Plan: Making Request a day in the Life of a Doctor

A Day in the Life of a Doctor
A doctor who is employed in a hospital has to attend his duty according to schedule. I am, however, here going to describe a day in the life of a doctor who is self-employed and works at his own clinic. I’m talking about a well-qualified, popular and reputed doctor.
Such a doctor is first of all very conscious about his own health. A doctor who himself is not healthy can’t leave a good impression on his patients.
The doctor gets up early in the morning and prays to God. This may seem strange. But a truly good doctor is also a man of faith. He believes that he only treats and it is God who cures.
After praying to God, more in his heart than with his tongue and lips, he goes out for a long walk. He takes regular exercise. As he returns, he has a bath and then his breakfast and leaves for his clinic.
Before he reaches his clinic, the sweepers has already swept the floor of the clinic and the compounder is at his seat. Often a number of patients are sitting on benches, chairs or sofas and waiting for the doctor.
Some doctors think that going to clinic later than the scheduled time is a matter of pride, prestige and dignity. But, I think, they are mistaken. The patients appreciate only a doctor who is regular and punctual. In any case, it seems unethical to keep anybody waiting just to display one’s self importance and false egoism.
A really good doctor charges reasonable fees. He calls the patients strictly according to their turn. However, seriously ill patients may be attended prior to others. Such a doctor examines each patient very carefully and prescribes the best treatment he can think about. He does not ask his patients to go in for any unnecessary tests. He prescribes only those tests which are essential for proper diagnosis of the disease.
The doctor closes his clinic for lunch and reopens it in the afternoon. He examines the patients till 9 or 10 pm and returns home thereafter. He often has a nurse to assist him in his work. If he is a specialist in any particular area, he only prescribes medicines, but if he is a generalist, he generally has a pharmacist to deliver and administer medicines from his own small drug store.
A good doctor is ready to serve patients even at midnight. He may get high fees from rich men, but he treats poor patients free or at nominal charges. Such a doctor is an asset to society.
This statement sums up the life of a doctor quite nicely. Of course, there is no such thing as a “typical” day. Each day is different, and there are many types of doctors. There are gynaecologists, endocrinologists, oncologists, gastroenterologists and the list is endless. S, it is very natural that their life can’t be the same. So, here is a description of how a day of a doctor really looks like.
Well, the eight or more hours of work are all about back-to-back meetings. A doctor’s bread and butter is seeing patients, and each appointment is essentially a meeting with a client. You check the details of the case, try and get a sense of what’s going on, and then figure out the medicines–often trying to do this within a half hour.
The thinking process is a lot like troubleshooting a broken device, only it’s from a foreign manufacturer. You possess thousands of different but crude tools, and you can only try to fix the device so many times. When someone comes in with a complaint, you think of a bunch of things it could be (your differential diagnosis) and then ask questions to try and narrow it down and separate it from similar problems. Then you choose your tests and hope that you can pin down the source of the problem to something in particular (your diagnosis). Then you figure out if the problem is fixable.
The finer details of the job depend on the work setting. If you work in a hospital on a medical team, it’s like being an officer in the military, or a middle manager in a large company. Middle managers don’t do the grunt work–you’re paid to figure out what work needs to be done, make sure that the work is done, and bear the responsibility of right and wrong decisions. It is accomplished by a lot of paperwork–meeting patients to find out their issues, documenting your findings and your thinking process, writing orders, communicating those orders to other healthcare professionals to act on them.
If you work in a clinic, it’s more like being a small business owner. The work is the same, but you have a bit more autonomy and control over the setup, though you aren’t able to get your results or make changes quite as quickly. We spoke to some doctors to understand what their routine is to better understand the point in question.
“I work four days a week for about 10 hours a day. I have my own clinic as well as work for a well-known hospital. My day usually starts at 9 am, and I prefer taking new patients first as they take more time than follow-ups. Since I am a neurologist, I have to sometimes rush for emergency cases to the hospital and take care of the patients. I spend a considerable time in reading up the patient history before I start my day. After having back-to-back patients till 1 pm, I come home for quick lunch. I go the hospital in the evening, and it’s the same routine of seeing patients.
