Profession from page 13 What advice would you give to physicians entering medical practice? My advice would be to welcome the coming challenges to improve patient care and the health care system. Only if you are a part of it can you affect change. It is our responsibility as leaders in care delivery to own our profession and advocate for our patients and the health of the country. We should remember that this responsibility is not only to the individual who sits before us, but also to the population as a whole. What, if anything, would you have done differently in your career? I have no regrets about my career. A colleague of mine once commented that “it is human nature not to be completely satisfied.� So of course, there are things I would have liked to have done more of, learned more of, or experienced more of. But there is no sense worrying about what I could have done differently; instead, I need to think about what I need to do differently in the future.
Annie Tan, MD, PhD Gynecologic oncologist, Minnesota Oncology, Coon Rapids clinic Number of years in practice: 4 Medical degree: 2000 (University of Minnesota) What aspects of medical practice have surprised you (in good and/or bad ways)? My medical training did not prepare me for the administrative aspect of medicine. There is so much documentation, not only the patient’s medical record, but also for billing and coding. Even within my four years of practice, I have
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MINNESOTA PHYSICIAN OCTOBER 2012
noticed the increase in the requirements for documentation, most recently with “meaningful use.� These requirements have increased the time needed for administrative work and detracted from the time for actual patient care. I was surprised to learn about the politics in medicine at the local and national level, and how it affects my daily practice. This is not in reference to office politics, but rather how policies and laws can influence how we want to run our practice and care for patients. What were the most important factors for you in choosing a medical specialty? Early on, I had an interest in oncology at the basic science level, which was the topic of my graduate dissertation. In medical school, I found that I enjoyed doing surgical procedures. I wanted to be in a field of medicine where I could combine these interests and also feel like I was making a difference in people’s lives. I found that to be true in gynecologic oncology. Fortunately, because I had no medical school debt, I was able to pick the specialty that truly interested me the most. What was your debt, if any, upon graduating? I was in a combined MD/PhD program and had full financial support with a tuition scholarship and stipend. How has the culture of medical practice changed since you began practicing? I have noticed that there is much more acceptance for physicians to find a work-life balance, with resources available to assist with overall physician well-being. Even within our practice, there is a committee working actively to achieve this for the whole group. The paradigm for how we care for patients is also changing. There has also been a shift to a patient-centered care model. I see more collaborative efforts and better communication among the different specialties, resulting in better coordinated care for patients. There is more practice of evidenced-based medicine, applying this to many more aspects of patient care. Along with this, there is the expanded effort to be cost conscious in how we care for patients. This has affected the types of procedures we do, length of stay in the hospital, medicines we prescribe, and clinical tests we order. What, if anything, would you have done differently in your career? I am very fortunate to be very happy with my career, my practice, and my colleagues, and would not change a thing. What advice would you give to physicians entering medical practice? I would recommend finding a practice where you like and respect your colleagues. These are the people you will be working with daily and who will cover the care of your patients on call or when you are out of the office. They can influence patient perceptions of you, as well as the growth of your practice. If you are at a new facility, find key physicians that you can ask for help if needed. For instance, when I started, I did not have any of my gynecologic oncology colleagues at the same hospital or clinic site. So I introduced myself to a colorectal surgeon, general surgeon, and urologist that I could comfortably discuss patient cases with and also operate with when necessary. I also made myself readily available for consults and questions. This helped to build my presence not only at the hospital but also in the community. Lastly, it is also important to find a good work-life balance. This has been ignored throughout medical training but is necessary if you plan to work for at least 30 years without burnout.