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Leadership in Action 5 of 12
Dr. Tom Moffatt is the immediate past chairman of the Richmond Academy of Medicine. During his chairmanship, he led the effort to create Access Now, a nonprofit to improve access to specialists for low-income, uninsured patients. He now serves on its board. In its first year, Access Now provided $1.1 million in donated care, involving 800 Richmond physicians. Moffatt also is the founding partner of the Richmond Nephrology Associates. To find out his take on health-care system fixes, why he dislikes electronic health records and more, visit richmondmagazine.com.
Q: What got you hooked on medicine?
A: I decided to be a doctor at about age 5 because I liked my pediatrician. I eventually went into the Army. Knowing that they didn't need pediatricians, I picked out thoracic surgery. After about a year as a medicine intern, I decided I couldn't stand having people think about me what they thought about surgeons. So I went into nephrology because I thought it more interesting than the rest of the specialties.
Q: What's the biggest lesson a patient has taught you?
A: It was when I was an intern. We had an oncology patient who was a Do Not Resuscitate at home, and he was brought into the emergency room and resuscitated. I went up on the floor, and the family was all around the patient who was thought to be comatose. They were talking about his DNR, how he was supposed to die. I went to check on him again at about 2 a.m., tucked in his sheets and just said, out of habit, "Now, is that better?" And he responded, "Yes, thanks" — meaning he probably heard every word his family said earlier. He made me pay attention to what I say and do around patients. We need to see patients as people rather than "cases."
Q: How did Access Now start?
A: The Academy was invited to attend a meeting for REACH [Richmond Enhancing Access to Community Health Care]. The Academy needed to be present, have a seat at the table, so I was asked to go. Everyone was so involved, so enthusiastic about the goals that I just went with it.
Q: What's the most important thing you want a resident to take away from working with you?
A: I can be frustrated with a patient in private, but you have to get the frustration, aggravation out before you open the door to see them. When you interact with Mrs. So and So, she has to believe she is the most important person in the whole world at that moment, and you must be good enough to deserve the feelings she has for you. It is your obligation to make that person believe you have forged a therapeutic alliance, which is why I don't like the [TV show] House. House is a throwback to when I was a resident. You were allowed to be an ass if you were that smart. You are no longer allowed to be an ass, and you do have to be nice to her.