A Day in the Life of a Physician: Part 3

By Robin Dasilva and Therese Fitzgerald

This is the third in a series of four posts about a day in the life of Barry Izenstein, MD, an endocrinologist and internal medicine physician who practices in Springfield and Holyoke, Mass. Read Part 1 and Part 2.

Why I Am a Physician


Dr. Barry Izenstein’s dedication and compassion for his patients illustrates his motivation for choosing to practice medicine.

“Medicine was a calling, I thought about going into medicine since high school. I was also influenced by my father, who was a physician, and I wanted to take care of sick patients,” he said. “During my medical training in the 1970s, it was popular to go into a sub-specialty. I wanted to practice internal medicine, but also wanted to be a consultant in endocrinology in order to bring something else to internal medicine. Internal medicine and endocrinology seemed to go hand-and-hand. “

Dr. Izenstein explains that there are important characteristics needed to pursue the specialties he has chosen.

“Internists and endocrinologists must first be good listeners. Patients may arrive with multiple symptoms and signs that the physician must be careful to pay close attention to. They must also have the ability to pull together various facts and diagnoses in order to devise a plan for their patients.  A person doesn’t come in with one condition or diagnosis. Therefore, the physician needs to act like the conductor of the symphony, and the orchestra is the human body.”

Around noon, Dr. Izenstein takes a time out to have lunch. But just because he’s taking a break from seeing a constant stream of patients to eat a salad doesn’t mean he’s not working. Lunchtime consists of checking e-mails and returning phone calls between bites of his salad. Some of the e-mails Dr. Izenstein answers pertain to his work as a governor of the American College of Physicians.

Although Massachusetts consistently ranks high compared to other states for the number of physicians per 1,000 population, Dr. Izenstein’s juggling act reminds us that many of the physicians working in Massachusetts are balancing work and other health care sectors including research, teaching and leadership positions, in addition to — or in lieu of — providing direct patient care.

During lunch, Dr. Izenstein shares his thoughts on the passage of health care reform in Massachusetts and how it has impacted his medical practice.  To summarize his opinions, he refers to an article he had written for a local medical journal outlining the three essential elements he believes are needed in the national health care debate: universal access; fix primary care; and reform the tort system.

Dr. Izenstein believes that no matter what changes occur under health care reform, “My relationship with my patients will never change.” He does hope that ongoing health reform efforts will allow internists to spend “more time, not less, with their patients in the exam room.”

The hospitalist movement has changed the lifestyles of physicians coming into practice. Internal medicine practice is totally different now with not having to care for patients in the hospital. In this new generation you work in a hospital or private practice, not both. This allows for more time to attend soccer games and improve a physician’s lifestyle. Lifestyle is no longer going to be an issue for internal medicine physicians. It is far easier than a cardiologist, for example, who must bear the brunt of working in the emergency room in the middle of the night., although, cardiologists are compensated nicely.

Dr. Izenstein’s salad is almost gone and he has just enough time before his next scheduled patient to run next door to Baystate Medical Center to check on a couple of his patients who have been admitted for inpatient care. Although Dr. Izenstein’s patients are cared for by hospitalists when they are inpatients, Dr. Izenstein takes time to visit with them. Although he is not reimbursed for these visits, he likes to let his patients know that he is still involved and that he is available if they or the hospital staff needs him. Dr. Izenstein’s patients appeared happy to see him, and their family members thanked him for taking the time to visit with him

In Part 4: Dedication from Physician and Staff

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