Thread by @rosslevinemd

Finishing up 2 weeks on inpatient (non-COVID, largely) service. Reflecting back, particularly in light of my friend David Weinstock's perspective on being a physician scientist involved in clinical care; nejm.org/doi/full/10.10…
My two cents

1. I had a great experience being an inpatient leukemia attending the last two weeks. Great colleagues, really touching interactions with patients and their families, and I learned a lot as always.

2. There is no doubt my clinical skills are not the same as they were out of residency/fellowship. I do 4-6 weeks of service a year, which is not the same as my clinical/clinical investigator colleagues.

3. That being said, I feel very comfortable on the wards, partially because my care is focused on a set of diseases (acute leukemias almost exclusively) I know well and which I am up to date on changes to clinical practice.

4. I also have the best damm clinical colleagues in the world on the @sloan_kettering leukemia service including people like @MarkGeyerMD Aaron Goldberg Jae Park Eytan Stein Anthony Mato Lindsay Roeker. They know things I don't know and teach me new things each rotation.

5. I also have the pleasure to round with a set of spectacular team members inc. a fellow from our program, the best APPs, superb residents, and pharmacists who constantly show us why having pharmacists on rounds is best innovation I have seen in my career WRT clinical care

6. There are plenty of things I do not know, but others do. There are things I know and see in our patients WRT leukemia care that I know and the others do not. We are a team, and I am a member of that team.

7. We have a weekly conference where all patients are reviewed by our whole group, and I email/talk/text with my clinical colleagues constantly. This is key.

8. I believe I can bring value to the care team, and that I am not out of touch with clinical leukemia care. It is harder to do than it was when I was right out of fellowship and less ensconced in the lab, but worth it.

9. I think every physician scientist will make different decisions on whether to continue limited clinical work as part of their career. I chose to continue, for a clear set of reasons.

10. First, I find value in being a doctor and part of our leukemia service, never more than during the pandemic. I get a lot of personal value out of the experience.

11. Second, I love to teach, and I find opportunities to teach residents, fellows, and APPs/pharacists about leukemia biology and therapy all the time (including dedicated teaching sessions).

12. Third, it continues to markedly impact my science and the work my lab does. We study leukemia, and the mechanisms at play in this disease, and not the other way around. Keeps me and the group grounded and centered on our primary mission.

13. Fourth, I have the chance to work with the best and brightest trainees, and in some cases initiate relationships which then continue in the lab. Some of my best lab members have been clinical fellows I met on the wards, and it clicked for us to work together.

14. Fourth, future investigators need role models who are primarily clinical, clinical investigators/trialists, and lab-based physician investigators. They need to see the paths we choose so they can forge their own path.

15. I am not sure if my feelings on this will change over time. It is harder each time to keep up with the evolving clinical literature, to devote the time away from lab to clinical duties, and to deal with the exhausting amount of paperwork/EMR/insurance crap we all deal with.

16. These are my thoughts, and my own personal perspective. I think there has to be room for everyone's view on this. I welcome other's views and hope to learn from listening to how others manage their balance...