This week's faculty spotlight is Kathleen Waite, MD, a primary care doctor at Duke's Pickett Road Clinic. In this interview we talk to her about building 20-year relationships with patients, helping patients with long-term behavior change, and her own figure skating career.
How long have you been at Duke? How long have you been a member of the Division?
I joined the Division when I finished my residency here at Duke in 1993.
What does a typical day for you at the Division look like?
Usually I start my day at home by reviewing all of my patient's labs, x-ray studies, and consultant reports from the day before. My goal is to have this all done before I get to the office and start seeing patients at 8 a.m. I have a combination of half-day and full-day sessions.
When I am done in clinic it is time to finish the notes, return phone calls, reach out to consultants to help coordinate care and prep charts for the next day. I enjoy teaching, so it is not unusual to have a medical student in clinic with me. At Pickett we also serve as a site for the Internal Medicine residents to do a continuity clinic so I precept the residents one session a week.
What aspects of your position do you enjoy the most?
I really enjoy seeing a wide variety of patients and disease processes. I am interested in education and serve as the director of the ambulatory outpatient rotation in Ambulatory Internal Medicine. My areas of interest include preventive medicine and women's health issues such as osteoporosis. I also enjoy dermatology and doing simple dermatology procedures like skin biopsies in clinic.
As a general medicine clinician, you spend a lot of time dealing with chronic issues that are complicated and require long-term behavior change. How do you establish open, effective communication about these subjects with your patients?
I think having an ongoing relationship with the patient is vital. Often we discuss different options for treatment and I illicit if the patient has a strong preference for one treatment strategy. Motivational interviewing techniques are very helpful with these issues. Understanding what the patient's fears or concerns are about their medical conditions is critical. Knowing what my patient is willing to do or not willing to do helps me provide them with the best care.
In your online profile, you talk about establishing long-term relationships with many of your patients. What’s the longest amount of time that you’ve been seeing a single patient? How does a long-term relationship affect your ability to communicate and provide care?
I have known many of my patients 15 to 20 years. It is wonderful to know not only a patient’s medical history but also to know that person as an individual. Sometimes this knowledge allows me to reflect back with the patient. For example, I can remind a patient that they were successful with weight loss several years previously and ask them what they did during that time. This allows the patient to help come up with behavioral changes based on their own experience.
How does this process differ when you see new patients? How do you go about establishing trust and communication with a patient who is a stranger to you?
Simply listening to new patients and allowing them to have time to talk is very helpful. Of course, this is often very challenging to do given the pace of clinic. To truly build trust, it is important to inform patients in situations where an uncertainty in their diagnosis exists, and to share the various treatment options in a way they can fully understand, especially in the case where a chronic illness needs to be controlled. I try to explain to patients their plan of care and reassure them that other options are available if needed. Most patients respond well when they understand their care plan.
What passions or hobbies do you have outside of the Division?
Outside of work I enjoy family activities - I have 2 boys, one 13 and one 16. I love going to the Duke Basketball games with my husband or one of my boys. Most of my weekends I spend watching both of my sons playing ice hockey. Recently, our family adopted a dog from the shelter and I have been learning about dog training with my youngest son. I also have enjoyed figure skating for years.
How long have you been figure skating? Do you specialize in a certain event or type of skating?
I started skating as a child when I lived in Canada. I can remember skating when I was three years old. I was able to skate throughout college. In college, however, I gave up freestyle (single) skating and did ice dancing only. I now am a judge as well and I am certified to judge all test levels in freestyle, pairs, dance and moves in the field (basic skating skills that replaced the figures that were once done). Typically I will judge in VA, NC, and SC on the weekends. It's been fun to see how much figure skating has grown in the area over the last 10 years.