Embracing compassion in family medicine [PODCAST]




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Family physician Dan Muntean discusses the article, “The heart of family medicine: a doctor’s journey of compassion and care.” In this episode, Dan shares his personal journey through 30 years of practice in family medicine, reflecting on the lessons learned from his upbringing in Romania, his diverse training experiences, and the deep connections formed with his patients. He emphasizes the importance of listening, empathy, and sacrifice in patient care, and discusses actionable insights for new family doctors on embracing the true spirit of medical practice. Throughout the conversation, Dan highlights how genuine compassion and commitment transform patient care into a familial bond, ultimately shaping the future of health care one patient at a time.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Dan Muntean. He’s a family physician. Today’s KevinMD article is “The heart of family medicine, a doctor’s journey of compassion and care.” Dan, welcome to the show.

Dan Muntean: Thank you, Kevin. Good to be with you.

Kevin Pho: All right. So tell us what led you to write your article on KevinMD in the first place?

Dan Muntean: It’s an interesting story. I was a physician for 30 years and had a hip replacement. It was the first time in my life when I stayed home for one month, and I had time to reflect. I was able to read books and articles. An interesting thought came to me about how I want the family physician to be in 2025 after a lifetime of experience.

What is the future of family medicine? How do you see a family doctor in today’s world with artificial intelligence, with a lot of specialties, and what’s the place of the family physician? I was thinking that it’s important to set some boundaries and to figure out where the future lies for the new generation.

Kevin Pho: OK, so tell us what your article is about for those who didn’t get a chance to read it.

Dan Muntean: It was about a little bit of history about my mom. She was the chief of the hospital, and she worked for 40 years. She trained me as a physician. After that, I started to explain the responsibilities of being a family physician.

I talked about how I see how a family physician should be regarding compassion and about the joy to practice medicine. I think that was a focus: the joy to practice medicine. There are a lot of people who enjoy this profession, and I’m one of them. I go to work, and I’m pleased to see my patients and happy when I’m working.

Kevin Pho: So tell us what your practice is like.

Dan Muntean: I practice in Surfside. I see around 25 to 30 patients a day, and I’m fortunate to have some of those patients for 20 years. We’ve developed an incredibly good relationship. I call my patients my people. I know everything about them, and they know everything about me.

My patient is not a number. I know everything about their social lifestyle, their struggles, their medication. I’m a strong believer in the human touch. Medicine is not only about professional expertise; it’s about the human touch. To give them a little bit more than 15 minutes of your time.

Kevin Pho: Now, do you practice by yourself or do you practice with partners or in a large group?

Dan Muntean: We are part of a good corporation, Conway Medical Center, and we have about 15 satellite clinics. In my office, it’s me and one doctor and a physician assistant—a very good group.

Kevin Pho: Now, when you say that you want to practice medicine with the human touch, as you know, there are a lot of obstacles that prevent doctors from giving that human touch in the exam room, right? How do you maintain that humanity in practicing medicine when it is so difficult to do so today?

Dan Muntean: That was the main issue of the article. Sometimes you are forced in 15 minutes to address a lot of problems. You are on the fast track. You have to address a lot of parameters, a lot of points, but sometimes you forget to address the person.

You need to see how they are truly feeling. What is their perspective about medicine? Patients have a totally different perspective about how they feel than how the doctor thinks they feel. It’s important to see from the patient’s perspective, not from the doctor’s perspective.

Sometimes the numbers look great, but the patient is not doing great, and you need to address that. Sometimes when all the numbers are perfect, the patient is still not well, and you need to see how to make them feel better, not just improve the numbers.

Kevin Pho: That was the saying that I was taught very early on. When you’re talking to patients, you have to treat the patient, not the number, right?

Dan Muntean: Correct. It’s very easy to say, “Just treat the patient,” but it sometimes takes a lifetime of experience and a human touch to develop the social skills needed. Everyone is different, with different social backgrounds, different levels of comprehension about medicine, different openness to the physician.

You don’t establish this in 15 minutes. You establish it after spending probably 10 years practicing with the same patients. They feel comfortable and open up to you, and after that, a bond is created. We all say the patient-doctor relationship is the most important thing, but it’s easy to say that in a sentence and very difficult to achieve.

