Published: September 10, 2005 12:03 am         

Behind your doctor's doors

By Tippi Rasp

Staff Writer



EDITOR'S NOTE --On the job is a first-person account by reporter Tippi Rasp as she experiences the careers of members of the community.

Have you ever wanted to break those invisible and physical barriers that separate you from your physician's office or hospital. Ever wanted to peek behind the sign that reads "Doctors only" or swing open the door with the "authorized personnel only" sign?

I recently joined Dr. J. Michael Pontious for a brief glimpse into a day of a teaching physician. I broke down some of those barricades and found that, in some cases, I had erected the barriers myself.

Pontious, professor and program director of Enid Family Medicine Clinic Residency Program, allowed me to follow him around and witness a teaching clinic. Pontious weaved teaching and patient care together through a hectic day that started several hours before I arrived sleepy-eyed at 7:30 a.m. at his office.

At times, Pontious stayed busy "waiting for the teaching moments." Other times he was meeting with a pharmaceutical salesman, taking phone calls from some of the most prominent doctors in town or consulting with Janet Cordell, long-time Enid Family Medicine Clinic nurse.

"He is the best at multi-tasking," said Tracy Bittle, Enid Family Medicine Clinic Residency Program coordinator, as Pontious took a phone call.

That morning, I joined Pontious on grand rounds which actually is a round table-type setting where residents "present" patient histories with Dr. William Price, assistant professor and program director, and other residents. Pontious says this type of setting provides "docs" and patients the benefit of multiple professional opinions and the "collective widsom of the group."

Pontious also took me on regular rounds with him that day to see hospitalized patients. I got to see how he interacted with nurses and other doctors. I crossed all those physical boundaries hospital patrons typically aren't allowed to cross: The imaginary gate through to an Intensive Care Unit nursing station; the ICU family waiting area; the doctor's lounge during the lunch rush.

I felt completely unworthy and I was even a little uncomfortable at times with the access. I often was intimidated by my surroundings that day, to say the least. At one point during grand rounds, I realized I was in a large room with seven other people who were all doctors.

But as the day progressed, I realized the general public often puts doctors on an unreachable pedestal. Pontious tells me the Enid residency program tries to "humanize" the medical profession as much as possible and to make sure residents know the value and importance of family medicine.

I guess I was guilty of believing my doctor's time was more valuable than mine just because he makes more money than me. The truth is when doctors aren't meeting with you to diagnose an illness or listen to your lungs, they probably are consulting with other physicians about you or one of their other patients, trying to decide the best course of treatment.

Pontious has been program director since 1989 and professor since 2002. He came to Enid after serving a small community in a family practice of his own. He said one of the benefits of a small residency program is it can become a "nurturing environment" for students. It also can provide patients a nurturing environment.

But it isn't all champagne and roses with Pontious either and he doesn't give any mixed signals. I got the distinct feeling everyone knows exactly where they stand with him.

"I expect everybody to do their job and they should expect me to do my job," Pontious said to me after someone on his staff relayed a phone message from someone faulting his handwriting. Let's just say he didn't take kindly to the criticism, or from where the criticism was coming.

He has been known to anger other physicians with his editorials in the Journal of the Oklahoma State Medical Association. And he has been known to pen scathing e-mails to beaurocratic entities and aim his indignation at "the system" towards anyone who will listen.

But I could also see how the residents would feel nurtured and supported by him. He's excited about teaching. He's excited about his students' education, and he often uses Plato's Allegory of the Cave to demonstrate the fact that there is much more behind primary care than meets the eye.

Pontious said he learns as much from his students as they learn from him.

"We are human beings and we do respond to positives," Pontious said. "Even 25 years into this I'm learning that."