Q&A with Dr. Johnson
As Chair, you have responsibility for the education of students, residents, and fellows; research efforts; and clinical care. How do you see your team making all of this count for patients?
An oncologist I trained once told me that he went into cancer care because cancer patients need a doctor. He said they need a doctor at all levels, not just for their physical needs, but also for their psychological needs. I find it very rewarding when I am able to do that, and I think it should be true for all specialists.
One of the things we will focus on during my tenure as Chair of Internal Medicine is how to become the best deliverer of health care. We can have the best doctors in the world, but if you can’t access those physicians in a timely manner, and we are not efficient in the delivery of the care that you need, then it doesn’t matter how good we are. We have to be able to demonstrate that we are capable of giving really great care, and being the model of efficient, high quality, and safe care.
As someone who was involved in a training program at another institution, I can tell you that we literally rejoiced when we received residency applications from UT Southwestern Medical Center students. One thing we were absolutely sure of is that these students knew how to take care of patients. There was just never any doubt.
Likewise, the men and women here at UT Southwestern as faculty are as good as any physicians in the country. I believe that, or I wouldn’t have come here.
Throughout your career, you have been both a clinician and a researcher – a physician-scientist. How does this combination of efforts help patients?
Physician-scientists in many ways represent the distinction between an academic medical center and all other health care delivery systems. Men and women who have a foot firmly planted in two camps: discovery and the implementation of discovery as it relates to the human being.
Basic scientists are important at many levels, but don’t have the contact with fellow human beings where their discoveries are actually brought to light. Terrific clinicians interact with physician-scientists or basic scientists and often can be an instrument of implementation of discovery. But the person who is really a physician-scientist straddles that chasm and really lives in both worlds. In my mind, they are incredibly important for advancing discovery. Not only do they make discoveries, but then they bring it from the bench all the way to the bedside.
They are the men and women who really stimulate those of us who have more of our lives planted on the clinical side to think about basic sciences, think in scientific ways, think about how we can integrate new discoveries into the care of patients. At the same time, they also get our colleagues on the basic sciences side to think about the impact of what they are finding, their discoveries: how they relate it to humankind, what we can do to improve the lot of mankind. So I think they are very much the engine of discovery that is important for an academic institution.
How have your personal experiences informed your own clinical practice?
I observed in medical school that we, as physicians, are often asked for a recommendation about the care or prognosis of a patient by a family member. We give advice, and then we walk away. Not in an uncaring way, but we do walk away and may never encounter that family again. What I learned is that our words and our recommendations have consequences that are long-lasting and echo in that family for years to come.
Later, when I was in my 40s, I myself was diagnosed with cancer. Even if you are a physician, you still have all the same fears that everybody else with cancer carries with them, and perhaps amplified by the fact that you know so much more about the disease you are dealing with. I saw the strain that put on my family. My daughter was quite young at the time, and it impacted her, even though we tried very hard to shield her from that.
Looking back, I realized that withholding information was not the right thing to do. Plus, the people who cared for me were my partners, friends, and buddies. They made all kinds of accommodations for me, but still it was challenging for my family.
I tried to imagine what this must be like for people who didn’t have that, and that led me to focus intently on how we could improve care in the area I had responsibility for, to make it very patient focused and very personalized. It was the beginning of my transition from a physician-centric world, which most of us experience, to a world in which the patient really is the focus.