Top 10 Do's and Don'ts in Medical Practice: Advice For Younger Colleagues

I was recently asked to give a talk to our county medical society about mentorship to some of our younger colleagues. After careful deliberation, and considering all the mistakes I have made, I came up with a top 10 list of do's and don'ts:

  1. Always look both ways when crossing a one-way street. A certain amount of paranoia may be healthy in the current environment of our medical field. Never assume anything. Listen to that "inner voice."
  2. The first rule of pediatrics: never disagree with a mother with regard to her child. The mother is almost always right. "Should I give Johnny some extra fluids?" "Yes, I was just going to suggest that!"
  3. Respect the chain of command. I stole this one from the Army. Make your life easy for the person above you, and be nice to the person below you. Remember the old saying: see one, do one, teach one. Learn from the person above you. Be a "go-getter" for your superior, and he/she will be more likely to teach you. Be nice to the person below you; you can teach them a lot.
  4. Expect the unexpected. Plan for the chaos. But also take care of your family. Take a day off on special occasions. It takes the stress out of it. Without fail, all hell breaks loose when you are trying to get home early for your spouse's birthday.
  5. Do not yell at the nurses. (It doesn't work). Inject a bit of humor at the right time. My least favorite call is the 3 a.m. page: "Doctor, Mr. Jones needs a diet order." Now I have two choices. If I yell at the nurse for such a menial page, I will make an enemy for life (the nurse), I get worked up and cannot get back to sleep, and Mr. Jones is still hungry! On the other hand, I might say: "I recommend the lobster bisque, followed by pheasant under glass paired with a nice chardonnay, and finish with some crème brûlée." After falling off his/her chair from laughter, he/she announces that the hospital is all out of it. I then order a regular diet, I go back to sleep and everyone is happy.
  6. Don't get stuck on stupid. I also stole this one from the Army. Do not keep trying things that are not working. For example, don't try to dilate a severely calcified lesion with a balloon – get the Rotoblator out!
  7. The M+M rule: never miss a meal or a meeting. I learned this from my surgery friends. You never know when you will be up all night working, so fuel up when you have a chance. Go to all the meetings you are supposed to go to ... If you don't take care of business, someone else will.
  8. Don't be afraid to say "I don't know." No one knows everything. Ask questions if you don't know something. Tell the patient: "I don't know about that subject, but I will inquire and get an answer for you."
  9. Be honest with your patients, but be diplomatic. For instance, never use curse words. Don't call your patient "fat." You might say: "Mr. Johnson, you are above your ideal body weight. Let's revisit your diet and exercise program."
  10. Always try to get in the last Thank You!

This article was authored by George J. Linsenmeyer III, MD, FACC, governor of ACC's West Virginia Chapter.