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Hourly Impact

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I read with interest the article about resetting the clock for resident hours [Spring/Summer, p. 5]. My question is: Have there been any studies correlating work hours in practice, leisure time, and family time [comparing] older generations with the new generation—in planning for the future? I wonder if [you would find] a difference for cardiovascular events, accidents, alcohol use and divorce between those whose residency hours were “reset” and those whose hours were not?

Efigenio L. Bautista, M.D.

A Teachable Moment

With regard to “A Noteworthy Endeavor,” [Spring/Summer 2017, by Richard Byrne]: This writer should teach. It is not often these days that one runs across an article that actually covers the basics—who, what, where, when, why and how—early enough that a layman has some understanding of what is going on when the meat of the article is served up.

Calvin Case

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Personalized Medicine in Jeopardy

I enjoyed receiving and reading your Winter 2017 edition. Your magazine has been an essential source of connection to my training days and of reading pleasure for nearly 30 years! For the first time, I feel compelled to write to you in reaction to the front cover and articles, with this issue’s arrival timed just off of my serving as a teaching attending to third-year medical students during their medicine rotation in February.

The front-page marquee, "It’s Personal," caught my attention, particularly in reference to the new clarion call of Hopkins’ so-called precision medicine. Somehow, this juxtaposition of phrases immediately rubbed me the wrong way, not because I don’t applaud the marvelous advancements in medical science, but rather that, ironically, just as the science of medicine has achieved great strides, the truly “personal” aspect of the practice of medicine, of knowing our patients well, which in my view holds the critical key to excellence in medical care, has come increasingly into serious jeopardy.

As a profession, we have allowed the “personal”—both that which promotes valuable insight from learning from a patient’s perspective as well as that which arises from attention to our own inward growth and personal reflection—to wither on the vine. I fear that as we become increasingly puffed up and enamored by our technical prowess, our attention is becoming seriously diverted from that which really makes the practice of medicine truly special for the patient and for the professional alike: formation of a meaningful relationship in the face of the real challenges of caring for the sick. It is through such a relationship that true, fully meaningful, wholly effective healing occurs. And I sensed in my recent teaching rotation that our medical students not only sense this “disconnect” but also are yearning for the skills to achieve this.

I do give you credit for including in the last two pages some due attention to my concern. Ronal Epstein’s book, featured in Mary Catherine Beach’s article [Second Opinion, p. 47], is truly a great read. I encourage physicians to explore this realm of “mindfulness,” especially valuable as growing new demands on our time and attention, particularly from the electronic medical record, pull us farther away from that attention to truly delivering good care. Also, in his piece [Post-Op, p. 48], Dean Rothman gives accurate and important focus and attention to the doctor-patient relationship as the key to turning around the tide of increasing physician “burnout.”

I hope future issues can give further important attention to the humanistic and spiritual-based aspects of medical care, and pray that Hopkins would fully embrace a sincere renewal of the spirit of such Hopkins giants as William Osler back into medical practice. I look forward to continuing to read your wonderful magazine with great interest.

Peter C. Belitsos ’83

(Housestaff, Medicine, 1983–87; Fellow, GI, 1987–90)