A Conversation with Dr. Eileen Moser

“Regular reflection is critical at the end of each day. What went well, what didn’t go well? What I can do better? What was the meaning of today? What is something I’m thankful for? What is something that I want to improve in myself?”

Bio

Dr. Eileen Moser is the Associate Dean for Medical Education and a Professor of Medicine at Penn State College of Medicine. As the Associate Dean, she oversees the curriculum for more than 600 medical students at the college. Dr. Moser completed her education and training in internal medicine and geriatrics at Rutgers University in New Jersey. She has held multiple positions through undergraduate, graduate and postgraduate medical education. Dr. Moser is passionate about mentorship and education as reflected through her research, which touches on important topics of high-value care and leading behavioral change during medical education. She is a member of many state and national committees, including the American College of Physician, where she serves on the Board of Regents and on the Board of Trustees on the Pennsylvania Medical Society.

How do you define success and were you always a high achiever?

“For me, success is not about titles. Success for me is, did I make an impact? Did I do something good? And is it addressing what I feel is the reason for my existence?”

“When I was in my final year of residency, my third year of residency, I was slated to be chief resident. And I had my critical care fellowship all set up. But then I got cancer, while I was seven months pregnant. This was a hardship, but in a way, it was a gift. It really made me go introspective, reflect and think about what’s my meaning? ‘Why am I here? What’s the purpose of my life? What do I want out of my life?’ And I think that was a really important moment in my life, when I started to think about things differently.”

How has your personal cancer journey impacted the way you care for patients?

“Unquestionably when you’ve walked that walk, you do come out with a different perspective,” Dr. Moser explained.

“I don’t think you have to walk that walk to come out with that perspective, but it sort of puts a little fire under your feet. It certainly provides meaning to go through something and it provides an ability to understand patients as well. I would like to think that I’m an empathetic listener. I’d like to think that I try to understand the patient’s point of view. I’d like to think that that comes out with shared decision-making, which is really what we need to do to help our patients.”

Dr. Moser continued to explain that her experiences have helped her build unique bonds with her patients because she better understands their struggles and they have more confidence in who she is as a physician.

For those who have not gone through your journey, how do they live with your sharpened sense of mission and purpose?

“I think it requires reflection,” Dr. Moser explained. “And so that’s really where I think the money is. It’s about, every day after the end of the day, thinking about what went well and what didn’t go well. What can I do better? What was the meaning of today? What is something I’m thankful for? What is something that I want to improve in myself?”

“The other thing that I think is really important is to think about your own ‘Why?’ What’s your personal ‘Why?’ A ‘Why’ is why I exist. Why I get out of bed in the morning? What’s my purpose, my cause, my belief that drives me?”

“How do you get to your ‘Why?’ One way you can get to your ‘Why’ is through reflection. Another way is to think about five stories in your life that are important to you. And then tell those stories to another individual. And then the second individual picks out themes. It’s those stories, when they come together, you can find themes that might lead to your ‘Why.’ Our ‘Whys’ are very personal. They’re discovered, not created.”

According to Dr. Moser, your “why” is your mission statement while your “what” is your vision statement. These two will guild how you go about pursuing your “how.”

What is SOAP-V?

“I’ll just explain that SOAP-V is the traditional SOAP note that you write as medical students, as residents. It is an attendings subjective and objective assessment plan with a twist. You’re adding V for value.”

“Within the V there are three components. The first is evidence of value. This is all about evidence, this is what we do as physicians. What is the benefit and the harm of that test or treatment? Have you considered the evidence of the treatment versus the alternative? Have you considered the evidence for the test and whether it’s going to help you or not? That’s the first part, evidence.”

“The second is patient values. Does the patient even want that particular treatment? Is a patient interested in getting that test? This is an important part of that shared decision making and understanding the patient’s point of view and understanding the patient’s meaning of their illness.”

“And then the third part of the V is the relative cost. What’s the approximate cost of the test or treatment? Are there downstream costs? Are there less costly alternatives with similar benefits? It’s really very simple. It’s just adding that V and using it as a cognitive forcing function.”

What does mentorship mean to you?

“I would say mentorship is finding those individuals that can help you understand, lead, and give you advice in different ways, even if it’s only small areas.”

“I think one of the pieces of advice I might offer is, when you look for mentors, it isn’t about finding just one person. It may be people along the way that help you with small things. And going up to a person and saying something like, “I’m very interested in value, can we talk about that.” It’s building that relationship.”

What’s one thing that you wish you knew when you started medical school or residency?

“It’s going to be okay. You’re going to be okay. You’re going to do great things. Just keep thinking about where you are, where you’re going, what’s your why, what you’re doing. Is it congruent with your values? Think about where you want to go, how you’re going to get there and reflect.”

Pearls of Wisdom

1. Success is about doing something good. It’s not about titles and achievements.
2. Distill the why, the what, and the how into your mission statement, vision statement, and SMART goals.
3. It’s going to be okay! You should be smart and take action, but after doing your best, rest and be confident in who you are.