To avoid burnout, “try to make every patient smile and laugh before you leave them,” James Blankenship, MD, MHCM, tells MedPage Today in this installment of 10 Questions.
Blankenship became president of the Society for Cardiovascular Angiography and Interventions (SCAI) in 2015. He is an interventional cardiologist at Geisinger Medical Center in Danville, Pa., and director of the Geisinger Cardiology Department and cath labs. He also serves as an adjunct professor of medicine at Temple University’s Lewis Katz School of Medicine in Philadelphia.
Healthcare and payment model reform are of particular interest to Blankenship, who takes annual trips to the Dominican Republic to provide medical care with Solid Rock Missions, a Christian group.
1. What’s the biggest barrier to practicing medicine today?
Requirements and regulations regarding documentation, pre-authorization, coding, admission, and discharge from institutions, departments of health, the Joint Commission, and other accreditation bodies.
2. What is your most vivid memory involving a patient who could not afford to pay for healthcare (or meds or tests, etc.) and how did you respond?
A surprisingly high proportion of patients with ST-segment elevation myocardial infarction (STEMI) in rural Pennsylvania have not seen a doctor in 10 years. Some don’t like doctors; some can’t afford medical care. In the acute care setting, we have the luxury of treating them all the same. I tell them whatever their financial status, they have to find a family doctor.
3. What do you most often wish you could say to patients, but don’t?
I wish I could share my Christian faith with them.
4. If you could change or eliminate something about the healthcare system, what would it be?
I would eliminate insurance companies altogether.
5. What is the most important piece of advice for students or clinicians just starting out today?
Find a mentor who is interested in you and will help advance your career. Then mentor others when you have the opportunity.
6. What is your “elevator” pitch to persuade someone to pursue a career in medicine?
There is nothing more fulfilling or meaningful than helping another person. Medicine is one of the best ways to do that.
7. What is the most rewarding aspect of being a clinician?
Today at 2:18 a.m., I left the emergency department with a patient with acute myocardial infarction, chest pain, complete heart block, emesis, and systolic pressure of 90. Twenty-one minutes later she was in the cath lab with a stented artery, normal sinus rhythm, systolic pressure of 120, and no chest pain or nausea. The patient was very grateful, because she thought we had saved her life.
8. What is the most memorable research published since you became a clinician and why?
The PAMI (Primary Angioplasty in Myocardial Infarction) study by Cindy Grines which demonstrated the superiority of PTCA over lytic therapy for STEMI. It led to what is now a standard therapy that has cut acute mortality of MI by over 50%.
9. Do you have a favorite medical-themed book, movie, or TV show?
In the novel The House of God by Samuel Shem, the intern Roy sees his resident, the Fat Man, walk into clinic and be mobbed by his adoring patients. The Fat Man shares that his patients don’t really want medical advice, they want someone to hold their hand, listen to their stories, and talk to them.
10. What is your advice to other clinicians on how to avoid burnout?
As much as you can, follow your religious faith first, care for your family second, and don’t let work push faith or family to the side. Exercise daily and keep fit. Try to make every patient smile and laugh before you leave them – and try to do that with everyone else you meet as well. Be optimistic. Look for the good in every person and every situation.