How to grow into a master clinician
CHICAGO—Many of us aspire to be master clinicians with the ability to solve any medical mystery, earning the respect and admiration of our patients and colleagues. But there are few practical ways to learn these skills. This fact can pose a problem for trainees, who are seeking to pursue a path toward clinical excellence, and for the educators, who are tasked with overseeing the maturation of rheumatologists-in-training.
At ACR Convergence 2025, a session titled, Masterclass in Medicine: Help Your Learners Develop the Early Career Habits of Master Clinicians, had an engaging panel discussion on this topic and allowed for a fruitful learning session.
The speakers: The session’s three panelists represented an esteemed group of clinicians.
Dr. Ronald Anderson
Ronald J. Anderson, MD, is the director emeritus of the Rheumatology Fellowship Program at Brigham and Women’s Hospital, Boston. Under his leadership, this program has trained more than 200 physicians, many of whom are now rheumatology leaders themselves, both locally and nationally.
Dr. Pisetsky
David S. Pisetsky, MD, PhD, is a professor of medicine and integrative immunobiology at Duke University School of Medicine, Durham, N.C. In addition to authoring more than 500 papers, articles and chapters related to medicine, Dr. Pisetsky has also written creative and narrative nonfiction essays and short stories. He is also the founding physician editor of The Rheumatologist, a role he served in from 2006 to 2011.
Dr. Michael Weisman
Michael H. Weisman, MD, is professor of medicine emeritus at Cedars-Sinai Medical Center, Los Angeles, where he has served as chief of the Division of Rheumatology. Currently, he is also adjunct professor of medicine in the Division of Rheumatology and Immunology at Stanford University. He has published more than 500 peer-reviewed papers, edited 12 books on rheumatic diseases and continues his mentoring of early career investigators in rheumatology.
Mentorship
The session began with each panelist discussing the mentors and role models who had lasting impacts on each of their careers. Several characteristics of good role models for being a master clinician emerged from this discussion. These role models:
- Actively engage learners and challenge them to think independently;
- Pay attention to the hidden curriculum (i.e., things that are demonstrated implicitly, such as taking an interest in the patient’s life outside the hospital or clinic);
- Keep track of what they have learned from each patient’s case in a systematic fashion to fuel lifelong learning; and
- Show trainees that it is never too late to change your path in medicine.
On this last subject, Dr. Weisman shared how he had already agreed to pursue a nephrology fellowship when he encountered Nathan Zvaifler, MD, a rheumatologist at the University of California, San Diego. Dr. Zvaifler emphasized asking such questions as “What is the mechanism for why this is happening?” and “How does the patient feel about what is going on around them?”
Dr. Weisman was so inspired by what he learned from Dr. Zvaifler that he decided to become a rheumatologist instead of a nephrologist—and has never looked back.
A ‘Good Doctor’
Dr. Anderson shared his thoughts on what it means to be a clinician rather than a technician. He noted that a master clinician has great medical knowledge and technical skills—and is often sought after by colleagues for sage advice. But they also are able—as said by Philip Tumulty, MD, a legendary physician at Johns Hopkins Hospital, Baltimore—“to manage a sick person with the purpose of alleviating most effectively the total impact of the illness upon that person.”
A technician goes through the motions, dutifully taking a history and working to solve discrete problems for the patient. Meanwhile, a clinician takes the holistic view of a patient’s care and attends to their social, psychological and overall health and well-being.
Dr. Pisetsky provided an interesting twist on what it means to be a good doctor in the eyes of a patient. He agrees that it’s important to build rapport with patients and establish strong therapeutic relationships with them whenever possible. However, he recounted his own medical ordeal. He had been suffering from acute back pain and—after seeing many providers—was still without an answer. Finally, a doctor made the right diagnosis and provided an effective therapy.
For Dr. Pisetsky, these efforts made all the difference. He did not say that he has—or needs—an ongoing therapeutic relationship with this doctor. Yet, he feels grateful that this physician fixed the specific problem he needed addressed.
This anecdote emphasized for the audience that, sometimes, just doing one’s job and focusing on the specific medical issue at hand is a demonstration of clinical excellence and all the patient truly desires.
From the Q&A
The session was highly interactive, with about half of the time devoted to questions from the audience.
One first-year fellow asked how it is possible, in this modern era of busy in-patient rotations, note-writing and endless electronic communications, to find the time to connect with patients. In response, Dr. Weisman asked, “What made you want to be a doctor?”
The ensuing discussion demonstrated that as long as a clinician remembers the goals and values that drove them to a career in medicine, it’s possible to hold true to these principles and make connections. Although doing so may not be possible every single minute of the day, small actions—such as displaying attentive listening skills, recognizing and validating the patient’s experience—don’t always take a lot of time or effort. Through these small actions, a doctor can have a profound impact on the patient’s life.
Another audience question dealt with how doctors can maintain their professional identities as healthcare system and societal changes continue to evolve what it means to be a physician. To this, the panelists recommended staying grounded in one’s core values, advocating on behalf of the well-being of patients and trainees whenever feasible, and staying connected with colleagues to share stories of success and failure.
In addressing this question, Dr. Pisetsky reflected on his lifelong passion for writing, something he feels has increased his powers of observation and allowed him to express himself. In a recent book on master clinicianship, he wrote, “The journey to being a doctor is long and arduous. It is a passage filled with ritual, myths and mystery. The journey does not end with medical residency or fellowship. It is lifelong, continuous and forever forges new ways of thinking, builds empathy and, in the collaboration of patient and physician, can instill grace, equanimity and compassion.”1 (Editor’s note: Dr. Pisestsky took the time to review the plethora of research presented on psoriatic arthritis at ACR Convergence 2025 and shares his thoughts on what stood out here.)
In Sum
Judging by the engagement of the audience, it’s clear that attendees will take these sentiments with them back to their clinics, hospitals and conversations with young rheumatologists in training, who—with support and guidance—will become the master clinicians they aspire to be.
Jason Liebowitz, MD, FACR, is an assistant professor of medicine in the Division of Rheumatology at Columbia University Vagelos College of Physicians and Surgeons, New York.
Reference
- Bolster MB, Liebowitz JE, Seo P, eds. Masterclass in Medicine: Lessons from the Experts. CRC Press. 2024 Oct:122–129.
