Blog | Friday, November 30, 2012

Teaching in the hospital; treating in the office

This past week I started teaching medical students for the first time as an attending physician. It's a new start, but of course it's also a return: the last time I taught medical students was as a senior resident.

Treating patients in the hospital is something I've done even when I haven't been teaching, of course, but teaching increases one's powers of observation if only briefly. What I notice now is that, as doctors, we spend most of our time not in rooms but in corridors in the hospital: hurrying back and forth, holding whispered conversations or rounds at full volume. "Prepare yourself in the anteroom," says Pirkei Avot, a basic ethical-moral work in the Jewish tradition, "to enter the palace."

On the other hand, my daily work is in the outpatient setting, the clinic. Patients wait not in their sickrooms but in their chairs of delay, while we work things through in our chambers.

In the hospital we're always hurrying about while the patients wait; our activity is often an illusion and there's much we can't speed up. In the clinic, we are all on the same clock.

Medicine comes in many different mixtures of waiting and action, passivity and frenzied procedure, and I want some way to tell the students that neither hospital nor clinic is all there is.

Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews. He is also a poet, journalist and translator in Yiddish and English. This post originally appeared at his blog.