Have you ever wondered why your physician chose to become an internal medicine doctor in Raleigh? Or what it is that he/she finds so rewarding about the practice of medicine in Raleigh NC? Let’s face it, the road to becoming a physician is strenuous and a tremendous commitment of time and energy. Even after the years of study and residency, you still have to stay up to speed on the latest advances in medicine, pass certification exams, and participate in formal continuing medical education tasks. What kind of person makes these sacrifices and chooses this path?
Many people assume that doctors offices in Raleigh NC make a lot of money and that this is a driving force for entering the medical field. But if you took all of the hours that they must dedicate to becoming a physician and all of the hours that they spend daily completing the necessary tasks associated being a good physician; you will find that their “hourly rate” is not nearly as much as most think. I have had the pleasure of working in health care for over twenty years and have long admired the dedication, compassion, and sacrifices physicians make. I now have the pleasure of working along the side of a team of physicians with a passion for caring for patients like none I have ever seen.
I recently became privileged to an interview questionnaire that one of our finest completed for a college student’s assignment (something few busy physicians would take the time to do). I was so struck by his candid and sincere responses I asked his permission to publish them for others to see and he humbly agreed. For those of you that might already be his patients, I’m certain your stories could echo my observation of a caring and dedicated physician that goes beyond caring for people…he also inspires!
Matt Johnson, MA, MBA
Chief Administrative Officer
Wake Internal Medicine Consultants, Inc.
Below are excerpts from this insightful Daniel “Dan” Mollin, MD interview:
1. Could you give me a brief overview of your area of work/ your profession?
DR. MOLLIN: I am an internal medicine doctor in Raleigh. I partner with patients from age 17 till the end of life. I not only evaluate, diagnose and manage acute and chronic conditions but work very hard to engage patients on their own path of wellness.
Acute conditions can be rather simple with minor respiratory, urinary tract and gastrointestinal infections to more serious pneumonia, sepsis and acute coronary events and strokes. Chronic conditions such as diabetes, hypertension, chronic obstructive lung disease, Congestive heart failure and dementia are managed in a way to slow progress of disease, avoid complications and promote the best quality of life. Many of these conditions coexist in the same patient. Other conditions are more nebulous or rare and need some thoughtful investigation to attain an accurate diagnosis and ultimately a treatment plan. Some cancers, endocrine, infectious and rheumatology diagnosis fall into this category. This can be challenging and rewarding at the same time.
2. What are your responsibilities during an average day or week?
DR. MOLLIN: I arrive at work at 6:30 AM to review and prep charts for the day. I have patients scheduled from 8:30 on and typically finish with my last patient close to 5:30. I am in a private practice and serve on several committees regarding the practice operations that meet during a lunch time or after hours. I typically spend several hours after patient visits to review labs, X-rays, diagnostic tests and complete charting. I am on call an average of once every 10 days and weekend.
3. What do you like the most / least about your present job? What do you find rewarding or challenging about it?
DR. MOLLIN: OK… You asked for it! I most enjoy my patients. I enjoy sharing in their successes and working through their failures while constantly reinforcing good lifestyle choices and achieving appropriate clinical goals for their medical conditions. I least enjoy the bureaucracy created by insurance companies, government regulation and restrictions on revolving door drug formularies that lead to excessive inefficiencies and ironically less time with the patient to help modify their behavior.
I call this “the catastrophic irony of wellness” when an insurance company or government program defines quality based on buttons clicked in a chart rather than the outcome of the patient. The more time a physician has to spend “doctoring” the chart, the less time he/she has to impact that patients’ behavior and life style choices. The end result is bloated records with useless, unintuitive information with no flow and more prescriptions being written for disease states that can and do respond to diet, exercise, stress management, good sleep and a focus on healthy relationships. Medications are necessary in many disease states regardless of lifestyle but for the most part they are best used for conditions where a person’s DNA and environmental circumstances bleed through their lifestyle choices. For instance, my borderline or newly diagnosed diabetes patients will always here this quote from me. “The good news about Type 2 Diabetes is that I have a lot of medicines to treat it! The bad news about Type 2 diabetes is that I have A LOT of medicines to treat it”. Most will be motivated to work harder on lifestyle modifications to avoid multiple meds. The consequence is, these are often my healthiest patients, and they are clearly motivated.
4. Can you speak to the demographics of your office? What is the importance of working with different types of people in your career?
DR. MOLLIN: My patients are becoming more diverse as the diversity in Raleigh changes. I see all age groups though I favor my 80 and 90 year old patients with extensive histories that report “I feel great doc”. I see all races and religions and learn something each day.
I have about 50% Medicare patients (age > 65) with the balance commercially insured. I see CEO’s of major corporations, physicians, lawyers and offer them the same care as my Wal-Mart greeters, grocery clerks, farmers and IT wizards.
Wake Internal Medicine has about 100 employees from diverse backgrounds managing phone call, emails, faxes, patient check in, billing, insurance claims. Multiple managers for our lab, X-rays, Ultrasounds etc. I am very proud of our staff. Their jobs are harder than ever.
We have 25 doctors and 5 PA as well as nurses, medical assistants, administrators, IT staff and financial experts.
5. What skills or abilities do you find are the most important in the work you do?
DR. MOLLIN: You must be knowledgeable but humble and compassionate and know that you cannot know all things. You must be willing to share your concerns and uncertainties with your patients and work toward the correct diagnosis together and with help if needed. You must be able to ask the correct questions and be able to listen and observe the response. Ninety percent of our diagnoses can and should be made with a careful history. The physical and labs can help support or refute your thinking. Be able to consider other alternatives to your initial impressions so as not to get caught up in clinical inertia…the tendency to stay with the same diagnosis despite evidence to the contrary.
6. How did you prepare yourself for the work you are doing? What preparation do you suggest for someone interested in entering this field?
DR. MOLLIN: Many years of formal education are required to be a doctor. However, it is more the passion, scientist’s curiosity, lots of varied work experience (working with Spinal cord injured patients, Intra-operative neurophysiology monitoring), Sherlock Holmes and Edgar Allen Poe deductive reasoning, perseverance and a love of medicine. I also had some friends push me through doubts and financial hardship to take the big step toward getting an MD.
When people ask me, should I or could I be a doctor? I tell them…If you want to be a doctor for the Money, forget it. You will never be happy. You have to enjoy the science, diagnostic dilemmas, the challenge and most important the patients.Empathy is key while being professional. It is very rewarding but very difficult. As I tell my kids. Do well in school. Not for me but to create opportunity for yourself. The difficult part is to find your passion and be the best that you can be at that. Then figure out how to make money with your passion and you will be happy. Never chase the paycheck.Of course your passion has to make money, because you will get off my payroll at some point!
7. What would you look for in hiring someone?
DR. MOLLIN: Skills suited to the position, a confident, congenial attitude and a team player with good character. Many people have the résumé but we need people that make the whole process better. After all, medicine is a service industry now or a team sport.
