Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The key to being an attending physician

Mary Braun, MD
Physician
November 26, 2019
804 Shares
Share
Tweet
Share

When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention.

“Being an attending physician means you attend. When you attend me, all I want you to do is show up. You do not have to do anything. Keep the people with needles, knives, and nonsense away from me.”

We never discussed that I was his attending physician again. I was careful to do little for him besides our routine appointments. For him, the importance of “attend” was “show up” versus “do interventions.” This is attend in the spirit of “attend a basketball game” or “attend elementary school.”

When I became a patient, I learned other meanings of attend: Apply one’s mind or energies to, pay attention to. As in, I am attending the warning signs.

I had been bouncing around in the medical system for months. I was attending my symptoms quite assiduously. Some of my doctors seemed to be, and some did not. When my attending doctors did not seem to be applying their minds and energies, I felt like I was wasting my time and money, being told I was fine, despite not feeling fine, on the one hand, and having inappropriate tests on the other.

I get it. I’m a primary care doctor. My patients stream by so quickly that it is difficult to focus my gaze—never mind my attention—on each one before the system conveys me away to the next one and the next. Focussing my attention requires me to direct my energy, which is a surprising amount of work. However, if I do not direct my energy to each patient, I will miss details that aren’t really details.

The common expressions about attention—give, and pay—imply something of mine changing possession and going to the object of my attention. In exchange for the attention I pay to my patients, the present, shared moment is revealed to me. The opportunity to attend this moment is given by the act of attending to this moment. I am affected by being present in this moment. This being affected is what I am paying for with the attention that I am giving to the patient.

There are many ways to be present, but it seems to me that all of them require that I direct my attention to something. I find patients, by the nature of their being in the room with me and the palpability of their suffering, are easy aids to concentration of attention. I feel my practice of medicine is the most straight forward way available to me to practice presence at the moment.

Attend: Be present.

Attend: Pay attention.

The two meanings of attend converge here right now. If I can figure out how to be really present at my patient’s appointment, I will be applying my mind and energy to them. I cannot apply my mind and energy to them without really showing up. If I am present, I will be affected. My patients can tell. I can tell.

The first meaning of attend was taught to me as a doctor, by a retired physician who was my patient: only, be present. It is fitting that I learned more about attending as a patient from practicing physicians: pay attention.

The older I get, the more I see that attention is love made manifest. Let us show our love to and of our patients by being attending physicians, in every sense of the word.

Mary Braun is an internal medicine physician.

Image credit: Shutterstock.com

Prev

The myth of resilience in preventing burnout

November 26, 2019 Kevin 1
…
Next

3 reasons why smart doctors fail big exams

November 27, 2019 Kevin 5
…

Tagged as: Primary Care

Post navigation

< Previous Post
The myth of resilience in preventing burnout
Next Post >
3 reasons why smart doctors fail big exams

More by Mary Braun, MD

  • Miscommunication leads to misunderstandings: the tragic consequences of misinterpreted sobriety

    Mary Braun, MD
  • Depression is a notification that the old patterns are not working

    Mary Braun, MD
  • Thinking about frailty like slow-moving PTSD

    Mary Braun, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD
  • Embrace the teamwork involved in becoming a physician

    Nathaniel Fleming

More in Physician

  • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

    Montreh Tavakkoli, MD
  • The harmful effects of shaming patients for self-education

    Maryanna Barrett, MD
  • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

    Wendy Schofer, MD
  • Skydiving and surgery: How one doctor translates high-stress training to saving lives

    Alexandra Kharazi, MD
  • Don’t be caught off guard: Read your malpractice policy today

    Aaron Morgenstein, MD & Laura Fortner, MD
  • The dark side of medicine: an urgent call to action against greed

    Don Gaede, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • Maximize sleep efficiency with stimulus control

      Pedram Navab, DO | Conditions
    • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

      Montreh Tavakkoli, MD | Physician
    • Surviving clinical rounds: tips and tales from a pediatric hematologist-oncologist [PODCAST]

      The Podcast by KevinMD | Podcast
    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • How Many Steps a Day Keep the Grim Reaper at Bay?
  • RA in Remission? Stopping DMARDs May Be OK
  • Masking Still Required in About Half of Medical Offices, Poll Finds
  • Drug Shortage Leads to Firing Squads; FTC Non-compete Backlash; Illegal Laughing Gas
  • Abortion Is Not Murder in the Eyes of the Law

Meeting Coverage

  • Children Do Well With Fewer Opiates After Surgery
  • Advances in Diagnosis and Management of Severe Cutaneous Adverse Reactions
  • Orismilast Clears Skin in Moderate-to-Severe Psoriasis
  • New Combinations Promising in Advanced Urothelial Carcinoma
  • No Survival Benefit With CRT Versus Chemo for Locally Advanced Endometrial Cancer
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • Maximize sleep efficiency with stimulus control

      Pedram Navab, DO | Conditions
    • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

      Montreh Tavakkoli, MD | Physician
    • Surviving clinical rounds: tips and tales from a pediatric hematologist-oncologist [PODCAST]

      The Podcast by KevinMD | Podcast
    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The key to being an attending physician
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...