Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What it means to be an attending physician

Mary Braun, MD
Physician
October 4, 2019
Share
Tweet
Share

Dr. Ryme had been retired at least thirty years from medicine when he met me, his last pupil. I was a freshly minted doctor, and he became the first teacher of a new course at my new school called “Life as an Independent Doctor.”

At our first office visit, after telling me his life story, he quizzed me, “And furthermore, Dr. Braun, you’re an attending physician now. You are no longer a resident. Do you know what it means to be an attending physician?”

He paused. I searched frantically for something to say that might be a worthy answer.

Dr. Ryme was not the type of man to ask a frivolous question. He did not waste his breath. He was 96.  His lungs were so bad that he had been using oxygen for almost a decade. He had founded a clinic in South Carolina after medical school. When World War II interrupted his career, he met his wife in Europe. They had three children and twelve grandchildren. He now lived with one of these granddaughters in New Hampshire.

Dr. Ryme gave me the answer before I could come up with anything. “Being an attending physician means that you are supposed to attend. Don’t just do something; stand there. Attending physicians attend.”

We were both quiet for a moment, then he said, “I have a great heart murmur. Want to hear it?”

I remember his lesson to this day. When I have a panicked patient who can’t breathe, or who is in terrible pain, I first attend. I slow myself down and make sure that when I act, I am not just doing something, but doing something attentively. I try to think of what the patient really wants two months from now, two years from now. I ensure my actions are pointed towards that patient’s long term goal. Sometimes this means the best I have to offer is just being there.

I think of Dr. Ryme telling me to attend to the patient when someone whose blood pressure is too high requests that I give them one more month to try lifestyle modifications before we commit them to a pill. Attending to the patient, in this case, means ignoring the guidelines, understanding full well that their insurance company will note my score for “percentage of hypertensive patients whose disease is controlled” is not be as good as it could be. I am choosing to attend to the patient and not the numbers by which people other than the patient evaluate the patient’s care.

At other times, the pressure to do something is overwhelming. Human nature seems to think that action is preferable to inaction. As people age, medical interventions become more burdensome on the patient. Side effects that would be minor in a fifty year old can be fatal in an eighty year old. This makes it even more important to remember to balance the risks and benefits of the intervention considered in light of the particular patient, to attend to their wishes and desires.

I attend a lot of things these days: recitals, movies, lectures. But none of them is more important than attending to the person in front of me.

Thank you, Professor Ryme.

Mary Braun is an internal medicine physician.

Image credit: Shutterstock.com

Prev

The public charge rule crosses the line, and doctors need to push back

October 4, 2019 Kevin 6
…
Next

Taking away a senior's smartphone is a complicated issue

October 4, 2019 Kevin 0
…

ADVERTISEMENT

Tagged as: Cardiology

Post navigation

< Previous Post
The public charge rule crosses the line, and doctors need to push back
Next Post >
Taking away a senior's smartphone is a complicated issue

ADVERTISEMENT

More by Mary Braun, MD

  • From passion to burnout: When a doctor’s love hurts

    Mary Braun, MD
  • Miscommunication leads to misunderstandings: the tragic consequences of misinterpreted sobriety

    Mary Braun, MD
  • Depression is a notification that the old patterns are not working

    Mary Braun, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD
  • Embrace the teamwork involved in becoming a physician

    Nathaniel Fleming

More in Physician

  • The dying man who gave me flowers changed how I see care

    Augusta Uwah, MD
  • How market forces fracture millennial physicians’ careers

    Shannon Meron, MD
  • Unity in primary care: Why I believe physicians and NPs/PAs must work together toward the same goal

    Jerina Gani, MD, MPH
  • Guilty until proven innocent? My experience with a state medical board.

    Jeffrey Hatef, Jr., MD
  • How to balance clinical duties with building a startup

    Arlen Meyers, MD, MBA
  • When life makes you depend on Depends

    Francisco M. Torres, MD
  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast
    • How chronic stress harms the heart in minority communities

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • The dying man who gave me flowers changed how I see care

      Augusta Uwah, MD | Physician
    • Universities must tap endowments to sustain biomedical research

      Adeel Khan, MD | Conditions
    • Exploring the science behind burnout [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why palliative care is more than just end-of-life support

      Dr. Vishal Parackal | Conditions
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • A powerful story of addiction, strength, and redemption

      Ryan McCarthy, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Why doctors should rethink investing compared to the average U.S. investor [PODCAST]

      The Podcast by KevinMD | Podcast
    • How chronic stress harms the heart in minority communities

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • The dying man who gave me flowers changed how I see care

      Augusta Uwah, MD | Physician
    • Universities must tap endowments to sustain biomedical research

      Adeel Khan, MD | Conditions
    • Exploring the science behind burnout [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...