Whatever decision is best for the patient is the right one to manage the problem at hand.
First and foremost, I consider it a privilege to be a physician. I take very seriously the responsibility given to me by my patients and their families and have their well-being in mind through all my interactions, decisions, and advice I give to them. A patient often comes for help and information at difficult and vulnerable times in his or her life. It is my duty to provide the best possible care to each and every patient at all times.
In genetics, perhaps more often than in other fields of medicine, one has to be comfortable practicing in the ‘gray zone’ with their patients. I am often taking care of patients with extremely rare and complex medical diagnoses for which there is no routine treatment or well described clinical course. However, the fact that their genetic diagnosis is extremely rare and therefore little is known about how to manage the new diagnosis is not acceptable. To that patient or family, their ‘rare’ condition occurred 100% of the time. We must cobble together anticipatory guidance and medical care for that individual by scouring the literature, consulting with colleagues, and drawing from experience. I feel it is my job to instill confidence in a patient and their family that they can manage a new diagnosis, even when there is little traditional data available to do so.
The logistics of clinical care today are often overwhelming—battles with insurance providers, issues with electronic medical record documentation, scheduling inefficiencies, and more. If we are not mindful, these irritations can consume our attention when we should be focused on providing healthcare to our patients. Our best response in these situations has always been to consider the patient first. Whatever decision is best for the patient is the right one to manage the problem at hand.
Finally, it is not possible to practice medicine in isolation. It takes a team of people to provide the best care to our patients and I value the input of all our team members. I trust my teammates’ clinical judgement and have confidence in their ability to function independently. I try to remember to tell them thank you for their work and to remind each member of their value to our team which increases their job satisfaction and dedication to our mission.