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Sad Days Ahead?

After reading “Letters” in the last issue, I am writing to share some thoughts about house staff training and “patient ownership.”

As I reflect on my own house staff training at Johns Hopkins many years ago, it seems to me that we had a different attitude about patient care and continuity of care than that which is currently the “standard way” of training medical house staff in 2014. The Osler house staff tradition, as well as the department chair, i.e., A.M. Harvey, dictated that responsibility for our patients was a 24/7 responsibility. The concept of ownership of the patient was so ingrained in us at Hopkins that it carried over to later times — in my own case, over all my life.

Another concern I have is related to obtaining a consult on our patients. I make it clear to house staff that a consulting physician is a consult to those requesting the consult, not to the patient. It is then the responsibility of the patient’s primary doctor to transmit what he or she has been advised by the consulting physician to the patient. I have always agreed with Dr. Eugene Stead, who has many times said, “What this patient needs is a doctor.” The patient does not need several physicians taking care of them at the same time. I try to pass this concept on to house staff, but on many occasions, house staff are not available to discuss the patients, since it is their “day off” in the middle of the week, or they have to go to a clinic.

Based on my experience over the years, I am predicting that in the not-too-distant future, patients will not have a doctor but a cadre of physicians and/or other practitioners who manage them (and confuse them), excluding the physician who is responsible for the patient. This will be a rather sad day for medical education and for our patients.

C. Richard Conti ’60, M.D., MACC

Emeritus Professor of Medicine and Eminent Scholar Emeritus (Cardiology), University of Florida College of Medicine

We Heard You!

In October, we sent a short email survey to about 17,000 readers of Hopkins Medicine magazine, asking for feedback on everything from the quality of our writing and design to the most memorable stories of 2014. In response to our question “What is it you like most about the magazine?” the responses ran the gamut. A sampling:

  • It keeps me connected to the place where I trained for six years and remained on the faculty for an additional eight years. Hopkins was a huge and wonderful part of my life.
  • Short but sweet articles; well illustrated and personal.
  • It keeps me informed as to the wonderful world of constantly developing new understanding in human medicine.
  • The depth and breadth of the articles as well as the highlighting of Hopkins faculty, residents, students and employees — together the individuals at Hopkins make it the great institution that it is. I also like the articles on Hopkins history for the same reason.
  • It is exciting to read about all of the advances made at Hopkins and the cutting-edge research underway.

Topics are current, informative and many times outside my area of expertise. But that’s a good thing, giving me new insights to topics I would never bother to investigate.

In reply to “What is it you like least?” Our readers had no shortage of opinions. Among them:

  • Sometimes too Hopkins-centric and doesn’t look at global issues that Hopkins faculty/alumni are working on.
  • I don’t admire articles that are boastful. A surgical procedure cannot be “perfected,” for example. Excellence should speak for itself.
  • Would like more stories on “regular” doctors who trained at JHH and are out in private practice.
  • Liberal political bias. 2. It’s understandable that the content is upbeat; however, it’s a little “rah-rah-cis-boom-bah” for my taste.
  • One can reduce the size of photographs that usually cover an entire page, and instead put more content there.
  • Sometimes the depth of the subject is deeper than I am able to completely comprehend. Please keep audience in mind.
  • Seldom are there any controversial topics.
  • Hate to throw them out after reading.

Thanks to all of you who took the time to reply to the survey; and rest assured that your comments and suggestions will guide us in our efforts to maintain the magazine’s excellence.  SD