Virtual Mentor

An Interview With...

John W. Calkins, MD, Professor
Department of Obstetrics & Gynecology

Recipient of the: Ruth Bohan Teaching Professorship 2006

POSITION: Medical Director / Health Officer for the Health Department of the Unified Government of Wyandotte County/Kansas City, KS and Associate Professor in the Department of Family Medicine.

WHAT IS YOUR HOMETOWN?
Kansas City. I’ve lived in Overland Park most of my adult life.

WHEN DID YOU JOIN THE KUSOM FACULTY?
1980

HOW/WHEN DID YOU BECOME INTERESTED IN SCIENCE AND MEDICINE?
It probably came from a comment my mother made when I was very young. She told me I had big hands and would make a good doctor. Although my father was Chairman of this department until shortly before his death, when I was 9, I never really appreciated the “physician” aspect of his life until much later.

IS THERE A TEACHER OR MENTOR WHO HELPED SHAPE YOUR CAREER?
Yes. Dr. Kermit E. Krantz, past Chairman of my department and my father’s successor as Chair. His undying support of my career began early and continued with his influence on my choice of residency programs and then the obvious one, staying on as a member of his faculty in 1980. When he retired from the Chair in 1990, he recommended me for his successor and I was one of three candidates for the position in the initial search.

HOW OR WHY DID YOU CHOOSE THE KU SCHOOL OF MEDICINE?
I believe my undergraduate GPA (3.0) influenced my medical school choice. The Associate Dean for Admission at the time “dogged” me about my GPA during my 1st semester as a medical student. He stopped at the end of the semester when I ended up being 1st in my class ... With no help from Kermit I might add.

WHAT KINDS OF PROFESSIONAL OPPORTUNITIES OR ADVANTAGES DOES BEING A FACULTY MEMBER AT KUSOM PROVIDE? WHAT ABOUT CHALLENGES?
Sometimes changes on campus first appear to be major but are usually just on the surface. One great advantage I have derived from being at KUMC is the continual opportunity to establish new relationships, be it students or residents. Many have continued to touch base with me through the years, both professionally and socially. The former at times creates one of the challenges, that is, the difficult patient management scenario about which my advice is sought. Some of these former students or residents are clearly brighter than me, and yet they expect me to solve a problem that has stumped them.

PLEASE DESCRIBE YOUR PROFESSIONAL INTERESTS?
First is doctor-patient care. Second, and what has kept me here 26 years is teaching – the interaction with students and residents. Specifically I love getting involved as a teacher: lecturing, small group interactions, presenting in a way that students get the most out of it, and working with them. Third is the technical side of my practice – the continued evolution in the arena of pap smears, laser, and HPV along with my own training to stay current in the field.

WHAT ARE SOME OF YOUR OUTSIDE INTERESTS?
Family is the significant component followed by selecting a career path (academic medicine) that offers a life style supportive of spending time with my family. I’ve stayed active in the lives of my children as they have grown, like coaching 3-2 baseball for both my sons. As far as hobbies, I try to play golf once or twice a week and still canoe and fish with old friends from medical school every two to three years.

IN WHAT WAYS ARE YOU ENGAGED WITH THE GREATER KANSAS PUBLIC?
I am a member of several local, state and national OB/GYN professional organizations. As for the greater Kansas public, probably activities through my kids like coaching 3-2 baseball, attending swim meets or Boy Scout campouts.

DO YOU HAVE AN INSIGHT OR PHILOSOPHY THAT GUIDES YOU IN YOUR PROFESSIONAL WORK?
Two areas: Patient Care – I’m committed to my patients. I see many physicians that are not committed to their patients and that is very frustrating to me. For example, how some doctors can care for a woman during her entire pregnancy and then pass her off at the end saying “you take care of it.” Nature’s schedule doesn’t always follow ours but if you are committed to your patient you have to follow her care all the way through. Education – I had great resident teachers as a medical student so I wanted to continue the trend by providing my students with good learning materials. I want to give back what one time was given to me.

IF YOU COULD CHANGE ONE THING ABOUT THE WORLD (OR THE WORLD OF MEDICINE/SCIENCE), WHAT WOULD IT BE?
My biggest pet peeve is doctors that don’t “care” about the patient so I would say I would like to make physicians more compassionate.

WHAT IS THE BIGGEST CHANGE YOU'VE EXPERIENCED IN YOUR FIELD SINCE YOU WERE A STUDENT?
The biggest changes have been advancements in minimally invasive surgery and the reduction in length of stay. C-sections use to stay 5 to 6 days, now they stay 2. Vaginal deliveries stayed 3, now 24 hours. Hysterectomy patients were a 2 to 3 day stay and now with hysterectomies being performed laproscopically the stays are substantially much shorter. Another major change is with resident education. It has become much more scripted with 80 hour work weeks and other work issues mandated across all specialties. When I was a resident on call you never saw an attending. Today the attending on-call is 24/7 on-site.

