Savage.MD Blog

Today was a whirlwind. I'm on the Bone Marrow Transplant Service this month, and that alone would make any day busy. Today, though, was a little different. The day started at 7:30 with me pre-rounding on my patients before going to see them on the floor an hour later. Rounds started at 9:15 am. Half way through rounds, the nurses from our apharesis unit let me know that one of my patients from a few months ago was on site for labs and hoped to see me. I made a note of this and continued with rounds. Rounds finished at 10:30 am. I went to see the patient in apheresis. He's had a complicated course with advanced cancer and I was worried he might not make it through the Christmas holiday weekend. It was so good to see him! We talked about his family. He also told me that he'll be starting hospice care this week, which means today might be the last time we might see one another. I walked his wife and him to their vehicle to say goodbye one last time. It was truly the highlight ...

I wrote this poem April 26, 2020.  The green & gold elephant with its crown sits above my fireplace mantle. Small enough to fit in my palm, but weighty because of its metal base.  This token brings good fortune to our home. It reminds me of my Texas friend John.  I have known him since age 10.  He gave this as a parting gift before we came to Ohio two years ago. I wrote the poem as a part of a "poetry workshop" hosted by the House Staff Association at the Cleveland Clinic planned Dr. Abarna Ramanathan. Poetry is a "way to observe things around you that you take for granted," and I was asked to describe the meaning of the first thing that met my eye that day. I thought of the poem again this week when I got a wedding invitation from Dr. Ramanathan for November 2022 in New York City. She was one of my first friends in residency, and I am so happy for her. The poem describes another very dear friend named John who I first met in the fifth grade. Like me, he was...

Today ends Block 5 of fellowship. It's amazing to think I've already been in fellowship for five months. It's been a really great experience so far and I'm so proud to be in my program at Scripps. This week was especially busy. Early Saturday I attended the tail end of the AMA-CME meeting. We were supposed to have met in Orlando, FL, but the meeting became virtual because of the COVID-19 pandemic. Sunday afternoon the AMA had a really excellent forum on Health Equity. Saturday night I worked my fist moonlight shift as an attending at the VA San Diego. I still fondly remember going to the VA Dallas with my grandparents as a kid. My grandpa got all his care there and thought the world of his doctors. It really means a lot to me now to be a VA doctor, even if only part time. I worked with UCSD residents and had a great time as we cared for our patients. I look forward to working at the VA again next month. Sunday after taking a nap I continued working on my NIH grant appli...

 There were a lot of great things that happened this week, but two in particular stand out. Wednesday I was seeing a patient in a faculty clinic. This means that the faculty member is the primary hematologist/oncologist, while I'm just a guest in the clinic for the month. I try to explain this to patients when I first meet them so they understand my role on the team. In this instance, mid-conversation with the patient, our team's nurse entered the room to draw blood. I was just about to examine the patient, when her partner asked, "Could you tell me again what your role is, doctor?" I again explained that I am a rotating physician in the faculty clinic for the month. Then the nurse spoke up for me and provided some additional context. She said "Well actually, Dr. Savage is a fellow, which means he's already a fully board certified doctor in internal medicine, but he's getting extra training in this field." This put my patient at ease, but it was also...

Today I was elected to be the next Chair of the CMA Resident and Fellow Section (RFS) . This will be my first chance to participate in a leadership position within the California Medical Association and I'm very excited.  The slate of leaders that were elected alongside me are phenomenal physicians and advocates for medicine and trainees. It's also a bit of a homecoming. I have known many of the people actively involved in the CMA-RFS for years because of our work together in the American Medical Association. I've been a proud AMA member since 2009, and the first national meeting I participated in was Fall 2009 in Houston. In 2012-2013, I was Chair of the Texas Medical Association Medical Student Section (MSS). In 2019-2020, I was Chair of the Ohio State Medical Association RFS. It'll be fun to lead now in my third state of California. Each of these positions has helped me grow as a leader, advocate for meaningful change for my colleagues, and grow my network of profess...

Today a physician mentor told me a story of some local oncologists who recently had their practice turned upside down by venture capital. It was formerly a private practice group of three physicians. One physician owned the practice. The other two physicians were employed. The owner decided to retire and rather than selling to his employees, he sold the practice to a venture capital firm. The VC firm owner is a businessperson and not a physician. The VC investor's goal was to make as much money as possible from the practice. So the VC firm shortened all the appointment slots and introduced untenable "production goals" for the employee physicians, requiring them to see a certain large number of patients per day. These are cancer  patients, some on treatment and experiencing complications. The thought of such appointments being cut short for the sake of profit broke my heart. The thought of two well-meaning physicians being forced to cut corners to make money for the VC own...

Last Monday I got the most exciting news earlier than expected. I am now a Board Certified internist! This was the culmination of three years of training in internal medicine at Cleveland Clinic and UCSD, and the next step in a lifetime of learning to be the best doctor I can be for my patients. I became "board eligible" after June 2021 when I graduated from residency at UCSD. I started to study using ACP's MKSAP in Jan 2021, but I took it up a step starting July 1 once fellowship began. I studied 2-3 hours each weeknight and spent each weekend studying throughout the two months before my exam at the end of August. By the time test day arrived, I had completed 2400 practice questions (from MKSAP and UWorld) and read each chapter of ACP's Board Basics  multiple times. I felt as ready as I could be. It was so gratifying to find out that I'm not Board Certified. Our residency class at UCSD had a 100% pass rate this year, which is a remarkable achievement for my progr...