Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
StoryBlog Post

The Reason for the Reason

Marissa Tsoi, MD CCFP
November 01, 2019

I was lucky once to meet a great teacher in residency, whom we will call Dr. B. I met her during my rural family medicine training in Small Town, Canada. Here lore preceded her – countless trainees, patients, colleagues, who have crossed her path agree she is a great human being and doctor.

Up till residency, medical training had sometimes seemed too fomulaic, i.e.

Net Learning = (Duration of rotation) x (Actual Interest in the Subject Matter) x (Teacher's Ability to Get Through to Learner), all raised to the negative power of any fear, ignorance, or low confidence inhibiting a learner.

The difference with Dr. B is that she let me clear the hurdles of pride and awkwardness. The kind of pride that lets you assume you know more than do. The kind of awkwardness that prevents you from asking questions once you see the gaps.

I was also interested in what I was doing in residency. Rural medicine encompassed anything and everything, and rural physicians were attentive teachers. Whether inserting a chest

tube, treating a hamstring injury, or managing hypertension, I got to soak up the wisdom these teachers poured forth. Dr. B was really one of a village of teachers who raised me.

Dr. B’s best lessons drifted into the abstract: I learned about social determinants of health from watching her example. Week One she told me to look up the Black Report, a 1980 research document from the United Kingdom that established socioeconomic inequality as a major health determinant. She emphasized occupational history. You learn more the more you ask – about patients’ self-made fortunes, their trades, their hobbies (Model ships! Motorbikes!), which ties directly into their health limitations and treatment choices. There was so much to discover, she taught me, by finding out what patients DO, and seeing past the “Past Medical History”.

I learned how to apply the 5 Whys approach to root cause patients’ problems. Or, as Dr. B called it “There’s always a reason for the reason”. A patient would come into hospital with serious illness, unwilling to stay one day more for further treatment and investigations.

Why?

On morning rounds you learned her husband was even more frail and exhausted.

Why?

They were caring for a beloved young grandchild at home.

Why?

Their daughter was struggling with addictions in another city and could not get child care.

Why?

The whole situation had drained their finances. There we go, the reason(s) for the reason she wanted to leave hospital. Not so illogical anymore.

On discussing her own travels and professional experiences Dr. B marveled at "this little piece of paper I got from a medical school across an ocean" (referring to her medical degree) that had allowed her such wealth of human interaction and clinical learning. Some people aspire to their dream job, and some become what that dream job should be. Dr. B raised the bar in my mind of what a physician and lifelong learner could be.

Dr. B taught me how to stretch my mind, have confidence in my abilities, and meet the patient as a multi-faceted, fellow human being. If I make a positive impact in the world, as a physician or otherwise, she is a reason for the reason.

Dr. Marissa Tsoi is a generalist family physician and lifelong learner in Calgary, Alberta. She is a clinical lecturer at the University of Calgary, and currently enjoys teaching medical students and residents on urgent care shifts.

Copyright © 2019 The College of Family Physicians of Canada

Collections

  • Featured Content
  • Free
Download PDF
Share
The Reason for the Reason
Marissa Tsoi, MD CCFP
November 01, 2019
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Email Blog Post

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
The Reason for the Reason
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Blog Alerts
Sign In to Email Alerts with your Email Address
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire