Provider wellness is beginning to take center stage in health care as professional organizations and licensing bodies realize the need to tend to our emotional health so that we can bring our best selves to the work of caring for others.
At OHSU, we’re known for our School of Medicine Resident and Faculty Wellness Program and are exploring additional ways to promote physician engagement and fight burnout. I also like the American Medical Association’s national campaign around reconnecting with the joy of practicing medicine. I find joy in the service aspect of medicine, especially in taking care of veterans.
When I was a medical student, my third-year internal medicine clerkship rotation was at the New Orleans Veterans Affairs Hospital. The satisfaction I derived from those experiences stuck with me. Ever since I have been at OHSU (26 years now!), I have also been a VA physician and have kept my inpatient and outpatient clinical duties at the VA going, even since becoming dean.
Many people don’t realize that veterans who access VA care are often economically disadvantaged. If they have resources, then the VA copay is quite high (it’s higher than the Medicare copay). So the VA is the safety net hospital and health care system for veterans. That’s one of the reasons I like caring for these patients. VA patients often have complex conditions, sometimes caused or exacerbated by their military service. It’s an honor to serve them back.
I’m a nephrologist, so I focus on kidney disease. In addition to seeing patients at the Portland VA, I spend two days every month seeing clinic patients at the Roseburg VA, about 180 miles south of here. I’ve been doing that for 19 years now and will be there again next week. It’s a real labor of love.
My job with these patients is to diagnose or manage their kidney disease. Sometimes this means helping them transition to dialysis or to a kidney transplant -- or seeing them come off dialysis when they are lucky enough to get a kidney transplant.
I don’t just care for patients; I also care for their families by educating them about kidney disease and how to take care of their loved one.
I also frequently have the conversation with family members about whether a frail elderly patient with chronic kidney disease should go onto dialysis. Dialysis is time-consuming and physically taxing. Just because we have these technological tools does not mean that using them is the most compassionate care. So we decide together on the goals of care, which sometimes means electing comfort or hospice care, rather than dialysis. That’s my job too.
This week, I had a chance to stop by the dialysis unit at the Portland VA and visit with a patient I’ve known since I came here.
Richard Waliser grew up in Milton-Freewater, Oregon, and served a tour of duty in Vietnam, heading out for his first firefight a month after turning 21. He remembers being surrounded and compelled into hand-to-hand combat like it was yesterday.
Some years after returning home, he developed kidney disease. He has survived on dialysis for a staggering 28 years.
I told him this week how proud I am of him; how well he has done.
After I left, someone told him about my new job as dean of the School of Medicine and that I’m only the second woman to hold the position in the school’s 130-year history. He said he was proud of me too. And he paid me the kind of compliment that will keep me coming back to visit him and all my other patients:
“She makes you feel like when you’re talking, you have something to say.”
This Veterans Day, I’m grateful for Mr. Waliser and the men and women who served our country and now entrust us with their care.
This Viewpoint piece is an expanded version of a speech Dr. Anderson gave at the OHSU School of Medicine Alliance luncheon in October titled “At the heart of healing: how practicing medicine is first about service.”