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

ADVERTISEMENT

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

  • From basketball to bedside: Finding connection through March Madness

    Caitlin J. McCarthy, MD
  • The invisible weight carried by Black female physicians

    Trisza Leann Ray, DO
  • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

    Dr. Damane Zehra
  • The hidden cost of malpractice: Why doctors are losing control

    Howard Smith, MD
  • How scales of justice saved a doctor-patient relationship

    Neil Baum, MD
  • Rediscovering the soul of medicine in the quiet of a Sunday morning

    Syed Ahmad Moosa, MD
  • Most Popular

  • Past Week

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
  • Recent Posts

    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
    • She wouldn’t move in the womb—then came the rare diagnosis that changed everything

      Amber Robertson | Conditions
    • Rethinking medical education for a technology-driven era in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From basketball to bedside: Finding connection through March Madness

      Caitlin J. McCarthy, MD | Physician

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

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
  • Recent Posts

    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
    • She wouldn’t move in the womb—then came the rare diagnosis that changed everything

      Amber Robertson | Conditions
    • Rethinking medical education for a technology-driven era in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From basketball to bedside: Finding connection through March Madness

      Caitlin J. McCarthy, MD | Physician

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...