Kevin Pho: Now, you’ve been practicing medicine for 30-plus years. What advice do you have for the medical students who may be listening to you now, or some of the new physicians who may be just becoming attendings? What advice and wisdom can you share with them?

Dan Muntean: Become more qualified in all aspects of medicine. I train students in my office from Campbell University, and I’m fortunate to have six students a year—every month, I have a different student. I teach them and explain that you do not want to be boxed into small areas where you cannot practice because you don’t have the knowledge. You need to develop knowledge in all aspects of medicine and all the complexities. Sometimes you need to do pain management, sometimes psychiatry, sometimes complex cardiology or pulmonology cases, and you need to accumulate all that knowledge. Do not depend on specialists because sometimes specialists are not available easily. They are available, but you might have to wait five or six months, so you need to be comfortable taking care of the patient and all their problems.

Yes, the specialist’s input is very important; we are part of a team. I have a saying: Family medicine is the quarterback of the team, the captain. You have all these people who are very important in the health care of your patients, but you are in charge. You will make the main decisions and have easier access. This is important because sometimes the patient may not see the cardiologist for five months, while you can see them in two days and address their problems. Get competent in multiple areas and practice whatever you choose in the future, and it will be very helpful.

Kevin Pho: Now, as you know, there’s a primary care shortage in our country, and a lot of medical students are not choosing family medicine or primary care but going into specialties. Tell us some of the joys of primary care and why you love primary care. Maybe you can inspire some of the students who may be listening to you now.

Dan Muntean: They have the sense that primary care is not an important specialty. I am an expert in family medicine. I have two specialties, and I have the joy of practicing medicine because I feel comfortable treating all those problems. I can treat probably 90 percent of the issues my patients have, and it creates a bond that is not created with any other specialist. They may see a cardiologist, a rheumatologist, an endocrinologist, and me, but they know me the most. I see them the most. I know everything about them.

They come and say, “Hey, I went to that cardiologist. What do you think? What’s happening with me?” You need to translate the medical terms into their language. I think primary care offers the most joy in practicing medicine. If you take the financial aspect, I think the joy of practicing medicine is in family medicine. Sometimes—and I’m sure in the future—the financial aspect will catch up. Right now, there is a gap between specialists and primary care, but when that gap closes, you’ll be happy to be a family physician. I feel comfortable. I go to the clinic, and I’m happy practicing medicine.

I often tell patients about the joy of practicing. Patients are a little apprehensive when they go to the doctor; they feel uncomfortable in a different environment. But when they come to me, they know who I am, they know that they will be relaxed and well taken care of. This is the joy of practicing—being positive in your practice. That’s very important.

Kevin Pho: Well, I think your perspective is wonderful to hear. I talk to a lot of physicians who do not have that joy of practicing, and it is so difficult to maintain that physician-patient bond in the exam room when there are so many obstacles and challenges that try to break that bond. Now, you’ve been practicing for 30-plus years. Give us some tips in the exam room on how to strengthen that bond you have with patients when there are so many outside forces that chip away at it.

Dan Muntean: We are living in a world where we are slaves to computers and documentation. Most new doctors look at the computer and type and type. Their notes look extraordinarily good, but they don’t have the bond. I try to talk with the patient. I examine the patient, I listen to them, and sometimes I do part of my note before and part at the end. But during my 15 minutes of communication with the patient, they have my attention. I do my physical exam, I touch every patient, I examine everything, and I have a human-level interaction with them. On and off, I ask them what’s happening with them. I have a very good team—my nurses collect information, so it’s not necessary to repeat 90 percent of what we’ve done. I make some modifications, but it’s important to look them in the eyes, listen to them, and examine them. Documentation is important, but you can do both.

Kevin Pho: We’re talking to Dan Muntean. He’s a family physician. Today’s KevinMD article is “The heart of family medicine, a doctor’s journey of compassion and care.” Dan, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Dan Muntean: I believe primary care medicine is vital for our health care, and in the future, we will still be the most important part of medicine. We’ll have access to all the specialists, and we’ll get access to technology, but it’s important to coordinate all the care in family medicine. We need to keep the bulk of medicine in primary care and help patients navigate costs and tests, and educate them about modern tests and technology. That is a challenge that can be achieved through education.

Kevin Pho: Thank you so much for sharing your perspective and insight, and thanks again for coming on the show.

Dan Muntean: Thank you very much, Kevin.


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