Residency Director's Message:
I came to Tulane University to make a difference. Having trained at the Johns Hopkins School of Medicine, and the University of California at San Francisco, I knew there were many quality programs at which to work. But I wanted to do something special with my life, and I wanted that contribution to be for the benefit of my patients and students. I didn't want to continue marking career signposts to a far-off grave. I wanted to do something unique, and I wanted to be part of a team of individuals who wanted to do the same. I wanted to care for people that the remainder of society somehow saw fit to ignore. I wanted to be an active part of my community, not a passive bystander. I found this at Tulane, and I have been happy since. People need us here, and we enjoy caring for them. I suppose that patients need their doctors everywhere, but the people of New Orleans rely upon Charity Hospital. And it is the Tulane University Medical Service that provides that care. In doing so we have established a special bond with the New Orleans community, and that makes me very proud of Tulane's residents.
Of course caring for a city the size of New Orleans requires vision. Education is our top priority because it allows us to be exponential. A productive physician may care for 40,000 patients in her life, but a productive clinician educator who teaches 10 students per year, will indirectly care for eighty million patients over a twenty-year career (160 billion if she teaches her students how to teach). Education is the key, and we hold that sacred at Tulane.
We believe that everyone on the Tulane team has something to teach, and the day-to-day schedule is constructed to facilitate this teaching. Residents here make decisions, and they use the mentorship of their attending physicians to hone the accuracy of their decisions. Tulane is the perfect balance between autonomy and guidance.
The Tulane Internal Medicine Program is owned by the residents. They are instrumental in every program decision. The program is the engine that makes the Department of Medicine run. Even with all of the service that our residents provide, they are never treated as employees but rather, as stock-holders. The resident work hour changes have had no repercussions on our program because we have always been in compliance with all ACGME guidelines. And while most (if not all) programs have reached ACGME compliance by doubling the “work intensity” as they halved the work hours (i.e., they dumped the same amount of work on fewer hours), we’ve developed a unique system that eliminates fragmentation and inefficiency,,, ensureing a comfortable work intensity and preservation to our core principle: our patients come first (Check out “The 4+1”). Indeed, Tulane is the first program to be fully compliant with the Institute of Medicine’s new duty-hours recommendations…. Recommendations that have not even been fully required yet. We comply not because we have to, but because we believe it is the right thing to do. Exhausted, over-worked residents do not make good physicians. Our mission is to empower our residents with the tools and the environment to make good decisions, and to have the energy to be compassionate physicians and effective educators. We work hard to foster an environment of respect. Regardless of the circumstance, disrespectful and demeaning behavior is never tolerated. We work hard here, but we never compete against each other. We compete against disease, and that requires a team effort.
But for all of its attributes, Tulane's greatest asset is its patients. Nowhere in the country will you find the diversity of patients found at Charity Hospital, Tulane Hospital and the New Orleans VA. One look at our patient roster will convince you of the diversity of disease we see. We also see an important diversity of severity of disease: from acute symptoms to the chronic manifestations most physicians only read about. But of vital importance is the social, ethnic and racial diversity seen in New Orleans. Becoming a great human is requisite for becoming a great physician. Appreciation of diversity is fundamental to becoming a great person.
The result of all of this is that the Tulane resident goes where he pleases. Tulane carries a national respect. People know that if you can practice medicine on the wards of Charity hospital, you have earned your stripes. Our residents go on to subspecialty training, academic careers, private practice or medical administration.
I am happy I came to Tulane; it was without a doubt the best decision of my life. Once I devoted myself to a mission that really mattered, my career took care of itself… taking a meteoric rise that was a product of being fulfilled and sincere. The residents’ careers here, without exception, prosper in the same way… doing well, because they are doing good. If you have a similar desire to do something special with your life, and if you want to be an active part of caring for a patient population that really needs you, we want you here. Spend some time looking through our website; it is symbolic of our marriage between tradition and progress. If you decide you want to see more, give me a call. I look forward to seeing you here. And if this speaks to you, I would love to be your coach.
Jeff Wiese, M.D.
Internal Medicine Residency Program Director