Dr. Jay Perman knows that in medicine, seconds count.
But Perman, who recently left his position as dean of the University of Kentucky College of Medicine, to become president of the University of Maryland, Baltimore, also knows that seconds matter not just in the fast-paced environments of the emergency room or in the surgical bay.
They matter just as much in the consulting room, where careful listening is crucial to a good diagnosis, he said.
"The ability to listen, that's what patients want," said Perman, during an interview in his last week at UK earlier this summer. Studies have shown that an additional 32 to 35 seconds of uninterrupted conversation with a doctor improves patient safety and decreases lawsuits, he said.
"I've tried to take the sort of soft and fluffy out of it. But you have got to be nice. You have to ask them to express their concerns and not interrupt them," he said. "That's not something that is necessarily taught in medical school."
But it's something Perman emphasized, especially during the three days a month when he would see pediatric patients in the UK clinic.
"In the back of my mind, I always hear Dr. Perman saying, 'You have to let the patient speak,'" said Dr. Janelle Reed, an emergency room doctor who was a student during Perman's tenure.
In addition to knowing nearly all the 600-plus medical students by name, she said, Perman talked frequently about the need to work across departments and specialties.
As dean of the College of Medicine, Perman oversaw 700 faculty members, 1,800 staff members and more than 500 residents and fellows.
Pharmacists, nurses and doctors all speak a different language and come at patient care from slightly different angles. Perman formed committees to help various segments better understand each other and work together more effectively, Reed said. He changed the culture, she said, bringing home the lesson "that we all have a common goal of patient care."
Perman didn't just preach about listening, said Carol Jordan, executive director of the Center for Research on Violence Against Women. Within a week of Perman's arrival at UK in 2004, Jordan called him to get an appointment to talk to him about her then-fledging research center. She was floored when he told her to come by his office.
"There was no way he should have taken that appointment," she said. There were dozens of other people he needed to meet as he became acquainted with the new university. But he met with her and "let me talk for, like, two hours." It was the beginning of a great working relationship, she said. He took seriously the link between domestic violence and women's health and helped the center grow and thrive, she said. He put in place changes that make a real difference in patients' lives. For example, because of the center's research, any woman coming in to the high-risk obstetrics neonatal department is asked about domestic violence in her life.
Having Perman move on to another school "is a huge loss," Reed said.
Of his tenure at UK, Perman said that he is proudest of his efforts to recruit women and minorities to the medical school and his outreach efforts. He was honored by the Lexington Fayette-County Health Department this year as a "public health hero" for creating the UK Jumpin' Jaguars, an after-school program at Fayette County's Johnson Elementary that promotes healthy, active lifestyles.
Reaching out is a lesson Perman said he learned early. His parents operated a hand laundry in Chicago, and his mother was the seamstress. He saw his parents put their social consciousness into action in their everyday lives.
"People would bring their clothes in to be repaired, maybe it would be their only shirt. Even if they didn't have any money, they would get stitched up," he said.
He said he knew he wanted to be a doctor by the time he was 4 or 5. The only "fork in the road" was a brief consideration about becoming a rabbi. Ultimately, his true passion was medicine.
When he talks to someone about to embark on a medical career, he said, he always asks the same question: "Are you ready to work hard?"
People tend to underestimate the amount of training and the amount of money that goes into the profession, he said. The best physicians realize that the eventual monetary rewards can't be a primary motivation.
It all goes back to his central philosophy: Seconds matter. Civility counts.
A doctor has to make a point to be considerate of his patients and his peers. If that message resonates after his tenure at UK, he said, he will have accomplished something.
"I hope I have changed the culture," he said.