Lessons learned from three decades of medical practice

April 27, 2017

The practice of medicine has experienced many changes over the years, but one thing that has stayed consistent over time is the importance of physician-patient communication, said Dr. Dan Avery, an obstetrician-gynecologist who has practiced in Alabama for more than 30 years. He shared key takeaways from his years in practice in a presentation April 17 as part of the Mini Medical School lecture series hosted by the College and UA’s OLLI program. Avery practiced privately for more than 20 years before joining the College, where he was professor and chair of the Department of Obstetrics and Gynecology. He is currently director of Medical Student Recruitment and Scholarship at the College and a professor of Community Medicine and Population Health. He is also medical director for the College’s Institute for Rural Health Research. Avery began his presentation, “Lessons learned from three decades of ob/gyn and medical practice,” by comparing differences in medical education from the time he was a medical student to today. He said differences include the medical school application process, the cost of medical school, and the length of residencies and how those training programs are now structured. “The reduction of work hours for residents has decreased the number of procedures they are able to do,” Avery said. “The years of residency may be lengthened due to changing hour requirements.” An increase in the use of technology has also changed medicine, he said. The importance of communication between physician and patient, however, has remained a constant over the years, Avery said. “The relationship with the patient is everything.” In some ways, technology has helped communication, Avery said, noting that he will text patients if they have medical concerns that don’t require an in-person visit. Communication extends across all specialties in medicine and is particularly important in obstetrics, Avery said, not only because obstetrics is a high-risk specialty for malpractice but because many women want to choose when they deliver their babies. “You’ve got to have a good reason to [electively] deliver a baby preterm,” he said. And, this needs to be discussed with an obstetrician before a decision is made. The closer to term a baby is delivered, the better the change of the baby being born healthy. Avery said while many women deliver in hospitals, home deliveries are on the rise, so it’s vital to communicate with a physician if a home delivery is planned. While communication between doctors and patients is important, it often doesn’t get the attention it deserves in medical school, he said. “If you listen to a patient long enough, they will tell you what is wrong with them,” Avery said, quoting Dr. Tinsley Harrison, a long-time physician and educator at the University of Alabama School of Medicine.