WHAT DO YOU SEE AS THE FUTURE OF MEDICINE?
Unfortunately, one “development” I see looming on the horizon in Medicine is an increasing tendency for “shift work” to accommodate life styles for our future physicians. Even in Obstetrics and Gynecology, we are beginning to see “laborists,” i.e. Physicians who only cover labor and delivery and manage all the patients that come through that unit. Thus we are moving away from the continuity of care concept which I personally feel very strongly about.

WHAT PARTICULAR SKILLS ACQUIRED DURING YOUR GRADUATE CAREER DO YOU FIND MOST VALUABLE IN YOUR PROFESSIONAL CAREER TODAY?

1. From a medical school aspect – I’m a big supporter of the new medical school curriculum.  Integrating materials/studies with patient care is difficult and I believe this new system will give students a better foundation than the system in which I was trained.
2. From the technology aspect – I’m an “old dog”, but sometimes that’s an advantage.  For example I learned how to treat certain symptoms or cases with surgery.  Today’s younger physicians have learned methods that involve newer technology that is less invasive than surgery.  One of the advantages is that it has allowed me to perfect or improve the areas in which I’m more interested or those which utilize my strengths.  I have actually referred some of my patients to my colleagues trained on newer or better techniques. I don’t need to be a “jack of all trades” although some physicians seem to think they need to be in order to build their practices.  Junior faculty need to know (or learn) their limitations, accept them and perfect their strengths.  Kermit taught me how to respect junior faculty by referring patients of his own to those of us that were better skilled than he (if that is possible) … thus building junior faculty practices.  Mine was one as he referred to me patients that needed laser surgery because that was not something he did regularly.  I have continued to follow this practice today and do not feel threatened by giving up my patients to a physician better skilled at handling their medical needs.
3. From a personal aspect --I think over the life of my career I have realized the value of life-long learning skills such as reading.  I read much more now than I did when I first joined the faculty, and what I read has become more and more broad based.  I wish I would have begun this practice much earlier in my career.

WHAT ONE PIECE OF ADVICE YOU WOULD GIVE TO:

MEDICAL STUDENTS:
Focus more on developing your medical knowledge foundation & less on achieving a great grade. The former will take care of the latter, especially if you show interest in what you are doing.

GRADUATE STUDENTS:
Consider medical school!

RESIDENTS:
Develop your life-long learning skills now, which will not only facilitate passing board exams but is going to be critical in the near future for maintenance of certification.

JUNIOR FACULTY:
Don’t be afraid due to time constraints to get involved in professional organizations appropriate to your specialty. The connections that come from such involvement & the opportunity to “network” with colleagues across the country will not only strengthen your knowledge base, but also provide some diverse points of view not always available when one restricts themselves to one institution.

WHAT DO YOU BELIEVE IS THE KEY REASON THAT LED TO YOUR SELECTION OVER ALL OTHERS IN FOR BEING PRESENTED THE AWARD LISTED ABOVE?
“Perseverance, tolerance and blind stupidity for being so devoted to this institution.”

AS A VIRTUAL MENTOR, PLEASE OFFER YOUR ADVICE TO NEW AND/OR JUNIOR FACULTY ON A TOPIC OF YOUR CHOICE. (Mentors have a list of over 100 topics from which to choose for this interview, and target their advice to junior faculty.)

TOPIC 1: Asking for Help
ADVICE: never be afraid to ask for help. Many physicians are embarrassed to even imply they don’t know everything when they complete their training. Personally, I still learn things daily, and I respect physicians that recognize their limitations. Obviously they must care for their patients to ask someone with more experience to participate in their case.

TOPIC 2: Bedside Teaching
ADVICE: Include the patient in the teaching process while in their presence. They will typically validate your position, and actually make great teachers themselves.

TOPIC 3:Dealing with Students that Feel Entitled to an “A”
ADVICE: the vast majority of medical students are very accustomed to getting straight “A’s” in school. Consequently it is their right, not their privilege. I try to emphasize the value of obtaining a good fund of knowledge, a caring approach to patients, and let the grade take care of itself. A “B” is a very good grade.

TOPIC 4: Developing & Assessing Students’ Thinking Skills
ADVICE: Especially in the clinical setting, I emphasize common sense – try to have the student focus on the obvious issues, not the obscure ones. In academics many times the obscure issues get emphasized because they make good test questions.

TOPIC 5: Office Hours Outside the Office
ADVICE: Time management is a valuable skill to master, especially if one has a family. In my practice I spend a few nights each month on call in the Hospital supervising residents. Realizing that there will be periods of time on call when I am just sitting around waiting for a delivery, I will leave office work to do at those times to fill the void. In that way, on off nights, I can go home a little earlier to spend time with my kids.

TOPIC 6: We Are Here For Them, Patients Aren’t Here For Us
ADVICE: Students must be very aware that it is a privilege to participate in the care of our patients, no matter what their mechanism of reimbursement may be. The patient can clearly choose not to have students participate. I make a point to personally thank each of my patients for allowing the student to be involved in her evaluation.

TOPIC 7: When It Is Time to Leave
ADVICE: This is something I have yet to figure out.