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Rheumatologists want to be the best clinicians possible, provide consistently exceptional care to patients and serve as role models for colleagues and trainees. In the Lessons from a Master Clinician series, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology.
Michael H. Weisman, MD, is a professor of medicine in the Division of Rheumatology at Cedars-Sinai Medical Center, Los Angeles. Dr. Weisman’s academic and research interests involve the genetic risk, epidemiology, treatment and outcome of rheumatic diseases, including clinical trials, outcomes research, and health services research and genetic
susceptibility/severity studies of patients with chronic rheumatic disease.
TR: In your opinion, what makes for a master clinician?
Dr. Weisman: It is easiest to answer this question by defining the role of the master clinician as a consultant.
As a consultant, [you must] always [consider] two needs—that of the patient and that of the consulting doctor who sent the patient to you, usually a primary care physician or another rheumatologist, who wants your opinion. The patient need is usually straightforward: What is the problem (wrong diagnosis, wrong treatment, etc.)? But the doctor issue takes experience and learned skills. You have to figure out exactly why that patient was sent to you. What were the barriers that prevented the referring physician from figuring out what’s going on: Was it his/her attitude on a personal level, was he/she too busy, were the patient’s real concerns not being addressed in spite of adequate disease control, etc.?
You cannot always take over the patient’s care in every one of these situations, so you have to figure out what is in the best interests of the patient and communicate it in a meaningful way to the referring doctor.
It is like every collaboration you do, even in research—the ultimate success is figuring out other peoples’ needs and not your own.
Indeed, treating the disease and managing the patient are two separate issues, and understanding this concept is important in working well with colleagues.
