Halloween: Tricks and treats of the profession

What do you want to be when you grow up? We begin hearing this question at a very young age, when our interests usually revolve around make-believe and potential career aspirations: being a firefighter, police officer, nurse, doctor or myriad other capeless superheroes.

We then get a chance to fulfill our dreams on one special night in October as we get to be whomever we choose. Although this costumed transformation is fleeting, ghosts, ghouls, witches and vampires alike all relish the opportunity to masquerade around as someone or something different in the name of fun.

All Hallows’ Eve might make the question previously posed a bit easier to answer; however, this question is often a difficult one to address for those of us in the medical community. As medical students, we had—or still have—an opportunity to try on different specialties during our clinical or clerkship rotations. Transitioning from scrubs to office attire and back, sometimes donning PPE and often sporting a coffee- or ink-stained lab coat, offered us an opportunity to experience the unique and exciting world of medicine through the lens of different specialists, but for many of us that changed following the Match. The results of that special day solidified our career decision, and the transition to residency and fellowship training further narrowed our ability to “try on” a different career path.

Specialists share tricks and treats of their trade

For those of us who have experienced this transition and sport a more permanent medical hat, it is still possible (and never too late) to learn a trick or two from our colleagues. In fact, we may even find that these tricks suit us quite well in our current role. To provide a refreshing perspective, I’ve recruited the assistance of some of our osteopathic colleagues to share with us a few tricks and/or treats of the trade that I hope you will find helpful:

Radiology

Erin Horsley, DO (Prisma Health, radiology), shares, “There are many different imaging studies to choose from, which can make it difficult to decide on the preferred imaging modality for a given clinical presentation. When faced with uncertainty, it can be quite helpful to use resources such as the ACR Appropriateness Criteria, which offers guidance on the option that would be both effective and suitable for helping to confirm or evaluate a diagnosis. Of course, when in doubt, do reach out to your radiology colleagues. We can offer guidance on which option would be preferred.”

Emergency medicine

Brock Helms, DO (Prisma Health, emergency medicine), notes, “I find that when I sit down to interview a patient instead of standing bedside or at the computer, I slow down and seem to listen more intently. I feel that the patient feels as though they are heard. I think this is good medicine within itself—just listening. Also, consider using a mobile app such as Duolingo to learn basic phrases in another language, or even take a class at a local community college.”

Psychiatry

Karen Lommel, DO, and Breonna Kinnison, DO (Prisma Health, psychiatry), counsel, “Often, we see polypharmacy when consulted for a geriatric patient with altered mental status or impaired reality testing. It is usually helpful to do a thorough medication reconciliation, as often the altered mentation or impaired reality testing (hallucinations, delusions) resolve once the deliriogenic agent(s) is/are discontinued. If you encounter acute mental status change in a geriatric patient, do not forget to thoroughly evaluate the medication list and check the controlled substance database. The American Geriatric Society (AGS) Beers Criteria is an excellent resource to help identify and curb the use of potentially inappropriate medications (PIM) in the geriatric population.”

Primary care

Lastly, I’ll (Andrew Albano Jr., DO, MBA [Prisma Health, family medicine]) add from the primary care perspective that, as with trick-or-treating, there is safety in numbers. In other words, for us to truly advance health care and further our efforts to provide high quality, cost-conscious and safe care, it is imperative that we stick together.

Taking a cohesive, team-based approach allows each of us to leverage our unique strengths and skills to achieve the previously stated aims while helping to reduce or eliminate variables that often contribute to burnout, such as administrative burden, excessive workloads and a lack of organizational support. In my opinion, we can successfully overcome these challenges, and the many others not mentioned, if we each accept that we can do more together rather than trying to wade through them alone.

Final thoughts

As we wrap up our Halloween festivities and pack up our costumes for another year, I hope that you find these tricks and treats to be anything but haunting. Admittedly, it can be easy to narrow our focus after we have decided on what we want to be when we grow up, but regardless of one’s stage in their career, it is important to be open to learning from those in other disciplines or specialties. I believe—and hope that you’ll agree—that it is a good habit all of us should practice, because great patient and personal care can be some of the most rewarding treats of all.

Related reading:

Why I won’t base my specialty choice on my personality

Requiem for a radiologist