Dr. James Marcin
AMSA 10/13/17 Speaker Dr. James Marcin
Pediatric Critical Care
Work with lots of different people
Very, very rewarding.
Been to the philippines for medical projects.
UC davis has a lot of research going on. Clinical care, Education and Service
Work in the Pediatric intensive care unit
Largest in sacramento
Level 1 pediatric trauma center
Babies that are born term all the way up to 18 years.
Biased, like kids more than adults
Born in orange county- no one else in the family is in medicine
Public school- uc san diego
I have 5 kids
Medicine with many options
Children’s national medical center
Uc davis first job as a dr at 33 yrs old and have been there ever since
25% in hospital
Teaching, research, and administration
Do like a lot working with students. Start off with lots of clinical.
Able to structure a bit of what you do.
Lots of different things that are seen, trauma, cancer, diseases
Telecommunication of medicine. Medicine over skype
Lots of patients that travel more than 5 hours to get to have a 15 min appt with a specialist.
So many time an appointment can be done over high resolution video. More than 40,000 visits are done that way.
With this technology you can see an expert without having to drive to the local office. There are Dr.’s in southern CA that see patients in northern CA
It can reduce the cost of seeing a dr.
There are many workplaces that have dr. Kiosks, and the work pays for it, so the person doesn't have to take off a lot of time to see a dr.
In many smaller cities there is a lack of specialists so to help cover the need There are many tele specialists that can be video called.
There are surveys being done to determine how much families like the technology and ability to telecommunicate and if they prefer to do it this was or come to an office.
There is also a factor of how much money it can potentially save.
When getting news people have increasingly wanted to get it as fast as they can, and would rather be around friends and family when they get the news.
Kaiser is increasingly using the video technology more and more.
There is also an increasing use of videio psychology.
Video interpreters about ⅓ of all interpretation is done in person the other ⅔ is now done over video.
Telemedicine saves lives
W;hen some dr.s are on call, they are at their home on call. Others like myself when we are on call we are in the hospital.
What keeps you going: it's a blessing to work with other people. It’s one thing to be up trying to read or study at four in the morning, but it’s something different when your working. At four in the morning this morning i was doing chest compressions on a baby.
Comradery is a big part of it. When you come home at the end of the day its neat to know that what you are doing makes a difference. Its touching peoples lives.
You want to do things that you are good at and passionate about.
Here in the US we do lots of screening, and when caught early they can go up well “normal”
In the philippines that are many islands and they have a desire to do screenings just like the US so things can be caught early. Cost is a big issue, so telecommunication is being introduced over there.
What is it like working in the NICU it’s an amazing place. When babies come out early or early and sick. The most important part is to help the babies through that. The babies tend to be in there for months, and sometimes they pass away. There tends to be bonding with the family. It is a real skill to be able to talk to a family about a baby, especially when there is bad news. The interaction with the kids and the family can have lasting impressions.
Any advice. Folks that try for medicine and go into medicine, workaholics and perfectionists. If you're going to go for it, really go for it. You have to do it hard core. If you don’t put a lot of effort into it, it lessens the chance of getting in. If it doesn't work you can say you gave it your best shot.
Burn out. There are a lot of drs that are not counting down to retirement, that are wanting to do it for as long as they can, it’s their passion and their life. The whole thing is an investment.
Kangaroo care. There is a unit at UC davis that does kangaroo care.
In medicine there is a lot of things that we do wrong, but we are constantly trying to improve.
Research. In the philippines trying to do low cost telecommunications and machines hooked up.
PMR and EMS (emergency medical services)
Work with 2 grad students
2 med students
Wife is a nurse at the same place of work
How often are you in surgery
Don’t go to the operating room.
Do a little bit of central lines and things like that.
I like talking to families.
Why choose pediatric critical care vs regular peds
Most that go into peds are women, because of the regular schedule. In crit care the schedule is constant kids get sick 24/7. Most of the people going into peds don’t do it for the paycheck, it’s the lowest pay, they do it because they love kids. Not a lot of ego in it. Love kids.
UC davis a biggest trauma center. High speed blunt trauma, farming accidents. Sacramento is a little bit more real. A lot of asthma in the central valley.
Get good scores and good grades and be diverse.
Feel free to contact me. Seriously I would love to hook you up with somewhere you want to be.