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APRIL 6, 2012


The Short White Coat by Hevil Shah


y life as a medical student is almost at the end. In a little over a month, I’ll be walking across the stage with my diploma in hand. Come this summer, I’ll be starting my pediatric residency at Arkansas Children’s Hospital. And while I’m happy, excited, elated (and any other synonym you can think of) about starting the next stage in my medical career, I cannot help but feel heavy hearted knowing I’m leaving school slightly more cynical than when I started. Don’t get me wrong. I wouldn’t trade the opportunity to be in medicine for the world. But when I came into medical school, in my naïveté I believed that in end I would be helping patients out during their greatest need. While that is the case sometimes, at other times it seems that for today’s physician, patient care is at odds with two obstacles: administrative tasks and battling patients’ attitudes toward self-responsibility. Paperwork is the bane of a physician’s existence. It seems for every minute that a

patient is seen, up to double that time is spent taking care of paperwork. There are no doubt good reasons for this. As litigious as society has become and how quickly healthcare policy has been changing, it has become very important to document every detail. But as patients, you’ve seen the consequences of that. To help pay for administrative costs and not be in the red, the number of patients seen and wait time has increased, while the time spent with physicians has decreased. The work seems to have multiplied despite the transition to electronic medical records. Different systems don’t communicate with each other as they should and occasionally, as with any computer, the system crashes, requiring us to go back to paper charts. As vexing as all of that can be, the more disconcerting thing I’ve noticed is how quickly self-responsibility is declining. I recently met a young man who had a kidney transplant when he was an adolescent. For ten years, he had been doing great with no other health problems. The only thing he had to do — and was told to do at every checkup

A med student’s notebook he ever had — was to take his medications so his body wouldn’t reject his donated kidney. In college, seeing his friends not tied down with medications and being healthy himself, he stopped his daily regimen. A few weeks later he was admitted to the hospital. He was in renal failure. He completely destroyed his transplanted kidney and will now have to be placed back on the transplant list. Because he is more than 18 years old, he will be placed on the adult list, where there are many more patients waiting for a kidney than the pediatric list. I think this all comes down to taking ownership of your life and actions. He wasn’t living at home anymore where his parents kept a close eye on him.


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