accurate?

Hesham A. Hassaballa: like he's i mean he had a he had a great point like does the patient deserve either a trainee or an attending who is tired exhausted mentally drained physically drained and not at their best does any patient deserve that Do I as a patient deserve that? Do I as a patient deserve that? Does my family member as a patient deserve that? No. I mean, you have to the answer is no. Like, you know, he kept talking about efficacy versus efficiency, right? So can and and I say all the time to people, my own family, work smarter and not harder. Maybe, maybe they figured out how to work smarter. And not necessarily harder. Maybe, man. Like and and what I appreciated the most was you know, I c I I came at him pretty hard, especially when we talked about union residents and trainees unionizing. And I still still I don't know, there's still Part of me has a difficult time and I and I asked him, you know, so what do you need collective bargaining for if you guys got everything you want? Like what what is it that you need collective bargaining for? And he, you know, he every time I went at him, he was nothing but but a gentleman and respectful and and he made me think. He really made me think. And you could tell because I kept saying, Fair enough, right? I don't know, man, may maybe maybe we did it wrong. And maybe the trainees now know how to do it better. I mean i i i if they and we ended in agreement and I wrote a newsletter about that. We ended in agreement that if if the end result of the of the current training paradigm is producing happy doctors that are not burnt out, that are not bitter, that are not angry, you know what? It's a good thing. You can't you can't not say that it that it's not a good thing. Right. I make like a triple negative there. you know, he wants they wanna be happy. And I want to be happy. And they understand work life balance. They maybe they've seen what the previous generation, like we did, and their their doctor their dads and granddads and grandmoms and aunts and uncles, what kind of sacrifices they made. And they said th they they want to be present, more present in their life. And you know what? I'm the same way. I'm the same way. I want to be more present. I'm a doctor, I have a tough schedule, and I want to be present in my kids' lives. So You know, maybe maybe they they're maybe that maybe we were wrong all along. Maybe they're onto something. And well that all that said, I think it's super important to remember if you're gonna and he and we talked we we touched about this, if we're gonna have less work hours, right, less restrictions. meaning less time, then you gotta make every patient encounter worth it. Okay? If you have a lighter service, then you gotta you gotta you gotta die you gotta dive all in. And I would encourage every trainee listening to this to take advantage, see as many patients as you can. I'm not saying violate the rules or but see within your within your confines, see as many patients as you can. Do as much as you can because every patient encounter is a teacher. Same with me right now, 20 plus years in practice. Every patient I see teaches me something new. Become a better doctor with every patient I see. And the more I see, the better I become. The more I learn what to do and what not to do. And the more cases I see, the more different pre presentations of, you know, the September is sepsis awareness month. And the more patients you see with sepsis, the more you can appreciate how different they present. See and do as much as you can, especially if your time is gonna be cr shortened, right? Or or or less because because of the the new training paradigm now. Make it as like like he was saying, as efficacious as possible. Every patient is a teacher. I still believe it's it's this is a guild, and the more we do in our guild, the better we are. the more we see as apprentices, the better masters we become later. So yeah, maybe we maybe, maybe we were wrong all along, you know? And and and the reason I say that is because I just kept saying fair enough. I kept saying fair enough and even when I went at him hard. So yeah, again, at the end of the day, We all wanna we all want to produce happy doctors and you know maybe they're on to something. Thanks everybody for your time and attention and I'll see you next time on Healthcare Musings. Thanks for listening. Healthcare Musings is a production of FaithfulWord Media. Sign up at drhasabala.com to get every episode delivered directly to your inbox. And please don't forget to give the show a five-star review. Thanks so much.