A last goodbye…to a dear friend

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My colleague and dear friend, Robin Dibner, moves  on to greener pastures today.  We have had a great ride together.

I call her delicious,” because some people come blessed with that gene.  A wonderful soul and as good a person you will ever want to meet.

I will miss her dearly–both as a trusted friend and source of supremely good counsel.

Below, with her permission, I reprint her farewell message to close friends and colleagues:

 

As I take my leave of you and Lenox Hill Hospital to assume my new position at the ACGME performing site visits at teaching hospitals, please indulge me as I share a few thoughts I have had in the last few weeks. 

As most of you know, in addition to preparing to leave a career in medical education and medical administration, I also have spent the past two months dismantling a small rheumatology practice mostly focused on patients with chronic auto-immune conditions.  I have known a number of my patients for over 25 years and we have shared much of our adult lives together. 

 Looking back I realize several things:

 A cardiologist who served as one of my role models when I was a resident at St. Luke’s was right when she said the following about practice,  “You will eventually love nearly all your patients”.  I found that very difficult to believe as a trainee because if given a choice, my clinic patients didn’t necessarily seem like people I wanted to care for long term.  I am not speaking about their ethnic or socio-economic background, nor even disease spectrum.  I am speaking of the randomness of their assignment to me and sometimes their personalities. 

 However when you are in an ambulatory practice as an attending, whether solo, group, specialty, or faculty practice – you and your patients choose each other.  Over time the ones who are not a good fit drift away.  The ones who remain loyal are wonderful!  And you learn to work with each one in a collaborative relationship to promote their health, adherence to treatments, and prevention.  They learn to trust you, and you them.  You know how to read their faces when you walk into the exam room and what it means when each leaves a message – who cries wolf and who never does. 

 Of course a few of my patients (thankfully very few) have died or are more disabled now than when I first met them.  However I have been very fortunate to practice at a time when the therapies in rheumatology have become more focused and less toxic than the horrible shotgun approach that steroids afforded previously.  In my last visits with my dearest patients – I had an image of  how sick they each had been at some point in time and how well they each are now.  This realization has brought me an intense sense of accomplishment and satisfaction that I hope you each will experience some day.  It has made me confident that the long road to and the challenges of a career in medicine have been worth everything. 

 I have asked myself what these experiences have taught me is the most important thing in the care of patients.  I have concluded it is being a devoted advocate for each and every one of your patients.  I have always tried hard to communicate in clear language, to answer questions truthfully, to respond to unspoken emotional distress (watch their faces!), to seriously consider their desire for an alternative to what I am suggesting, to help them maneuver through the system and to fight it vigorously on their behalf when necessary.  I have gotten better at each of these every year in practice.  I know this is what patients want and what only we can provide.  For us, they could be just another patient with {name any disease}, one of a number in our practice or experience.  Never forget that for them it is 100%!  This is what I believe and hope my patients will remember about me as their physician.

 I could write another page about the pleasures of teaching and striving to be a role model for young physicians, and hope that each of you will seek and know this privilege and obligation.  The pledge to teach subsequent generations of physicians is a part of the Hippocratic Oath, as is the obligation to honor ones teachers as one would ones parents.

As you can see, I remain completely enthralled with our profession and its future.  I hope you will remain so as well.

 All good wishes to each and every one of you.  Feel free to keep in touch, and if there is ever anything I can do to assist you, please know that I will try my best.

 Robin Dibner, MD

rdibner@gmail.com

 

Godspeed Robin.

Always your friend,

Brad

Brad Flansbaum

Bradley Flansbaum, DO, MPH, MHM works for Lenox Hill Hospital in New York City. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education.

Currently, he serves on the SHM and NY ACP Public Policy Committees and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates.

Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University.

He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a proud resident of New York City.

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