I am also involved with my children’s schools and sports activities, so I make it a point that I squeeze in some time for it. I enjoy my work but I work hard, and then in late evenings, I spend time with my family and friends.
I also travel for meetings and conferences. I usually take my family with me on these trips so they can enjoy the experience of new cities.
“I don’t have a typical day. I generally begin the day performing rounds at the hospital. This involves going to various patients (such as the newborn nursery and paediatric ward), where he/she visits with the patient’s family members, takes vitals and checks the patient’s status. After two or three hours of rounds, I go to my private office to begin patient appointments. The busyness of the day sometimes depends on the season – for example, wintertime tends to be a busier season for paediatric appointments due to flu season and other wintertime ailments. Throughout afternoon, I am generally signing forms, writing prescriptions and conducting other necessary paperwork. Most of the times, I end my day around 6:30 or 7:00 p.m., but this varies.
Overall, my day is very busy. Patient appointments are one small part of a paediatrician’s job – but that small part impacts the lives of many people. I try not to schedule anything work-related on the weekends, but we occasionally have community outreach events that take some time.
This is how it’s like to be a practising doctor. It’s hard to describe one day because every day is very different. As long as doctors come equipped with a great attitude and a stethoscope, their is exciting with many opportunities to learn and develop their clinical skills.
I will never forget her eyes, sunken and dimly lit with the dying embers of hope. She was scared, exhausted, and wildly scanning the room filled with doctors, nurses, and hospice workers, looking for reassurance and any good news we could provide about her husband. Looking for a friend to say this was all a big misunderstanding. The young woman sat and waited for the emergency medical meeting to begin, desperate to know the prognosis.
Just 3 days prior, her perfectly healthy 39-year-old husband suffered a massive heart attack and was rushed to Houston Methodist Hospital in an unconscious state, precariously positioned on a thin ledge between life and death. After multiple operations, he landed in Bed 1 of the Cardiovascular Intensive Care Unit with all eyes on him. The medical team included cardiothoracic surgeons, cardiologists, pulmonologists, intensivists, and nephrologists who did everything possible to preserve life: two mechanical heart pumps, maximum doses of intravenous pressors, full ventilatory support, and continuous dialysis. But the patient was not getting better and remained in severe heart failure.
Heightening the challenge of an end-of-life discussion, the young woman spoke little English. She and her husband emigrated only months earlier from Vietnam, and they had been in the midst of their happiest days. A new baby due in 8 weeks. A new business. At a time when the photo albums would be overflowing with life's milestones, the young woman sat around a circle of strangers pleading for good news through a translator.
After introductions were made, the young woman's attention focused on the attending physician, and the meeting began. The attending spoke, “Thank you for meeting with our team today. As you know, your husband had a large heart attack, and we are doing everything we can to keep him alive. Unfortunately, his heart is failing and not showing signs of returning function.” We watched her as the translation was received.
She leaned forward expectantly, not fully certain of the news, and her expression pleaded for more information. Her voice trembled as she struggled to say, “But he can recover….”
A slight pause, and the attending continued. “I am sorry... but the chances are very low.” The room held its breath. “He is dying.”
Her gaze dropped and the last flicker of light went from her eyes. No translation was needed for the immense pain she felt or the heavy cloud of silence encasing us all. No words could break through and interrupt the moment she was coming to understand her husband would die. The veil of secrecy had been lifted, and she was now confronting the horrible truth we all knew and shared.
The question she had spent the last three days gnawing over had been answered, and she quietly sobbed. After a few minutes, she bravely collected herself and addressed the team.
Armed now with expectations and an appreciation for the grim prognosis, she spoke freely and thanked everyone profusely for helping her husband and supporting her. She thirsted for more information and trusted the team with many more questions: how this could happen; how we were certain and if he had any chance of pulling through; how much time she had left with her husband and whether she could stay with him past visitation hours.
The wall between family and medical team was demolished because of the shared understanding of prognosis, and different members of the team could answer her questions honestly and directly. The cardiologist informed her that no one could have predicted this tragic event in a healthy man this age. He thought there was less than a 5% chance of the heart surviving the week. The intensivist promised her that no one would ask her to leave her husband's side at any time. The palliative care team offered their advice for getting family assistance, ways to break the news to her own family, and alternative perspectives regarding her new baby, which could be the blessing to help mend her broken heart. She was encouraged to sit by her husband now “to say everything in your heart, to say everything that needs to be said.”
