Authored by: Ryan Nagy, MD, ACP, FAAP
If it wasn’t for that monkey I never would have gone to med school…
“Why do you want to be a physician?” is a common interview question asked of medical school applicants. There’s a variety of common answers including: caring for a sick relative, following in a parent’s footsteps, or being fascinated by the human body.
In my case, it was all of these things. But mostly, it was because I was bitten by a monkey.
After college, I worked at an animal facility. I learned a lot and was lucky enough to participate in the care and treatment of monkeys. One day while feeding a monkey, I was bitten on the arm just above my protective gloves. This was a minor injury, and I thought little of it at the time. I simply filed an incident report and returned to work.
The following Monday I began feeling sick with flu-like symptoms. I was sent to the emergency room, where I was transported to a tertiary care center. It was suspected that the monkey bite had transmitted herpes B, a tropical disease that is universally fatal to humans.
I was admitted to the hospital for a week, where I was pumped full of antivirals and antibiotics in an inpatient unit. My care was overseen by an Infectious Disease team and I was given a grim prognosis if the tests came back positive. The ID team actually sought help from a remote specialist who had previous experience with herpes B and had published his findings.
Thankfully, at the end of the week my blood work came back negative for herpes B and I was diagnosed with influenza. But after my time spent in the hospital, returning to work was the last time on my mind. At that point, I knew I had to follow my life-long dream of becoming a physician.
The Path to Medicine
Soon after, I was accepted at the American University of the Caribbean, progressed through medical school successfully, and became a resident at the Michigan State University Kalamazoo campus. It was there, years later, that I met the Infectious Disease consultant who had assisted remotely with my case. From afar, he had inspired me to pursue medicine, and now as a resident he was teaching it to me on a daily basis. This happenstance occurrence proved to me that all the connections we make, and all the lives we touch, can someday come back to us.
As a Hospitalist Leader…
Following residency, I began work as an attending hospitalist physician. I have been granted leadership positions amongst our IMM hospitalist management group, and in the hospital in which I practice. Having been through the medical system as a layperson and patient, I have an appreciation for the concerns and questions of families and patients. I find that physicians who have had the patient experience themselves tend to have greater empathy and are usually more willing to address patient concerns wholly and thoughtfully.
It’s easy to look at things from the provider point of view, as this is the role we play every day. However, it is important for us to remember that the clinical setting is an unfamiliar environment for most patients. As such, it is imperative that we walk our patients through every step of their care.
Throughout my years of practice, I’ve seen numerous patients return to the hospital soon after discharge, unaware as to why they were hospitalized or which medications they had been prescribed. At some point, we as the medical staff need to review our actions through the eyes of patients and determine if we have done enough to educate and compel medical compliance before discharge.
In today’s healthcare environment, each of us is being asked to provide more care, more quickly, to patients. And while we are consistently asked to work smarter and faster, we are also expected to be thorough enough to eliminate return hospital visits. Sometimes these expectations feel conflicting. In the face of this conflict, I assert that we must choose investment; we must invest the time in our patients’ understanding of their own health and limitations so that recovery can be achieved.
Making a Difference
As Regional Medical Director of Hospitalist Medicine at IMM, I have implemented several interventions to maximize the medical effectiveness of our hospitalist team including:
- Upholding a patient call back program, especially for high-risk patients
- Placing phone calls to family members who may be able to help with discharge instructions
- Using large print on our discharge instructions for items such as medications, follow-up appointments, information about the admission diagnosis, etc.
- Sending a reminder letter to the patient’s primary care physician announcing that the patient was discharged; or making a personal phone call to ensure follow up
- Prescribing medications electronically so they’re available when patients arrive to the pharmacy
- Calling a pharmacy to check out-of-pocket costs for home healthcare of high risk patients
- Setting up home healthcare for those in need of extra monitoring
Clearly there is much we can, and should, do to help ensure the compliance of patients and treat their medical conditions to the best of our ability. As an organization, we will continue to attempt to provide new and innovative ways to bridge this gap and provide the best care possible to our patients.
As individuals, we need to recognize our own deficiencies and proactively seek improvement. We never know when it could be one of us lying in the bed, looking up at the doctor, and hoping they will treat us in the same way we treat our patients.
Ryan Nagy, MD, ACP, FAAP, is a dual boarded physician in both internal medicine and pediatrics. Dr. Nagy obtained an undergraduate degree from the University of Toledo and his medical degree from the American University of the Caribbean. He completed his residencies in internal medicine and pediatrics at Michigan State University.
Dr. Nagy has extensive experience in hospitalist medicine and pediatrics. He joined IMM in 2014, serving in the role of Regional Medical Director of Hospitalist Services, and has proven to be not only an excellent clinician, but a great communicator among the clinical and administrative staff.
As IMM’s hospitalist division has grown, Dr. Nagy has been instrumental in managing the needs of our programs. Under his leadership IMM has developed a ‘hospitalist culture’ and expectations to maintain thriving, compassionate, effective programs. His focus remains on providing the highest quality patient care in each community we service.