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hi everyone today I'm here at dr. Anand
are a division head of allergy and
immunology and the head of graduate
education so thank you for being on this
today oh I'm so honored to be here could
you briefly describe what allergy and
immunology involves so allergy and
immunology is a board-certified
specialty it has a very large and old
board there's probably six thousand or
so board-certified allergists in the
United States you either have to have a
pediatric residency or internal medicine
residency to apply for the fellowship
the fellowships range from two to three
years and they involve both pediatrics
and internal medicine or adult care so
it's one of the few sub specialties that
gets to incorporate both pediatrics and
adult in fellowship now for example I'm
an internist by training and so when I
walked into my fellowship my first
patient was a six month old and I had no
idea because I hadn't seen kids for
years but that that's what's involved is
as either one of those board go to a
residency and then enter that fellowship
and what are the most common cases that
you see usually right so most people
have no idea what an allergy allergist
does they think runny nose and they kind
of scratch their head they're like what
is that but in reality actually there's
there's a really interesting niche that
we are pretty good at so for example
there's an immunologic aspect to this so
certain autoimmune diseases allergic
diseases which includes asthma allergies
a lot of skin disorders autoimmune
Ehrlich area food allergies so we are
really really good with asthma we're
great with chronic cough because we can
evaluate all the many different types of
chronic cough there's a lot of testing
and things that are done in our clinics
that often it really can't be done very
well in other clinics without the right
kind of setup and then there's things
that we treat also so for example
terrible allergic asthma can be
virtually cured and I use
word carefully put into remission even
with allergy shots so if we can fix
people's allergies a lot of their asthma
will get markedly better so there's a
whole bunch of things that we do that's
not just runny noses so yes and I think
our number one disease is probably
asthma what's a typical day in your life
like from when you come into when you
leave most allergists our outpatient
specialist so we are mostly ambulatory
there's a sub group of us that are
purely Pediatrics that deal with very
very severe immune deficiencies bone
marrow transplants things like that
those guys tend to be much more in an
outpatient and then there's a there's a
we often have like a it inpatient
consultation center for medication
allergies or weird stuff like that but
really the majority of us live in the
outpatient our morning kind of starts
often with with patients and we've got
and they could be kids or adults or even
the whole family might be our patients
sometimes we have special types of
procedures what we're doing challenges
so somebody thinks their reacted to
shrimp but actually their testing
doesn't look like they had a real shrimp
allergy so we we give them tiny amounts
of it to see if they're really allergic
or not so there's a whole bunch of
different things that we can do from for
morning tonight most of the time I just
spend a lot of time goofing off with
patients and my staff does all the work
because they do all the testing and a
lot of the other things that have to get
done and so what are the hours like
usually Oh crazy good hours because
we're a subspecialty we we're not first
of all we don't go to the hospital so
there's never emergency things that I
have to go racing off to the hospital
for we some some of us will take call in
the evening but most of that is home
call at most for some phone calls and
things like that we very seldom have to
cut race into anywhere and on the
weekends so our hours can be fairly
predictable and and easy I work for 10
hour days so I have Friday's off which
is why I'm here and so how is the
lifestyle different than other
specialties would you say it's maybe
more conducive to doing other things
well you know everybody has a passion
I know that when some of my colleagues
if they heard that they basically had to
sit there and deal with people on an
outpatient basis all day for some of
them it's a fate worse than death they'd
rather be inside the hospital doing
life-saving procedures and in the middle
of the night having a rush and scope
something and do that kind of stuff
which is awesome because that's what
they should do so but what I can say is
that for for for me this is wonderful
because my patients are often younger
families and and healthier people they
don't necessarily need to have a bypass
after having years of bad living they're
30 and they just want to bike outside on
a really beautiful day and how can we
get you to be able to do that so it's a
very different feel in my in my clinic
and I've have had patients for 20 years
but not in the sense that I'm their sole
provider like I don't have but in many
ways that we have been walking through
since they were a kid and they had a
peanut allergy and they had this and now
we fixed their peanut allergy their outs
was totally great but now they're
bringing in their kids who have now had
allergies and and so it's I like to
think of the allergy clinic as kind of a
happy place where we're actually helping
really people live the best possible
lives that they can in terms of exercise
and healthier eating and and just being
able to be with their families without
end and minimizing a lot of medications
they have to take what was your career
path to allergy and immunology like why
did you choose it
after doing your residency so I had
allergies really badly all my life so I
remember being on vacation and just
sneezing the whole time and just being
