Hello, I am excited to be a part of the Stop Smoking community and I hope that my input will help smokers, ex-smokers, and those who care about them navigate the struggles of trying to quit smoking. I am a specialist in pulmonary (lung) medicine and intensive care medicine at an academic center. I also perform research related to the biology of lung inflammation. I have been practicing medicine for over ten years, first as a trainee (resident and fellow) and for the past four years as a full-fledged attending physician.
I chose medicine because it offers a unique opportunity to combine intellectual challenges with the possibility of having a very direct impact on people's lives: their health and well-being. I chose pulmonary and intensive care medicine because of their focus on physiology and because lung disease remains a puzzle without good solutions. So far, I have not been disappointed by my choices! Every day brings fresh excitement, with new information and data to bring directly to patients. The last several years have seen several important changes in how we think of smoking (and other addictions) and how best to stop smoking.
We live in times of rapid change in heath care. We are rapidly moving from a top-down, doctor-as-deity model to a more patient-centered approach. In general, I support patients and their families taking an active role in health care decisions. Maybe I am old-fashioned, but I still also think that physicians are uniquely trained to understand the basic biology of the body and the science of epidemiology, and consequently, I still believe that physicians are frequently in the best position to judge which tests and treatments are most likely to succeed or be useful. This philosophy is tempered, however, by the knowledge that nobody knows a disease quite like the patient who has it. This knowledge takes two forms. First, only the patient truly knows how a disease or condition (such as smoking or tobacco addiction) impacts his or her life. Second, as the art and science of medicine become increasingly complex, almost no physician can master all the details about all of the diseases or conditions they encounter, and often the patients will know more about rare diseases that many general physicians.
In addition, as the health care system becomes increasingly bureaucratic, the burden falls more and more on patients to advocate for themselves to make sure they get the best or latest care available. My own experience with health insurance has taught me that persistence and patience are often rewarded when trying to get health insurance companies to pay for indicated or necessary care. This patience and persistence will pay off in your relationship with physicians and other health care providers as well. Unfortunately, the working days of physicians are frequently long and complex. We don't always return calls as soon as we ought to and spend as much time with our patients as they deserve. If you have read anything written by young physicians, you'll see that we recognize these defects and feel bad about them. But we spend a lot of the day fighting with insurance companies too! A little persistence on your part, making sure the doctor doesn't cut you off, making sure all of your questions are answered, making sure that your doctor PAYS ATTENTION TO YOU will result in a type of mutual respect that you will earn with your persistence, politeness and patience. All of your questions might not get answered in the first visit. There is a lot of uncertainty in medicine. But if you stick to it and keep asking, you will get results.
Find out how your doctors and other providers prefer to communicate. Do they like phone calls or email? Will they respond to faxes or letters? Find a way to interact with your physician that you can both agree on.
I will use this blog to keep you informed about new developments in quitting smoking, the science of addiction, and lung diseases. Please submit any questions you have about these topics and I will address interesting and important questions in this space. I cannot, however, make diagnoses or recommend treatment. I can help you come up with questions that will help you get the most out of your appointments and interactions with health care providers.
I look forward to hearing from you soon!
Published On: February 14, 2008