A Conversation with Dr. Richard Pittman

“The mentors that really stand out to me were those who not only demonstrated openness, but who would walk into the emotions of whatever I was wrestling with, and feel my struggle.”

Bio

Richard Pittman, MD, is an Associate Professor in the Division of General Internal Medicine and Geriatrics at the Emory School of Medicine. Dr. Pittman was trained at the University of Mississippi, completed his residency at UT Southwestern, and then spent 16 months in Swaziland for HIV care before joining Emory University. Dr. Pittman’s interests in technology began as a hobby, but have grown to serving as an EPIC Physician Champion at the Grady Memorial Hospital at Emory. He has delivered numerous presentations about the use of technology, more specifically on the use of mobile technology in healthcare. Dr. Pittman was recently awarded the Dean’s Teaching Award at Emory for his dedication to teaching medical students.

What were some of your early life lessons?

“I grew up in the Mississippi Delta,” Dr. Pittman began. “It’s just to the east of the Mississippi, a very agricultural place. My hometown was very small.” Despite this size, Dr. Pittman was blessed with some early mentors who helped steer him in the right direction. These came in the form of athletic coaches.

From his interactions, he discovered the value of mentors who pushed him hard. He learned how to receive constructive feedback and criticism from his teachers. As Dr. Pittman notes, “The whole point of giving feedback to someone is to help them get better.”

Feedback is a gift to the learner. “If somebody just tells me things that I’m doing good, I know in myself that I have many things that I can do better. And I kind of think they may not be being honest with me. So I actually really appreciate it when people tell me the truth and how I can get better.”

How do you create an environment where students can express themselves?

As Dr. Pittman notes, there is pressure for students to perform. It’s easy to tell students to not worry about their grades, and just try hard. But reality indicates that the current structure of the medical community calls for students to earn high marks. To this point, Dr. Pittman sympathizes with students who are caught in this dilemma.

That said, Dr. Pittman believes institutions can make the shift from placing less priority on grades, while seeking to create environments that are safe enough for students to take chances. There is value in taking risks and not being overly fearful of failure.

What is the key to success for a physician?

For Dr. Pittman, success can take many different forms. It is often “doing right by a patient” by taking the time to listen to them. Perhaps it’s being competent in diagnosing a patient correctly and helping them take the next step’s in their journey.

Success, as Dr. Pittman sees it, occurs when you are able to see the lights turn on for a student or patient. There is an aha moment when they discover something for the first time. “One of my favorite things is to watch my students’ eyes when they first hear egophony.” It’s rather humorous and Dr. Pittman will often say, “Hey, have you ever heard egophony before?” And they will respond that they haven’t. This presents an opportunity for Dr. Pittman to demonstrate the power of listening and action, thus creating another lightbulb experience.

Dr. Pittman continues, “I think that we can confuse ourselves when we start to define success as fame, or I need to be like this person or that person. That kind of the comparison game can really undermine us.”

What are some tips for positive interactions with patients?

A big point of emphasis for Dr. Pittman is showing respect to his patients. He strives to give them every modicum of control that he can. This includes simple actions such requesting permission before muting their TV’s or turning on their lights.

For Dr. Pittman, it’s simple. “I really try to just say, ‘Hey, how would I want to be treated?’ Or, ‘How would I want someone to treat my mom or wife?’” Every person has value and every person has a story.”

A third tip Dr. Pittman suggests has to do with personal self-awareness and perception. According to studies, it was discovered that patients who had a doctor sit beside them believed that the doctor was there twice as long as when they stood. As a result, Dr. Pittman encourages members of his team to sit when they are with their patients. “Sometimes I take a knee beside the patient or ask to sit on their bed. Those would be some examples of showing the patient respect, giving them some control, seeing them as a family member, and then really trying to communicate with our own bodies that we have time for them.”

How have you found and developed relationships with your mentors?

The metaphor that comes to Dr. Pittman’s mind is that of a ship in a harbor. Sometimes the ship is traveling, but other times it needs to come into port and restock. For the mentee, there are times when they are burned out and emotionally exhausted. They need someone to listen to them and provide advice.

Just as there are many ports in a ship’s journey, physicians should take the time to find different mentors along their life’s journey. Dr. Pittman believes it is a mentor’s responsibility to provide an environment that makes it natural for mentees to approach and interact with them.

The mentors that stood out to Dr. Pittman were the ones who demonstrated openness and were willing to journey with him through some of the hard emotions he was experiencing at the time.

What is one thing you wish you knew when you started medical school or residency?

For Dr. Pittman, he wishes he could have better understood the concept of deliberate practice. As he explains, deliberate practice is, “a certain kind of practice where you don’t focus on everything, but you focus on little bits at a time, with someone watching you, giving you regular feedback to get better.”

Dr. Pittman makes a sobering observation. “Sometimes, when we teach medical students, we say, all right, just go do the exam over and over again, by yourself, without observation or feedback. And rather than getting better in that way, they actually get good at being bad, or good at doing wrong, right? Because if you repeat the wrong thing over and over again, you just hardwire the wrong thing.”

In his opinion, it is much better to have someone journey with you and provide constructive feedback in the moment. This helps avoid a plethora of mistakes.

Pearls of Wisdom

1. Give back some of the control to the patient, and use that to improve the outcomes of the clinical encounter. Simply put: Treat patients how we would want to be treated – inspired by Dr. Jeffery Weiss.
2. Vulnerability is a sign of courage, not weakness – inspired by Brene Brown.
3. The path to become an expert requires deliberate practice, with continuous critiquing and constructive criticism – inspired by Anders Ericsson.