miserable on cabins and camping
traveling it just always felt like I was
always the sick
stuffy congested itchy one right so it's
miserable all the time and never
understood really that there was such a
thing as allergists so when I entered
the first week of my residency during
orientation week I developed chickenpox
and so I went through orientation with
all 900 other interns and breathed on
all of them and on Friday I developed
the little spots and
it was that amazing phone call to my
chief I'm like I'm sorry I just infected
your entire first-year class but what
happened essentially is that I got stuck
being out of sync with my schedule and
so they had to put me somewhere once I
was no longer infectious and so they put
me the allergy clinic and there it
wasn't kind of I'm like there's an
allergy clinic I walked in and it was
amazing we got these healthy kids and
these adults and all these things
there's wonderful Diagnostics we're
doing there's a lot of counseling
there's a lot of work with these
patients and then you see them come back
and they're better their lung functions
awesome they're like I went running it
was amazing I had all these foods I
didn't think I could have it's wonderful
stuff and so right at the end of that
first rotation in my first year covered
in like old chicken pox scars the
program directors like you you want to
be an allergist and I'm like okay and
that's actually how I became an
allergist is that I got weird weird luck
and ended up in the allergy clinic and I
haven't looked back I had to I was an
internal medicine resident loved I see
use loved every minute of it and then I
had a chief year where I was involved in
teaching and program management and all
of that loved every minute of it but
once I made it to allergy I was home and
why did you decide on an internal
medicine another field well you know I
mean it's sometimes first of all a
surgery I can't sew straight and I
literally can't sew straight so I'm like
I would be a terrible surgeon if I can't
sew straight and then family practice
seemed honestly too big I'd never felt
like I could know enough to be a decent
family practice doc pediatrics I didn't
really know a lot about kids cuz I
hadn't had any kids of my own and at
that time I remember doing some Hospital
rotations and pediatrics and just
feeling for the kids you know it's hard
to sit there and have to put an IV into
these little people it's I just I
couldn't do it I was very I was
traumatized a bit so internal medicine
it was there was and so and I enjoyed it
I got in
and I love the science of it I love and
I ain't got into a residency that I
truly loved and enjoyed and the rest is
history okay what's the most challenging
aspect of allergy and immunology I think
there's there's a lot of really things
that are challenging so number one is
that there's if you people minimize
symptoms and they're like oh it's just a
little runny nose but we know that kids
for example with bad allergies have a
lot of they don't sleep very well so
they're struggling to pay attention in
school and there's actually like
significant data but having people take
that seriously especially referring
providers where they're like oh it's a
little runny nose or it's just a little
eczema where actually there's a whole
body of data about eczema and infants
bla bla bla bla so that's that's where I
find that data in the world is evolving
so fast that sometimes it's hard to to
help people prioritize some things so
we're still sort of trying to keep up
with this stuff that's life-threatening
and horrible but be great if we could
work on some of these people that are
still healthy but but might need a
little addition or help the other thing
that's really interesting is the
changing world of medicine right the
world the job that I do now today is
going to look radically different in 10
years right anybody who pays attention
to apps and AI and all of that knows
that what we do now is going to be very
different and how I do it one-to-one
with the patient here sit down let's
talk about this it's very different from
what my patient care is going to look
like in 10 years and understanding how
to get ahead of that or at least keep
the human interaction which is what
people value while also creating spaces
for efficiencies and other things is I
think one of the big challenges in
medicine okay and what's the most
rewarding aspects of allergy immunology
oh it's being with people it's having
somebody come in and tell me that they
were able to go out and you know run a
mile so we we do a lot of work with food
allergies which is on the
so you can imagine these kids who have
like had terrible food allergies so
every food that they bite into can cause
serious problems and so for them being
able to like work with them and and
really treat their food allergies to the
point that they're eating these foods
without a problem that is exceptionally
rewarding so you know having people come
in and and say we went to a bakery and
there is a peanut on that doughnut we
flicked it off and we ate the donut even
though the peanut had touched it and we
were fine look how amazing you know look
at these doors that have opened for us
look at these places were going finally
because we didn't think we could that's
the most that's the most rewarding thing
for me and are there any misconceptions
about your field besides that you
mentioned like people think it's just
like Reno is yeah I think that's the
biggest one people truly have no idea
what we do I was really impressed with
some of my bosses when I first moved
here and got the current job that I do
where they made consultations and they
came down and they went through my
clinic to try to write like what do you
guys actually do down here and they went
through a lot of testing they went
through all the stuff that we do and at
the end you're like oh you could see
