Louisville Medicine Volume 70, Issue 4 - Page 6


The Box

Mabuhay !* Back in residency , one of my internal medicine attendings for my outpatient continuity clinic fondly referred to our clinic as “ the box .” Though I only had clinic one half-day a week , the primary care clinic was his full-time job with the occasional weekend hospital coverage . He loved to ponder about what medicine would be and could be like outside “ the box .” Our discussions soon referred to anything in medicine that did not involve the traditional caring for patients in the clinic or in the hospital as getting outside the box . Our discussions were full of imagination and creativity , and we covered everything from seeing patients from a computer to inventing new ways to diagnose patients without having to examine them . I enjoyed those discussions , imagining what seemed the impossible back then , especially since I hadn ’ t even started my career and could not really see myself doing anything else but seeing patients in the clinic and hospital . That was more than 20 years ago .

Fast forward to the present , and thanks to social media , I have had the opportunity to see my friends and colleagues take leaps of faith and venture outside the box , successfully practicing medicine in new ways . Most of them started in the traditional settings , but took a step or in some cases , a giant leap , to find themselves in a much different setting . Still , they ’ re using their medical skills to provide or even improve patient care . I know several colleagues who have developed apps for use in their specialty . I have a past medicine attending who shifted his focus to medical technology and works with computer gurus internationally to develop cutting edge medical software . I also know several hospitalists who solely provide tele-hospitalist services , where they provide night-time coverage remotely via a robot to rural hospitals .
I , too , have dipped my toes outside the box by shifting part of my career to leadership and hospital administration . Back in residency , it would never have occurred to me to not be seeing patients full-time in an office setting at any point in my career . However , it felt like the next natural step for me when I was asked to become a Hospital Medicine director many years ago . It required me to make a huge career decision , which was giving up my office practice that I was sharing with my Dad and work in the hospital full-time as both a hospitalist and an administrator . As difficult as it was to leave the comfort of my primary care practice , it ended up being one of the best career decisions . Though I don ’ t directly care for patients full-time , I use my medical skills daily in improving patient care in the hospital . I ’ ve also managed to find a fairly decent work-life balance as well .
This month ’ s issue features our colleagues who are practicing medicine outside of the box , or what we once considered a traditional clinical practice . Our challenging health care environment has provided many opportunities for physicians to lend their medical expertise outside of the traditional office and hospital setting . Whether it is delivering medicine in innovative ways , such as through concierge , telehealth or mobile models , or working with other industries to improve patient care , physicians now have the ability to care for a wider population in creative ways that seemed impossible not that long ago . My hope is that this issue is a reminder that as physicians , we can ’ t be limited by the box , and with a little imagination , creativity and faith , physicians can do amazing things in and outside the clinic and hospital walls .
* Mabuhay is a Filipino greeting meaning “ long life .”
Dr . Briones-Pryor is the Medical Director for the Hospital Medicine Service Line for UofL Health and is the Chief Medical Officer for UofL Health Shelbyville Hospital .