Letter From the Chair - April 2015

My mother recently  celebrated her 90th  birthday, with the help of  200 family members and  friends. The festivities  ran from early afternoon  to late night, moving  from church to home and  ending with an extended  sing-along by moonlight  and series of group photos  that included family  members of all ages –  including her two sistersin-law,  ages 85 and 90.  Through it all, I marveled at their stamina,  energy, and relatively good health.

They make it look easy, but my extended  encounter with our field’s prototypical “complex  older patient” has given me a personal  perspective on the immense resources  required even for healthy individuals with  strong support networks. Something as  simple as managing mild hypertension entails  sophisticated logistics to schedule office  visits, arrange transportation, fill prescriptions,  educate patient and family, monitor  compliance, refill prescriptions, and repeat.  A mild hearing loss complicates every step of  the process and requires its own costly interventions.  My family and I are deeply grateful  to have found an internist who’s a perfect fit  for Mom, willing to juggle all this and make  it look easy.  The broad range of issues and topics covered  in this issue of Reporting Out reflect  the array of challenges and strengths that we  increasingly encounter as our average patient  ages. There was a time when we could look  to “master clinicians” – wise, experienced  veterans of medicine – to provide overarching  training and insight, helping us develop  and sharpen instinct and skill. Indeed, my  late father, an internist, was one of these  treasures: a brilliant intellect, natural teacher,  and uncannily accurate diagnostician who  loved everything about his work. Sadly, as I  discussed with the incoming and outgoing  chiefs of pulmonary, critical care, and sleep  medicine (see article), the “master clinician”  is going through a fundamental change. It’s  literally become impossible to keep up with  the depth and breadth of information, insight,  and analysis that constantly cascades  around us.

The timing presents a unique opportunity: as  our healthcare system continues its unprecedented  transformation, and complex older  patients abound, we need the intellectual  and interpersonal skills of the master clinician  more than ever. So what will replace that  model? We’re still working out the answer to  that question, but you can be sure it will still  feature an updated form of the master clinician.  I’m proud that here at North Shore-LIJ,  especially in the Department of Medicine,  we’re shaping the conversation on a daily  basis. As for the specifics, stay tuned.

Thomas McGinn, MD, MPH, Chair, Department of Medicine,
North Shore-Long Island Jewish Health System, and David Greene Professor of Medicine, Hofstra North Shore-LIJ School of Medicine

From The Chair Archive

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Federally funded collaboration to battle alcohol and drug abuse in the wake of Sandy

Among Superstorm Sandy’s many devastating consequences to the region, this natural disaster has raised the risk of unhealthy substance use as well as incidence of substance use disorders.

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