them they're like oh okay this is why it
really matters to have an allergist or
several allergist as part of your staff
and so that I find very frustrating and
again that also boils down to not only
to other providers right like how can be
we be useful for them but also it's a
patient's I can't tell you how many
people put up with terrible asthma
terrible allergies what horrible rashes
and not seek out help and relatively
easy solutions for them other certain
personalities that do best in your field
oh I don't know that's hard to say right
I think you just like I said there's
probably some people who really really
prefer the surgical fields those those
people love the technical aspects of
things and and so on and there's
definitely people who are much more
capable of being on-call in hospitals
well into their late years right those
are that's not me um and there's you
know so so III can't say I know
holiday tight but there's definitely
people who much prefer more intense
professions and/or more technical
procedure driven professions those less
procedures and maybe more of manageable
hours well different types of procedures
I have a very very intense procedure day
but my procedure isn't about me doing
suturing on people although I do
biopsies on skin lesions my procedures
are much more like food challenges or
things like that where we are actively
desensitizing people to things so it's
quite high-risk there's a lot of
potential medical care that we may need
to provide but it's not that I have to
have a rhino scope or an endoscopy suite
or even scissors for what I do
how are those compensated because the
procedures tend to be compensated
mourning and how is áliveá immunology
physicians how are they compensated
generally and compared to other
specialties so a really good question
actually I don't I would say that
considering that we know very little
after-hours work that considering that
we do very little you know I don't have
to get in a car at 1 o'clock in the
morning and drive to any ER ever so I
think we're actually very reasonably
compensated I think when you look at
sort of national averages in terms who's
making what kind of money what we find
is that that paradigm for I may I do ten
of these procedures so I make a million
dollars a year is going to be
dissipating and changing in terms of who
actually will be receiving that kind of
money or why right so I can say that
considering the the the let's look
life-and-death stakes are not we're not
cardiology we're not saving a life today
in the next 25 minutes I need to be
there and open this guy's arteries or he
will die we're not doing that but I
think that in terms of the more
ambulatory ambulatory outpatient type of
sub specialties I think we we do very
well we're probably in the mid to high
range
there's always outliers so there's some
people who make far more than they
should or and some of them
cutting a few corners on one end the
majority of us do very well for time and
what employment types are practice
settings are they're like are they
independent by practice positions do
they mostly work in like big groups like
it seems to be nowadays so again if that
really varies depend on your geography
so for example California is largely a
place of very big groups because you
need to have that power and collective
bargaining in order to negotiate
insurance companies there are still
places around in the United States that
have much more likely to have smaller
practices most people are now going to
large makeup practices so for example
you will still find one or two Doc
allergy groups but modem people are
moving towards having six doctors with
three locations so that they can move
around a little bit but also provide
enough critical mass in terms of billing
and patient volume for coverage and for
income there's a few there's one or two
mega mega groups where they have
hundreds and hundreds of allergists in
clinics throughout the country those
guys have huge economies of scale in
terms of what they order and how they do
things it's a different level altogether
and now is there opportunity for like
locum tenens work and would you
recommend it I've never done it I know
I've seen people who have done it and
they seem to really like it it's either
for the time when you just finished
fellowship and really don't know what
you want to do or it's right at the end
where you really don't want to have to
work full time you want to still some
income and keep your skills up a little
bit there is plenty of opportunity
people always have to take time off
the thing about allergy is that you know
there's if I have an allergy clinic I
have patients that come and see me for
this and that and that's concern but I
often will have a whole separate line of
patients that are going through their
allergen immunotherapy treatments that I
don't necessarily see on a day-to-day
basis but they're coming in for their
shot
and other things like that that the
nurses are doing with them if I take a
month off so you go do something like
have a surgery somebody has to make sure
those patients are there has to be a
doctor or some licensed provider on-site
to make sure that those somebody has a
problem that they're they're taken care
of and so for that reason the the
opportunities for locums actually are
pretty good you mentioned you do a lot
of like are you done a lot of work with
like selecting med students to write the
residency yeah what tips would you give
medical students imagine to a
competitive I am residency and a
genealogy fellowship so great question
so first of all one of the reasons that
I love what I do is because I get to not
only be involved in patient care but I
get to do a lot of lectures and
education I have lots of residents and
things like that so I get to feel like
I'm still part of a training program
without having some of the other weight
