Kind: captions
Language: en
and from from the clip we saw you know
your your intern ear or your first year
there at residency it seemed to be
really stressful and overwhelming and
you use the term burnt out and it kind
of seemed that you know that sort of
environment might not be sustainable but
you stayed in the environment and
continue to care for this underserved
population so how have you managed to
balance the stress and work with your
personal life
all of a sudden I sort of became myself
again and so I think just not you know
having some weekend's free and being
able to catch up on your sleep so it
brings you back to yourself so I think
sleep deprivation and time off really
makes a difference actually I do want to
say one thing which is that watching
yourself on a 10 foot screen makes you
want to run to a plastic surgeon right
away our dermott AR good dermatologist
if anybody knows one let me know well I
definitely have more questions but now
let's open up the crowd so there's a
person up here who would like to ask a
question I think a microphone will come
around to you sir and what would you say
to the Obama administration on how
health care should be reformed two small
questions chains giving me the option of
going first I can't imagine why can you
hear me all I actually would think about
changing healthcare before healthcare
education I think the big issue is what
is the health care system the United
States look like and if we fix it I
think the people who go into it are
going to know what they're getting into
and I think education will probably be a
part of that it's going to have to fit
into whatever the world is going to look
like I think we desperately need to
think of healthcare as a right and not
something that some people get and other
people don't to me it's appalling
actually but there's a lot that's
appalling about the world so I don't
know whether it's going to get fixed or
not anytime soon I'm hopeful about Obama
being elected I really hope he can make
things happen i would say that when you
design a system you get the product that
you designed for and we've designed a
system where people who have high
technology know
to anybody you know cuz i know this is
technology we all like technology but
where you get rewarded for high
technology where you get rewarded for
invasive procedures where you get
rewarded for sort of the shiniest and
newest thing and you don't get rewarded
for prevention and that's why huh and
you know i work in a hospital hospitals
have so much power people who are
interested and systems that are
interested in prevention are really
really very very low on the totem pole
and i think it's because we designed a
system that way so if I were to redesign
the system that I hope and i think that
Obama has the ears so he he some of the
people i actually know from my
experience in primary care are very
close friends with obama in fact one of
his close friends is a guy who i know
through my professional work is a
physician in chicago and he's really
public health minded so I'm hoping that
Obama has been learned and swayed by
that so you know when it's and I think
you see a lot of people are really
interested in universal health care and
the reason they're interested in
universal health care is so that we can
have the same sort of expensive health
care where a lot of people make a lot of
money off of the insurance whereas why
don't we just have universal health care
where we as the public will benefit and
we will put public priorities and part
of the reason why I chose to do the film
is because I certainly have political
views which I were hoping and my sort of
view of medicine might help get on the
film so you've heard it
um what do you think is the function of
having the internship and residency
structured the way it is with the number
of hours and the number of hours and the
intensity of the work especially given
what you indicated is the degradation of
the service I'm just puzzled about why
you think it's structured that way so I
think that you have to look and I'm not
a historian and I don't know if there's
a historian in the audience but I think
you have to look at the historical roots
of internship and residency if they were
really were clinical apprenticeships and
it was a time when you didn't have you
know maybe not have beepers patients
were in the hospital for two weeks at a
time and it was a very I think a very
different pace a very different the
technology that the interventions were
much fewer and so I think that it might
I mean maybe it was more reasonable at a
certain time when it started and then as
medicine grew over the years i think the
structure didn't really keep up with the
changes and there's been a lot of
attempts to change it and I'm hoping
that they will continue to grow but the
question is how do you get young doctors
to have exposure clinical exposure you
need to see a lot of patience to learn
and so how do you do that within the
structure and have people sleep and I
will also say one other thing which is
that but jay and i graduated in nineteen
ninety one so that was quite a long time
ago and things have evolved since then
at least at Boston Medical Center you
know once a week that every resident
gets a day off of course the attendings
don't get a day off i just thought i'd
say that you know we sort of get the bed
and but also there's a lot of more
attention to you know night floats and
so that you don't have so many hours on
end so there has been some attention i
think so you're looking at you know sort
of one iteration ago in what you see of
us so it's not exactly what's happening
today
you don't have to your guests okay do
you agree with what you know we have
Nancy Oriole here who's a Dean at
Harvard Medical School so I just kind of
she's a guest but you know I thought you
know she might want to make a comment so
thank you very much to both of you for
participating and thank both of you for
putting this out there for the public to
see and Janes right life is better but
the transition that you go through the
sort of the growth that you have to
experience to go from being a pre-med
student to being a doctor is well
portrayed and that's something that's
actually very important for people to
understand it's it's not just you know
another day in the office and I think
you did a very an excellent job and a
very sensitive job of the you know
showing the transition in a way that
makes me proud of you guys so thank you