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What’s it like for a doctor to start painting again after 22 years?

Dr. James Legan has practiced internal medicine at his office in Great Falls, Montana (a town of under 60,000 people) for 22 years. Within the last year, he has rediscovered a love of painting. This has led him to paint portraits of his parents, profiles of famous generals, Namibian wildlife from photos that a patient brought him, and even portraits requested by patients. Dr. Legan hangs some of his work in his clinic, often prompting a different kind of conversation with patients—even ones he has known for years. He has also found an appreciative audience for his work on twitter, where he uploads photos of his paintings in various stages to completion. Apart from creating art, Dr. Legan has brought innovation to his clinic by MacGyvering a “projected electronic health record (EHR).” By projecting a patient’s EHR from a simple Chromebook to a flat screen TV shown to patients during appointments, Dr. Legan is able to decrease the feeling of paternalism in care and instead engage patients as equals.

Read about Dr. Legan’s inspiration for art and innovation in my Q&A with him below, and check out this gallery of some of his work:

V: How did you decide to start painting? Did you paint a lot when you were younger?

Dr. Legan: I’ve always been interested in art. My maternal grandmother did some painting (oils and pastels), quilted, and played the piano. My mother had a really nice singing voice and she did a lot of singing. So as a student, I was always attracted to drawing, and in high school I had an excellent art teacher. In college, I took an art history course as a freshman and an after-hours painting course where I painted a little bit with acrylics. That’s about the extent of it. Once I got into medical school and then residency, that part of me just sort of withered on the vine. I had moments where I’d think about it, but I just didn’t really put it as very important and it just sort of died off. I never really thought I’d become re-acquainted with that part of my interests. So probably what started this, and it’s kind of hard to define for sure, was being forced to go down a different pathway with technology in transitioning my practice to electronic records. That alternative pathway opened up a doorway. I had never done any social media, so I started twitter, much to my son’s chagrin, last June. Then, I started blogging. Then, all of a sudden, I just felt this desire to start painting again. I went and got a bunch of acrylic paints and started doing it, and it’s really been a therapeutic thing for me.

V: Do your patients see your paintings? How do they react to the fact that you’ve started painting?

Dr. Legan: I’ve got quite a few hanging up around exam rooms and the common area. And we have a large screen TV in each exam room, so I’ll often go onto my twitter and share some of the stuff that I may not have hanging, if they’re interested. It’s opened up a whole brand new world of exploration. I’ve been practicing for 22 years but only recently, I found out one patient is a professional painter showing his work in other cities. I had no idea he even painted. So I’m finding all these interests that people have that I haven’t yet explored. And now that I start talking about painting, it really opens up a whole different fascinating conversation. It’s been a very positive thing.

V: I wanted to ask you about your concept of the”Projected EHR” in clinic. Can you tell me about that idea and where it came from?

Dr. Legan: When I project the electronic record, it’s easy to walk patients through it to understand what I’m doing. Now, I have 4+ years of data points, so I start off with blood pressure, body mass index, and weight, and we look at those over time. Then, I drop down to the past medical history section, expand that on the screen, and we go through their history together so that if they see something that’s not right, they’ll correct me, and I type it right then and there so they can see it. We write it in real time, so it’s like a school project, like we’re working on something together. I’ve got their attention and they’re directing me. We always hear about the problem of paternalism with doctors, but this really empowers the patient because they can tell me what to do and make sure it is done correctly since they see it right on the screen. I’ve also got a flow of the most up-to-date U.S. task force recommendations that show up in my electronic medical record, along with the rationales behind them. When the patients see it in black and white on the screen with the words “U.S. task force recommendation,” rather than just hearing it, I think it somehow makes it a little more impressive.

V: What advice do you have for young doctors or medical students who are interested in innovation and keeping up some sort of artistic pursuit?

Dr. Legan: Don’t do what I did. Don’t go 20+ years stifling that creative spirit. What I’m finding out is that when I’ve been working all day hard and I’m tired and I get the kids to bed, I come to my wife’s pottery studio, I turn on the radio and it’s my time. Find time. You have to make time, whether it’s an hour or two a week, to keep that creative spirit alive and nurture it. The process of painting, not the end result, is key.  Music in the background, the smell of the oils, the brush hitting the canvas not quite as intended…but the result better than ever.  The time spent is really no different than playing as a child.  I have found that if I allot an hour or two in this environment a day, life is a bit more fulfilling. Medicine is a bit like this for me as well. Often the end result, if time and focus are utilized, will be something to be proud of in either art.

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