that comes with that so to answer your
question the same thing with getting
into medical school the number one thing
is your your scores and so on and your
clinical evaluations and then thereafter
your research becomes really critical if
you have any and then trying to look
like a normal human being which is
sometimes hard after several years but
the majority of it just the first cut
offs is you know where you know what was
there what were their scores it's number
one of scores what was their clinical
rotations and their first two years
grades looking like and then after that
oh and you know where do they go to
write so and then after that it's
letters of recommendations and essays
and so on and so forth so yes just like
getting into med school the scores still
matter but after that it's did you show
up did you did people like you did you
try to pitch in as best as you could
that kind of stuff and what if you tried
to make an effort to do some kind of
research along the way so you'd say
research is pretty important then for
well it depends is prospective or the
more competitive type of residency's it
does help
I know I did raise a research in medical
school I did even more during residency
and a lot of the good residences will
actually give you time to do some
research it's also a way to kind of
stretch your wings a little bit and get
out of sort of clinical training and try
to remember what you're doing in some
things so it does help to have that it's
not mandatory depending on the type of
residences that you or where you want to
go to residency so the same thing with
allergy fellowship I've you know again
it's the same thing it's you know what
are your scores and grades and then it's
it's it was the higher you get it's the
the grades felt like what are your you
know did you get honors in these
rotations or what have you and and the
letters of recommendations but then it
and any reports part three scores and
stuff but then it becomes things like
what what race research did you did did
you get a research grant so things like
that like how much interest did you show
it in this case allergy that you would
want to that an allergy fellowship would
say yeah this guy's really really wanted
to do allergy they look they've done
some allergy stuff they've got some
letters from some allergist that we know
this is somebody who want to interview
okay and so with all the changes in
medicine how do you see on top of all
the advances up to date it's actually
challenging I'm really really one of
those people that I like to read I like
to do a lot of those types of things
sometimes I feel like I get most of my
knowledge from like the New York Times
or that like the regular news but the
truth of the matter is is having very
nice ways of having a system for keeping
up is almost mandatory for anybody in
whatever field you get into most of us
kind of have to grind through our
maintenance of certification so whatever
it is that that looks for like in each
other everybody's boards but in addition
there has to be a little bit of a system
like ok Saturday the moment my journal
comes in I'm just going to spend two
hours just looking at it and answering
some of those questions and I'm gonna
make a point of attending the annual
conference and catch up with some things
there and then finally I'm going to
attend some of the see Emmy stuff that
goes around
the evening sort of dinner things and if
I can do those five things that'll keep
me at least partially up to date for me
I love having residents and fellows
because they ask questions and I'm like
and that really helps me to kind of keep
on top of things
so YouTube actually has a bunch of great
allergy lectures with all the like
rigors of medicine it's sometimes hard
to de-stress how do you recommend
dealing with like burnout so if I had
the answer to that question I would
ending every Medical Group in the world
would be would be calling me um but I
can tell you I can tell you what I've
learned and suffer so for example a
burnout in men looks very different that
burnout in women believe it or not
there's actually data but how burnout
men looks one way and burnout and women
looks very different so women tend to
get just a little meaner we stopped
carrying as much we don't we still show
up to work but we're just grumpy
apparently there's a lot there's a
different set of ways that we handle it
so there's there's a couple of things
and this is the same advice I always
gave even my medical residents and when
I was a chief because it's the stuff
that I had to do to keep my head above
water and I remember right at the sort
of March my interim year and you know by
March of internal year of residency most
people are just barely keeping up right
they're checking in it's a job you're
grinding through just don't kill people
get my notes done don't kill people get
my notes and that's that's what it is
and I was in Cleveland so it was a long
winter and it was awful and one of my
friends apparently she was in a
different neuron residency she seemed to
be doing better than I was she's like we
need to go exercise every day so she
would basically just pull me out at the
end of the day and we would go
rollerskating because I'll have my
rollerblades and we knew that 30 minutes
a day every day well you know and then
it became an hour and then there's I
think second year residency I think I
skated like 3,000 miles in a year I
docked it but it is also but what
there's I mean exercise is one of those
things that most doctors oh some doctors
are really still good at it a whole
bunch of us
are terrible at it because we just don't
think we have the time but if we don't
take care of ourselves we don't keep on
top of ourselves nutritionally if we're
not getting a little bit of sleep at
night and if we're not exercising we can
not take care of our families let alone
our patients so one thing I always
