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What Makes a Good Primary Care Physician?

Robert A. Goldsteen, DO, FACP
BCOM Chair of Primary Care; Professor of Internal Medicine

Hometown: Born in Philadelphia, Pennsylvania, but considers the Dallas, Texas area home.

Education: B.A. in Psychology and Pre-Medicine from Washington University in St. Louis; D.O from University of North Texas Health Sciences Center

Military Service: Attended college on a U.S. Army ROTC Scholarship; completed residency at William Beaumont Army Medical Center in El Paso, Texas; served in the US Army from ROTC in college to flight surgeon to serving as Chief of Inpatient Medical Service at Walter Reed Army Medical Center in Washington D.C.

Family: Wife, Anne Weinberg, is a Ph.D. Clinical Psychologist. They have two daughters, ages 15 and 9. “My daughters are my greatest accomplishment!”

Hobbies: Golfing, reading, financial planning, interior design.

How are you and your family enjoying Southern New Mexico?
We are loving the natural scenery. We’ve been hiking at Dripping Springs and up in the mountains. We’ve found restaurants that we really enjoy and we’ve started to embrace the Saturday market. People are nicer than they are on the East Coast, for sure. You can quote me as saying that the friendliest, warmest people I’ve ever met have been here in Las Cruces. I also really appreciate the Hispanic community’s tradition of taking care of extended family. My daughters are making friends within the community and it is a wonderful thing. Instead of being perhaps relegated to the nursing home, grandparents live with the family and help raise the kids. I like that multigenerational dynamic that places so much emphasis on the importance of family.

You’ve been educating medical students and army nurses, medics, and doctors since 1996. What qualities make up a successful medical student?
Students that have the “it” factor. When I can see that sparkle, enthusiasm, and interest in their eyes and they show that they are teachable. Discovering that the students are receptive and want to learn is invigorating to me. I enjoy when they show a thirst for knowledge. The students that have the hardest time in medical school are those that have the “I’m here, I’m passing through, tell me what I need to do” attitude. But the students that ask questions, that want to know about their career options, that are obviously stimulated by the study of medicine—these are the students that will always do well as they are “teachable.” This can be the case even if they have poor grades in their first two years. Medicine is as much about personality, desire to learn, and tolerating adversity as it is about studying.

What other tips do you have on getting through medical school?
My biggest, biggest tip is to live your life in the moment. Medical students spend so much time feeling pressure about what will come tomorrow. They worry about doing well in high school so they can get into a good college. Then, they toil through pre-med classes and the MCAT and medical school applications. Once they finally get in, the curriculum is inherently difficult, but they worry about getting good grades/ board scores, and fighting for the right residencies and fellowships. Eventually, if a student is always only looking for that golden ring at the end, they look back and realize how many years have been lost. My message: Being in the moment is so important; you’ve got to derive a little bit of joy out of everything that you do. No one knows what tomorrow brings, and the more you’re in the medical field, the more you realize that there is a rather slender thread of life. We have no idea what’s going to happen tomorrow, whether it’s an accident or cancer, reward or pain. If medical students can find ways to enjoy the process or at least certain moments, they’ll get much more out of the experience than if they are always saying “I’m miserable” or “I hate this.”

What are your goals for the Primary Care Department at BCOM?
We are always trying to increase our ranks for more people to bring more perspectives. The best thing we can do for students is to give them a lot of different perspectives on how medicine is practiced. This allows them to pick and choose the best parts of our teaching and experience. Of course, we want the students to be able show competency on exams and multiple choice tests, but “competency” also means walking into a rotation and being able to come up with a good differential diagnosis. It means being personable in how you interact with people. It’s being a good listener and soaking up any new information coming your way like a sponge. It’s knowing that a physical exam is not about just checking the boxes. We want the students to feel good about what they do and why they do it. Being a doctor is a lifelong learning process, so we don’t expect them to leave here with all the knowledge they will ever need, but we want them to hold their heads high and be able to say, “I’m good at the basics and I’m as good at the basics as I can be.” We hope they will be humble and feel confident to have a thirst for learning and be able to look up the answer whenever they want.

You were recognized as one of the Best Doctors in Dallas for multiple years. What makes a good primary care physician?
I grew up in a household where we exchanged a lot of ideas and were taught to think broadly. My father was an architect and urban planner by training, but he was also a university professor. My mother was a teacher as well. They raised me to be extremely flexible with my thoughts, and one thing I pride myself on is understanding both sides of an issue. One hurdle I think medical students need to realize is that it’s okay to be who you are and have your own perspectives, but you also have to be willing to hear other points of view. If I’ve succeeded in training medical students, they will be able to walk in to an exam room, discuss any issue from gender to religion, and really hear the patient’s perspective without judgement. In the end, every viewpoint is equally correct because it is coming from that particular person’s belief system.

What other advice do you have for new primary care physicians entering the workforce?
Primary care doctors make a lot of sacrifices, yet they often feel like there is never enough time to spend with each patient. We often leave the room feeling as if we wanted to give more of ourselves and realize that we can’t because there are so many other patients waiting to be seen. Every primary care doctor feels like they can’t do enough. Also we feel the same as medical students, that we have to take care of ourselves also. You’ve got to be happy too. There is a bottomless pit of health issues that need addressing, but there is only one of you. You can’t do it all and you can’t make everyone happy. While selflessness is certainly an important trait for a doctor to have, you also have to occasionally have the ability to be self-protective and a bit selfish because otherwise you’re not good for anybody.