Bringing the Light

22. Doctor David Freud

"Freud, you have some of the lowest treatment numbers but some of the highest improvement and outcome rates. Your patients and their parents seem quite happy with you. I'd like to see your clinical numbers up, though," Dr Phillips said.

"I like to take my time with my patients," I said. "They're mostly young and scared. They need understanding, compassion, empathy. They're not like kids with broken bones or a cut that needs stitches.

"Be that as it may, there are always more patients. You taking that extra five, ten minutes is putting more pressure on your colleagues."

"I'm sorry that they feel extra pressure. I won't compromise my personal ethics and standards or the safety and security of my patients," I said. "Or their trust."

"You can take all the time you want with your patients when you're running your own practice. We have expectations and you're not meeting them. Well, not all of them."

"So, my patients have the best outcomes but your complaint is that I take too long with my patients?" I asked.

"It's not a complaint, really. It's an observation. You're seeing maybe three quarters of the patients your colleagues are. So, your patient outcomes are better, but your time per patient is longer."

"So I'm not really understanding what exactly the issue is. You're happy with my patient outcomes, you've already told me my notes are succinct but detailed and of the whole group, I have the best patient outcomes."

Dr. Phillips looked at me for a long time. He had a slight smile on his face.

"Off the record, you're a fantastic physician and psychologist. The feedback I'm getting from your supervisors and your patients is phenomenal and I hope it's something you will carry on to private practice if you go that route," he smiled.

"But...?" I asked, my eyebrow raised.

"But, you do need to step it up clinically here. That's on the record. Now, if, for some reason, one of your patients requires some extra time, I may be able to look the other way. When you're on call for the ER, though, I have to stress speed. It's an emergency room. You need to make a quick assessment. In patient, out patient, which service. We need the beds and we need to deal with the patients as quickly as possible. You might have to make a few small compromises. But yes. You need to maintain your compassion and empathy, but it can't be at the sacrifice of patient care."

"So, what you're saying, if I'm to understand is 'keep doing what you're doing but be faster in the ER?'" I asked.

Dr. Phillips winked at me.

"Remember what I said off the record," he smiled.

"You're going to be a great doctor, David. I think you're going to be one hell of a youth psychologist. Just remember, right now, you're under constant evaluation. Now is the time to toe the line. Don't make waves. Head down, get 'er done. You're near the finish line."

I nodded in understanding.

"Now, get out of here and have a good Thanksgiving," Dr. Phillips said, smiling and offering me his hand to shake. I smiled, shook his hand and wished him a good Thanksgiving.

I went into the locker room and changed into my street clothes and out of my scrubs, gathered up a few things and headed home.

There was an unfamiliar car in the driveway as I came home. Frowning I went into the house. It wasn't terribly late and the holiday wasn't until tomorrow. Mom was still awake. The light was on in the kitchen and glowing down the hallway to the door. I smiled. Living back at home had worked out really well the past few years. I had one year left of my psychology internship and then I could either start my own practice or practice in a hospital. I hadn't decided yet.