This article is a collaboration between 51˶ and:
, is a nephrologist at Massachusetts General Hospital in Boston with an interest in end-of-life care. Eneanya went to medical school at Meharry Medical College in Tennessee and earned an MPH degree from Harvard T.H. Chan School of Public Health.
After graduation, she did her residency at Brigham and Women's Hospital, followed by a nephrology fellowship, also in Boston. She sat down with 51˶ in Boston, where she was talking to physicians about advance care planning. She talked about her passion for medicine and the issues in the field that drive her.
1. What's the biggest barrier to practicing medicine today?
I think it's the bureaucracy that's associated with practicing medicine -- all of the documentation that is required. We're having less and less time to actually do the things that we loved to do in medical school like have face to face interaction and touch patients and be caring. So it really feels like you're rushing through a lot of clinical care today -- either on the outpatient side or on the inpatient side. It's a big problem.
2. What is your most vivid memory involving a patient who could not afford to pay for healthcare (or meds, tests, etc.) and how did you respond?
I was an internal medicine resident at Brigham and Women's Hospital. At the time, the patient had a lot of other obligations with their family; they were dealing with housing issues, and the last priority was medications, especially because she couldn't feel the symptoms of her high blood pressure and diabetes. With the social workers in our clinic we helped her get enrolled in the Wal-Mart Program, where it's a few dollars per prescription. A lot of people don't know about that, actually, and it's surprising. It was a really great way for her to get her medications and still deal with the things she was dealing with.
3. What do you most often wish you could say to patients, but don't?
The biggest thing I wish I could say is that I care too. You're not just some kind of test, where we want to poke and prod you, just to learn from you. And I think a lot of patients can just feel like a test, where they don't understand why. But I don't want to hurt you. I want to help you as much as you want to help you. So if there's a recommendation that we're giving, that you don't quite understand, it's really for your benefit. It's really to get you better or to answer a question that we don't know.
4. If you could change or eliminate something about the healthcare system, what would it be?
I guess it goes back to the bureaucracy, to the check boxes we have to meet to actually bill for a visit or a procedure. There's all of these things you have to do that take away from the face to face interaction with the patient.
5. What is the most important piece of advice for healthcare providers just starting out today?
This is not an easy road. When it becomes difficult for you and you start questioning why you're in this career, really go back to when you were first accepted into medical school, that feeling there, the pride that you had, the goals that you had of becoming the type of doctor that you wanted to be. Remember that passion and that will carry you through. A lot of people will become disenfranchised and frustrated with a lot of things, but the passion doesn't leave people, in my opinion.
6. What is your "elevator" pitch to persuade someone to pursue a career in medicine?
I don't think there are a lot of professions out there -- and this goes back to the passion aspect -- that can be an actual job, one that helps you attain your financial goals for your family and that combines your passion. It's probably the best field in the whole world: I couldn't think of a better field that allows you to combine the work aspect with what you feel like your passion is in life.
7. What is the most rewarding aspect of being a healthcare provider?
I love talking to patients. I don't care if I'm having the worst day of my life, I'll talk to a patient, and we'll laugh, and it's like my day is instantly better. I really like the people aspect of it and the fact that you can build relationships and still help people at the same time.
8. What is the most memorable research published since you became a physician and why?
It's in my field, and it has to do with the mentor that I am working with. She's an oncologist and she published this study a few years ago that got into the New England Journal of Medicine, and it was looking at introducing palliative care early into the care of patients who had metastatic lung cancer. And she did a very structured intervention where she compared patients who were receiving palliative care with patients receiving usual care for their metastatic cancer. And what it showed is that the patients who had early palliative care introduced lived longer.
Which, everyone thinks that palliative care is Darth Vader -- that they're going to pull back care and I'm going to die. But those patients actually lived longer, and that was a very impactful study for me. It really helps drive where I'm going with my research as well.
9. Do you have a favorite medical-themed book, movie, or TV show?
I tend to not watch a lot of medical themed shows, but if there's one, and it got me through medical school, it was a show called Scrubs. And they used comedy a lot, and humor is considered a mature defense mechanism. It really got me through stressful times, and it was pretty realistic with some of the scientific things they talked about in the show.
10. What is your advice to other physicians on how to avoid burnout?
I may be an overly optimistic person, but I feel like you just have to take time for yourself. I love reading, I love exercising, and I love vacations. The best piece of advice that I got was in my first year of medical school when the dean gave a talk and she said, "Take your vacation once a year". I don't care where you are, what you are doing, just make sure you plan it and do that for yourself once a year. And since then I've done that. You can't care for others if you can't care for yourself. And patients know if you're not happy.