Tips for Mastering the Art of Patient Care

[AUDIO LOGO] Welcome, everyone. I'm Dr. John Whyte. I'm the Chief Medical Officer at WebMD. We've been talking a lot about burnout in the health care profession, especially among nurses and doctors. And it started before the pandemic, long hours, administrative tasks that overload the day, battles with insurers, constant flow of information. It can be exasperating.

We all want to provide excellent patient care despite the challenges we face. How do we do that? My guest today has a book out that may have the answers. Dr. Michelle Kittleson is the Director of Postgraduate Education and Heart Failure and Transplantation, Director of the Heart Failure Research, and Professor of Medicine at Cedars-Sinai. Her new book is entitled Mastering the Art of Patient Care.

Dr. Kittleson, Thanks for joining me today.

I'm so excited to be here. Thank you for the opportunity.

And I'm excited as well. I want to start off with asking you, how is practicing medicine today different than it was 20, 30 years ago? Because every generation has had their challenges. So what's different today?

I would say the most important thing that is the same is that our priority remains trying to touch every patient we encounter by helping them feel better and/or live longer. But what has changed is our ability to do that in a seamless fashion. And that comes from a lot of different sources. One, the mountain of information you need to know is a blessing and a curse.

The blessing is there are so many scientific advances. The curse is it's almost impossible to be up to date on everything you need to know. The second problem, I think, is one of expansion. We live in a world now of bigger and bigger systems. So instead of feeling like you are charting your own course, you and your patient together as a team, the team has become much larger, with so many more layers involved. So sometimes, you feel more like a cog in a wheel as opposed to the fearless explorer charting their course to better care for your patients.

You talk about in the book that medicine's an art as well as a science. But I have to tell you, Dr. Kittleson, we talk a lot about tech here at WebMD and Medscape, all the amazing innovations that we've seen. Is medicine becoming more tech and science? Where's the art nowadays? Is that part of the problem?

So I would say medicine is an art and a science. But a better way to put it is medicine is an art that uses, that requires science. So we are blessed to have the tech that-- thank goodness for places like WebMD that celebrate the technology of medicine. But it takes an art to understand how to apply that technology to an individual patient and not just the judgment to know how to apply it, but how you effectively communicate it so you establish that trust so the patient understands, believes, knows that it is the right path of technology for them.

Now, you and I have had the opportunity to talk before. You've been on some projects we've worked on together at WebMD and Medscape. And something that I learned about you that I didn't know by reading your book-- and correct me if I'm wrong. You're a fifth generation physician. So a lot of physicians in your family, right?

Congratulations, first of all on that. But does that color your thinking? Maybe that gives you more optimism. How are your thoughts different than someone who's starting medicine today?

Well, I guess I'll never know if it's nature or nurture that makes me love medicine so much. As the fifth generation, it's impossible to say. And it is true that the reason I went to medical school is because, as an only child, a fifth-generation daughter of Indian immigrants, I was told that was I was going to do.

And I'm so lucky that, from the very first day, it was the most amazing thing in the world. So perhaps my background prepared me for the rigors of medicine. My parents absolutely brought their homework with them. They absolutely engaged in vigorous discussions at the dinner table about complicated patients. But to me, that was inspiring.

Yes, medicine becomes your life in the sense that you're so dedicated to honing your craft, perfecting your craft, doing everything you can to do the best by your patients. And that's not to say work-life balance isn't critical. But to me, it was very inspirational to see not only their incredible fund of knowledge but how they applied that fund of knowledge to help patients feel better and live longer.

So your book is entitled Mastering the Art of Patient Care. What's your top three tips to listeners that can help them maximize patient care? We all want to provide quality outcomes, of course we do. But how do we do that in the current ecosystem?

Well, I love this question. And the first tip will focus on medical students. My top tip for medical students is to recognize that part of going to medical school isn't fun, and it is hard. But that hard work is valuable and important and will pay dividends. And you have to spend the time to learn the foreign language, the grammar, and the vocabulary of medicine before you will delight in the poetry of medicine.

The second tip is for women in medicine. There's actually a chapter in my book entitled, "Women in Medicine" in parentheses, "Men, Don't Skip this Chapter."

I was going to say that I did not. Everyone has to read that chapter. So tell us what's your tip there.

I would say this might be focused on women, but I think it applies to all of us who are trying to achieve balance between our family and our profession. And my advice for that group of individuals is to remember that life happens in stages. And there are seasons, so that what you do fresh out of training may not be what you do decades later and that if you keep your priorities as taking the best care of patients, taking the best care of your family, everything else will ebb and flow, whether it's research or education or administrative or hobbies outside of medicine.

There will be seasons for those. And you should give yourself permission to say no to certain opportunities if they don't meet your goals at the moment, which might be focusing on your family, focusing on your patients. Your priorities or right because they're yours, not because someone told you it was important to do it.

And they're going to change over time. So that's a great point.

And it's just so valuable to know they can change over time, that your life will evolve as your interests evolve.

OK, third tip is for those physicians who've been in practice for a while who feel they're at the point where they know the medical facts. And they know how to apply them. But they've gotten to the point that they've lost some of the joy in medicine.

What are you supposed to do at this point? And I would say it's so important. There are so many cures for burnout. And I think the most ineffective cure, actually, is working less. It's not that we want-- we don't want to work hard. We all love, we rejoice in hard work. But you want your hard work to mean something. You want to be fulfilled.

And I find when I'm approaching those moments, I go back to my cabinet of mentors, trusted colleagues, advisors to vent, to discuss in a safe space. So I would say, if you feel you're at that point where you're not deriving the joy from your career, you need a reset of your perspective, it can sometimes be extraordinarily helpful to reconnect with those trusted colleagues and mentors to debrief and find a way out.

Well, those are great tips, and you have many more in your book. Where can folks find out more about you as well as your book?

My book is available at your favorite online bookseller. Springer is the most reliable source, as I'm happy to say Amazon usually sells out pretty quickly before they restock. And you can also find me on Twitter where I share tips for new docs with my hashtag #KittlesonRules.

Dr. Michelle Kittleson, thanks for taking time today.

It was such a pleasure. Thank you so much. [AUDIO LOGO]