notice is because I was way fitter than
most of the other people in my residency
I could run two coats better needing an
inhaler at the end of the 20 minute run
to the big building down the down the
road and so it made a huge difference
just in terms of functionality but huge
difference in terms of noon mood and so
the one thing I can say is don't let go
of those things that really matter to
your personal care otherwise you really
in the burnout will accelerate it'll be
much much harder the other thing I say
is don't be afraid to say no you know if
you don't have a good system to kind of
get things done if you if you can't you
know work with mentors to say look I
want to do this and I want to do these
things how do I get fit this in with my
job in this and this and this and work
with them to try to get some good work
habits and if sometimes if it's just too
much say no it's not worth it okay and
on this on a similar vein how would you
how do you establish a work/life balance
I don't ask my husband
so I whatever that means great so truly
whatever that means I've been very soon
that means that when you're home you're
not really like dragging a bunch of
garbage from work home and that when
you're at work you're not dragging a
bunch of stuff from home into work but
we're human and so sometimes it's hard
when there's been something that rough
that happened at work to come home and
and be perfectly calm around my family
and in the reverse however what I can
say is being super aware a lot of that
can be very helpful so there's a lot of
things people tell you so work/life
balance also potentially may mean that
you're not at work all the time so that
you completely neglect home
we're not at home like screwing around
all the time that you never really show
up to work the truth of that matter is
if any that happens it's really really
really hard to keep a job or keep a
family usually that kind of stuff so so
one thing is is having it so in my case
I have a fabulous husband he's awesome
and he and I are have been have regular
conversations about what it is that both
of us need to kind of keep our heads
above water we have we don't have a lot
of help in terms of like 50 nannies and
things like that that's one thing we
committed ourselves not to doing and and
both of us have jobs where there is
there are fine end points that we can
kind of say okay we're done today and
then we can walk away for and and go and
you know be fully there with our
families and then maybe later in the
evening after it my kids are asleep you
know he and I might have some quality
time in front of our laptops getting our
other work done but in that case it's
still where we're not compromising our
family time it's hard though or when you
recommend having kids in the whole
medical process I can't even do the
heads for that it's really hard right
and it probably varies depending on who
you are what kind of training you are
expecting to go through what how you're
a partner is in terms of supportiveness
how much extra family you have what
other medical issues you may have you
know how old you already are all of that
is just part of a really major systems
biology analytic that only only you can
answer
so I don't know my husband and I we we
waited quite a long time until we were a
bit both a bit older I felt like I got a
whole bunch of we got all it were old
right so we would both of us went
through a whole lot of years where we
were in school and training and blah
blah blah blah blah and then I did a lot
of traveling you know and then we
finally got around to it way way late
compared to the average people but I
think we find that many women now in
medicine and in
national couriers are trying to get
through a lot of things so that when
they do get to have children they're not
having to go do call in the middle of
the night and then come back in and try
to be pregnant or have a baby or
something like that it's very
challenging like okay
and you mentioned with changes in
medicine might include things like
incorporating AI and see like the
overall kind of doctor medicine process
how specifically do you think that's
going to change medicine or allergy and
immunology in the next like a few
decades I'm not sure I understand your
question so how do you how what
technological changes do you see
happening technology medical changes you
see happening in the next few decades so
in that case so for example telemedicine
is a great example
telemedicine actually quite old now but
the idea that I can do a facebook live
consultation with somebody and give them
a full medical of virtually a full
medical evaluation go through all their
records discuss things with them and and
give them my consultation and results to
them is and build them for it is
fascinating and yet that's the the
quality of comfort that may provide for
some people is amazing so for example
for what I do with food allergies right
where we actually take people with food
like peanut allergy or what have you and
work with them and help them to get over
there or at least treat their peanut
allergy so they can eat this safely and
be around these foods that's something
not everybody does and so I have had
people who have called from Yosemite and
from places where it's hard for them to
come down to and had consultations where
they are somewhere three hours away or
five hours away and I'm comfortably in
my office wearing my tennis shoes and we
have a consultation and I can work with
them and give them very good attention
just with just by that and they don't
have to drive in so imagine so that's
just one little thing where I don't have
to sit there
and I could I could have done that from
my home I could have done that from a
beach in Maui I've thought about it but
work-life balance right but the point
being is that that's one thing most
insurance companies now are offering
telemedicine calls for for quickie