The young woman listened intently, noticeably calmer now by having more information and the near certainty of death. She signed a DNR order to avoid further suffering. She left the meeting and went to sit beside her husband, savoring the time and opportunity for closure of an episode she would undoubtedly relive for the rest of her life. She cried more, but the terror of the unknown was gone.
One of the biggest temptations in medicine is offering false hope; we often believe that good news builds trust while bad news alienates us from our patients and our very purpose of treating people. Prognosis is sometimes guarded, and the process of dying can be kept secret. But the hubris of promoting an unlikely turnaround robs patients and families of the opportunity for closure and quality moments together in the sunset moments of life.
Sadly, our patient died the day after the meeting, but I'm confident he would approve of how his wife was spoken to and treated. Providing an unambiguous prognosis allowed her to cross the threshold and begin her grieving. The young woman sat beside her husband and held his hand with understanding of the significance of their final hours together. What better medicine is there at the end of life?
Through the generosity of Charles R. Millikan, D. Min., vice president for Spiritual Care and Values Integration, an annual award competition was established at Houston Methodist Hospital among the resident staff. To enter the writing competition, residents must submit a poem or essay of 1,000 words or less on the topic, “On Being a Doctor.” A committee of seven was selected from Houston Methodist Hospital Education Institute to establish the judging criteria and select the winning entries. The following is the first-place winning entry for 2015; the second- and third-place winning entries will be published in the next two issues of this journal.
The human life on the earth is full of pleasures and sorrows, ups and downs, strength and weakness and health and illness like day and night these happenings are inherent in everyone’s life cycle. But it is silver lining that there are noble people who work all their lives to mitigate the sufferings of the others. Among them, the profession of doctors is perhaps most respected for service to the society.
A doctor dedicates his life to the service of the patients. He or she relieves the sufferings and pain of mankind. He cures them from disease and illness. He strives to make the life of others better and healthier.
The doctor works to prevent spread of the epidemics. Every now and then dangerous diseases grab the humanity. It is the doctor who finds the cure. Sometimes it may take years of painstaking work and research to find the cure, but ultimately the success is achieved.
As a result we find that the fields of medicine and surgery have advanced beyond imagination. A damaged organ can be transplanted, in today’s medically advanced world.
A doctor’s life is hard. Often, he has to visit the patient at off hours foregoing his rest, sleep and even food. Sometimes the doctor has to work throughout the day and night attending to serious patients or victims of war, epidemic or major accident. He has to always treat his patients with a smile and cheer. He motivates and encourages sick person. He is a source of hope and strength. Even in distress his duty is first towards his patient. Always remembering the famous Hippocratic oath, he pledges his life in alleviating the sufferings of the patients.
India has a long tradition of service to the mankind. It is ingrained in its culture and all the religions.
As a result, Indian doctors are well known for their charitable attitude, dedication, hard work and personal touch. They are in great demand all over the world. Many Indian doctors are working in famous hospitals abroad.
India is a country having one of the largest reservoir of doctors. It has about 300 medical colleges, which produce about 30,000 doctors every year. They work all over the country in the cities and villages, in large hospitals or their own clinics. In recent years there has been a great leap forward in the modernisation of our hospitals with latest equipments. This has facilitated the doctors to undertake complicated operations and treat critically ill patients with success.
Besides allopathic systems of medicines, there are doctors who practice Ayurvedic, Unani and Homeopathic system of medicine. Innovative practices of treatment, like the Chinese acupuncture and acupressure, yoga, Nature cure etc. have also gained popularity in the country.
The doctors practicing traditional systems are locally available and often called ‘barefoot doctors’. There is a revived interest in these systems of treatment and many allopathic doctors combine their treatment with traditional methods like yoga, nature cure and Ayurveda. The whole purpose is to serve the mankind and remove the pain and sufferings of patients. In this respect, the society is indebted to the profession of doctors.