
Family Medicine Clinician Spotlight: Jason Wall, MD
Jason Wall, MD, is a family medicine doctor and faculty member in the Duluth Family Medicine Residency Program. He received his medical degree from Chicago Medical School/Rosalind Franklin University of Medicine Science and has been in practice for more than 20 years.
What brings you joy in practicing your specialty and why?
Joy is sort of a twofold endeavor. What comes to mind is working in the hospital with the residents and the flow that we get from seeing a patient for the first time and then fixing them up.
Learning together and being together through the ups and downs of our patients and hospitalizations . . . It's a great chance to learn and it's also a great chance to work on the art of medicine. Good listening skills, good communication skills: They are every bit as important as the proper sort of medical knowledge, too.
I would make the case that you really can't be a great physician without the whole package. You need the medical knowledge, but you also need to be able to listen well and communicate well and engage or partner with the patient so that you're actually achieving the outcome that they would desire, too. Most joy happens when we're busy on the inpatient service and we're learning a lot and our patients are getting better. When the hard work actually becomes fun, having a little bit of joy or fun during a demanding day—that really insulates us against burnout.
Why did you choose family medicine?
There really was never any choice. I came from graduate school in the humanities (I have a master’s degree in ethics and theology) and wanted something more hands-on. Medical school was sort of an audition for family medicine anyway. I always envisioned being a generalist and looking at a person's health holistically.
My graduate studies definitely made me a more thoughtful doctor. It helped me realize that just because there might be a medical answer, that's not always the best path forward for that particular individual.
What advice would you give to yourself as a physician just starting out?
I think Osler said it: “The greater the ignorance, the greater the dogmatism.” Medicine is constantly humbling. There's always this drive to have the right answer right away, to be quick and efficient. And I would tell people to take their time. I know that's sort of wishful thinking in the fast-paced world of medicine, but within the bounds of a patient visit, I would say: stop and listen.
We know that as physicians, we’re historically very bad listeners. We interrupt the patient, often under half a minute. So, listen and make sure you attend to why the patient's there. Basically, touch what hurts. Lots of times patients come in and they say, “I didn't even get to talk about what I wanted to talk about.”
The last thing would be making sure that communication is happening. I can think of all the visits I had where what I said sounded very good from a medical standpoint and would sound great in front of a group of physicians or rounds or in a lecture. But it actually wasn't very meaningful to the patient and or their families.
It's funny: Alan Alda, who played Hawkeye on the TV show "MASH," runs this whole institute out in New York about translating science. It’s all about, with good fidelity, taking scientific language or medical language and making it relevant to wherever that person's at in their understanding and their education level. I think there's a lot of wisdom in that. Especially with medicine when you're talking about big decisions or end-of-life care. All too often people need time to hear it, and to hear it again.
We've gotten a lot better with teaching back and saying to the patient, yes, we've talked about a lot of things today and we really want to make sure that we're on the same page. Tell me what your understanding of the plan is. I would just tell myself to slow down and be a better listener. Listening is so important because if the patient isn't on board, nothing you're doing really matters.
What are your key messages when teaching residents clinical care?
I like to say that a good family physician does all of the simple things well. And when you do all the simple things well, then it's much easier to move to the complex things: taking a good history, thinking about your labs, making sure you're looking at all the results and reviewing the chart. Be thorough and do your homework, and then often the more challenging diagnosis presents itself. So it's sort of that plea for doing the simple basic things like we do in medicine, do the exam, look at the labs, look at the vitals, and talk to the patient.
There's this intersection of knowledge: We're always working on our knowledge, and then there's experience. We get that by being out there and seeing patients. And so you hope that over time, knowledge and experience give you that wisdom so that you can make good decisions for patients. Keep things simple, do all the basics so that you can keep learning, gain experience, and hopefully be a wise physician. I'm not saying I'm a wise physician, but that's what I shoot for.
What are you particularly proud of as you consider your clinical career so far?
I've been at the residency since 2011, and, figuring about nine residents per year for about 14 years, that's about 126 residents that we've prepared to go into the practice of their choice. it's sort of that ripple effect you see as a teacher. It's nice to think that you've contributed to the impact that these young physicians are having in their communities and the greater country.
We also started treating a lot of hepatitis C about six or seven years ago. And that's been incredibly rewarding because of the addiction medicine we do here in the clinic; to now be able to do some lab work and get them treated within a short period of time without having to refer to another clinic. It is super satisfying, and I feel like it's been a big leap forward in what primary care can do for people with hepatitis C.
What do you hope to achieve in the years to come?
I really believe that family medicine, the well-trained generalist, is the way out of our healthcare crisis. Family medicine is, I think, going to be the backbone of affordable, high-quality, highly accessible healthcare in the US moving forward. I just hope that the rest of the country sees it that way as well.
If you're a family medicine physician and you have a good training base, you can do a lot: sports medicine, psychiatry, dermatology, all that stuff that your community is going to need. And those are people that otherwise would have to travel a long distance, wait a long time, or they would just never get that care. I think those are all part of why family medicine is such a vital service to America, especially rural America. And then the same with urban—they're just underserved in their own particular ways, and family medicine suits those environments well.
What do you enjoy doing in your spare time?
I have too many interests, but I like fixing things because it gives me that immediate gratification. I really like keeping things working and out of the landfill. It's very satisfying to reuse or repurpose or just fix something, and I find it empowering to know that I can do it.
The other day, my truck was indicating that the O2 sensor was bad. I went to the muffler shop, and they told me to come back in a week. I just went to the auto parts store, bought the oxygen sensor wrench, bought the O2 sensor from the dealership, and then 10 minutes later it was fixed. I just like tinkering with stuff.