Saying Goodbye…
Saying goodbye…
As many of you know, I am leaving Northwestern Medicine to go into my private practice soon. Just one year ago I started my part-time practice - and during this time, my practice has grown so fast, the time came before I knew it. It is both wonderful and scary, and as I get ready to dive now full time into this adventure, it is marvelous to reflect on all that brought me to this moment.
Thankful for the Time
I clearly see how everything I learned in the hospital has taught me to be a good clinician. There is something very special about this acute and crisis place we meet people. We see many things that are unusual or rare, in addition to all of the straightforward cases. Of necessity, we have to slow down. We have to really read the chart, get a good history and consider all of the angles. I have learned that slowing down usually gets a much better outcome for the patient. What is the type and source of the anxiety? Is it a SSRI type of anxiety, a benzo kind of anxiety or a Propranolol type of anxiety? Is it really trauma? Is the depression really just depression – who is this person and what are the factors in their lives that brought them to this point?
Thankful for the Team
It's also wonderful to be a part of a team. If we are smart, we learn from everyone: RNs, PCTs, therapy, consult services… every single colleague has brought me gifts of skills, expertise, and wisdom. Many of us are fortunate to have learned alongside very giving physician partners (I was blessed in this regard with five very generous members of our team.) It’s not exactly a “residency,” but it’s great to have received this incredibly valuable teaching and troubleshooting experience.
I’m carrying both of these things into my practice: time and collaboration.
Thankful for the Trust
What’s more, I’ve learned relationship is everything with the patient. It’s how I diagnose and treat. It’s how they heal. The particular details of pills or labs or procedures are much less important than how they feel with me. Are they willing to share something so intimate as their vulnerability? Are they willing to risk because they trust me? Trust is utterly essential: the immense trust a patient must have to undergo invasive or intimate procedures - everything from a gyne exam to a colonoscopy to open heart surgery - is present in the work I do as well.
I also wish to thank you for trusting me to share some of the things I have learned to make your lives easier in the front lines of the pandemic. I never knew until the lockdown that I could be of that kind of use in a disaster. My managers saw things in me that I did not see in myself, and encouraged me to grow with that.
Time. Collaboration. Trust. These are some of the things you have given to me. I cherish them. I have made them the kind of medicine I practice.
Taking it into Tomorrow - Together
Isn’t it wonderful that APPs can practice now to the limit of our training and experience? We aren’t physicians, and if we are compared to them we come up short. However, we are special and unique in our own lineages. We fit and fill a badly needed place in the care continuum. We free up our physician partners to work to the limit of their license when we work to the limit of ours. At its best, it is a beautiful match. There are teams that APPs can and should lead. There are teams physicians can and must lead. When we do, we all achieve more -and better - for the clients we serve.
I love my NP and PA colleagues here, and will miss you a lot. Thanks for all you do and all you are. Here’s to the adventure ahead!
Tony