Excellence in clinical care requires intellectual rigor, keen observation, empathic communication, an understanding of the context in which the patient lives, and consideration of the individual patient as the center of care.
The ultimate goal of medicine is to improve the health and well being of people. My philosophy as an academic physician is guided by the goal of improving the health and well being of the patients who come to me for help, and for all the patients like them the world over. I do this through excellence in clinical care, development and leadership of innovative models of clinical care, facilitation of clinical research that informs best practices in the care of patients, and teaching future physicians (and nurses, social workers, child life specialists, respiratory therapists, chaplains, and others) to practice and implement best practices that improve patient outcomes.
Health and well being are not simply the absence of disease. Although identifying and treating curable diseases is one strategy to improve health, we practice in an age when there are innumerable chronic incurable conditions that must be effectively managed in a holistic way. Combining expert medical assessment and treatment with relationship-centered care that helps patients to understand and cope with their conditions is essential. I believe that excellence in clinical care requires intellectual rigor, keen observation, empathic communication, an understanding of the context in which the patient lives, and consideration of the individual patient as the center of care.
Providing this type of excellent care, teaching future clinicians how to practice excellence in clinical care, and creating new knowledge about the pathophysiology, diagnosis, and management of new and complex health conditions requires innovative models of care that are responsive to the needs of individual patients and the trends in epidemiology and outcomes of these conditions.
Pediatric and adolescent HIV infection was one such new and complex health condition that appeared in Baltimore as I began my faculty time at Johns Hopkins. I created a comprehensive care clinic based on the scholarly work in academic general pediatrics regarding care for children with chronic conditions, on the scholarly work in nursing regarding interdisciplinary clinical teams and home-based care, on the Hopkins tradition of excellence in clinical research, and on the ethical principle of justice and equal access for vulnerable and marginalized children to clinical trials of promising new treatments for this life-threatening disease.
I expanded the scope of my work to specialize in hospice and palliative medicine, a field that embraces my values regarding individualized whole person care in the context of the family and community, in order to serve as a role model and teacher for colleagues and future clinicians while mentoring junior faculty in their clinical research. Palliative medicine provides the framework for promoting the well-being of patients even as their physical health deteriorates, filling the gaps in disease-directed treatment models in order to achieve our ultimate goal: improving the health and well-being of individuals and those around them.