things like we have a cold call my call
our 1-800 number there's a nurse
practitioner over there who can talk to
you and maybe prescribe something if you
need it so this is stuff that that
allows and then there's a whole bunch of
app based medical care where people are
doing concierge practices there's robots
now that go around throughout hospitals
and our stroke our stroke department and
my group has robots and telemedicine
right so they so somebody comes in with
an acute stroke in many hospitals in the
region the ER calls are telemedicine doc
and says looks like here's here's what
they look like here's what their CT
looks like and the doc says here's
here's the loved thrombolytics you want
to give them and do this this and this
and then so they can give them a
neurology consult in the comfort of
their pajamas right but to somebody
who's out four hours away if we had to
wait for a neurologist to come it would
be well past damage time so the
possibilities are endless
just from utilizing technology when we
get into AI it's it's amazing but also a
little worrisome because they say that
so much of our medical thinking is
algorithmic that you can train an AI doc
in AI bots to do that and provide
significant either triaging for you for
actual diagnosis and the doctor is just
kind of there to lay hands and be
charming but not really need to do any
thinking it's an interesting it's an
interesting time it's a fascinating time
for us to think about how much does it
matter to a patient that they come and
see me how much dork is it okay if they
talk to me on the phone or see me on
skype how much does it matter to a
patient if I like lay hands on them and
examine them and versus devices now that
we can send a student like you with a
bunch of devices to go to people's homes
who have ear infections and you can put
this device in their ear and I'll get
the picture
and then I can tell them oh hey it's
it's an ear infection I'm gonna send in
a scrip for amoxicillin for you so that
I don't have to go in they don't have to
come see me there's somebody is maybe an
intermediary that doesn't need hundreds
of thousands of dollars but may need
twenty dollars an hour or what-have-you
to go around and do these types of
things so it's a it's a it's a different
world in terms of how we're going to be
providing these types of care so it
seems like you're pretty content with
your specialty do you have any career
regrets or any changes you'd you'd wish
you could made no I I am actually very
happy I love I love I've been very
blessed I very much love my patients the
work that I do is extremely satisfying
every time I see families and and who
we've worked with for some time and
they've I know what they were before and
now how far we've come
it's amazing to me and every single one
of them worked so hard on their own
health that it's very inspiring I've
been very lucky to be in a group where
my bosses are amazing they are brilliant
you know extremely professional I've
never had a meeting where I felt you
know where there wasn't a very high
level of courtesy and respect just just
good stuff so so I'm in a environment
I'm in this area which is fabulous
immediately so the truth of the matter
is I'm very very happy I I think that
very few allergists by nature tend to be
unhappy because our jobs tend to be
positive happy jobs and and so in that
way I can say that we're it's it's a
it's a good day to be an allergist
climate change is going to make
allergies much worse so I guess it's a
growth market for us I'd rather it not
be but the truth of the matter is is
that Springs are elongating throughout
the throughout the majority of the
Midwest and in Northern Hemisphere's so
more spring more pollen okay it's the
last question we're device would you
give medical students to become good
doctors the one thing there's days when
I simply
so tired and that it's really hard for
me to especially a residency medical
school you think it's really bad
residency it's really challenging and
you you know struggle to like keep your
eyes open and hold your head up let
alone like care right and what I found
is that I have to remind myself that
this is somebody's something when I took
my mom to the hospitals I wanted those
interns and residents and students to
give her the same kind of courtesy and I
very consciously tried to remember to do
that with family members that are really
inappropriate or angry or just downright
obnoxious to me it's their mom's sick
their wife is sick you know their child
is potentially dying I'm gonna keep it
together I wasn't perfect I don't think
anybody is but if I could remember that
it would always kind of snap me back
into let's let's do the best we can
today might not be a hundred percent or
even a hundred and ten percent day but
if I'm at 40 I can definitely get it up
to fifty or seventy-five percent get
some effort try to make this a better
experience for both of us most doctors
will tell you that kindness
professionalism thoughtfulness sometimes
just sitting back and going what's
happening with you will go a long way
towards easing an awkward horrible
situation an uncomfortable patient
encounter even mistakes as providers
we're all human but if you have a good
relationship with a patient even you
know human error becomes human error
rather than lawsuits and horribleness so
so just always if you can if you can
hang on to the humanity of each
interaction you'll go a lot farther than
just being mad about this the charts you
have to do or whatever okay well thank
you guys for watching and thank you dr.
enum darker
being passe interview if you have any
questions or comments about allergy and
immunology you can leave it down below
in the description box and I can ask my
daughter and get back to you I think you
guys again for watching hi gross today
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