Sometimes a physician’s choice of specialty is borne of one patient, one mentor, or one experience. And then sometimes there’s just a good feeling.
Put David Pressel, MD, PhD, FHM, in the latter category.
He simultaneously earned his medical degree and a doctorate in neuroscience from Washington University in Saint Louis in 1993. He did his internship and residency in pediatrics at St. Louis Children’s Hospital.
He hasn’t left HM since.
It was the “first temporary job out of training that I really liked and continued,” Dr. Pressel says.
Fast forward nearly 20 years and Dr. Pressel is one of six new members of Team Hospitalist, the volunteer editorial advisory board of The Hospitalist. Dr. Pressel is a pediatric hospitalist and inpatient medical director at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del. He has served as an associate professor of pediatrics at Jefferson Medical College in Philadelphia since 2008 and was an assistant professor at Temple University School of Medicine before that.
He was Nemours/Alfred I. duPont Hospital physician of the year in 2008 and recently won the Marcum Innovator of the Year Award for development of a hospital program to improve the care of patients experiencing a behavior emergency. He also has been an executive board member of SHM’s Philadelphia chapter for two years.
He admits to having a lot of trepidation and uncertainty as a nascent physician but happily notes that those emotions subsided as he “became more competent and independent.”
Of course, the stresses of the job are still there today, but he can’t imagine a better job than being a pediatric hospitalist. Now, Dr. Pressel enjoys the variety of experiences that HM provides: interacting with patients and colleagues across the hospital, taking satisfaction from mentoring others, and networking at national meetings. In fact, he got his current job by chatting up a colleague at an SHM convention.
Question: Why did you choose a career in medicine?
Answer: Had an unbelievably positive experience with a physician during a personal illness. My degree of emotional concern was disproportionate to my physical issues—the doc I saw was perceptive and discussed them with me. It was an epiphany, and I decided to become a physician. Unfortunately, I don’t know her name and have no way of letting her know what a profound impact she had on my life.
Q: Did you have a mentor during training or early career? If so, who was the mentor and what were the most important lessons you learned from him/her?
A: Several. How to integrate work-life balance. Some folks I worked with seemed to be consumed by their career to the detriment of home life. I learned from one mentor to try to integrate one’s interests. I have tried to involve my family in my teaching—my wife and kids have role-played as model patients. My son is a co-author on a presentation regarding violent patients in which he plays a violent patient that workshop participants need to control and care for.
Q: What’s the biggest change you’ve seen in HM in your career?
A: Development as a full career rather than a temporary choice. I started as a hospitalist before the term was coined and initially was thinking I’d need to do a fellowship to have a successful career in academic medicine. This has not been the case.
Q: What’s the biggest change you would like to see in HM?
A: Board certification with salary increase.
Q: As a group leader, why is it important for you to continue seeing patients?
A: A boss who is disconnected from the front line is potentially dangerous.
Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?
A: The uncertainty of whether I’m making a mistake. Dealing with families with mental illness.
Q: What aspect of patient care is most rewarding?
A: Getting thanked.
Q: What aspect of teaching in the 21st century is most difficult? And, what is most enjoyable?
A: Same as 20th century except mobile technology, and the students are better. I am a late adopter of technology, having become reasonably successful and happy without these tools.
Q: Outside of patient care, tell me about your career interests.
A: Lots, including comanagement and violent patients. As above, agitated patients who become violent are encountered in hospital medicine. I’ve been bitten twice; other staff members have been injured by patients. There is limited training for staff in this area. By necessity, I have become expert and am expanding my skill and research interests in this area.
Richard Quinn is a freelance writer in New Jersey.