Interview Summary

Dr. Baker is a pulmonary critical care doctor who works in both in-patient settings where he sees patients in the hospital and in out-patient (clinical) settings.
Dr. Baker typically works in a different setting each week, rotating between the clinic, the pulmonary service in the hospital, and the ICU.
Pulmonology refers to lung problems that are diseases of the lung and respiratory system. Critical care doctors are almost like the “cowboys” of the hospital as they get called in to help when everything seems to be breaking loose.
To become a pulmonary critical care doctor, you must first complete four years of undergrad, followed by medical school. You then must complete three years of residency, followed by a three-year pulmonary critical care fellowship. If you choose to do a more research-based fellowship, it can be four years long.
Dr. Baker explains how he loves working with people, especially his colleagues and his patients. He also says that he enjoys his job because it is very rewarding and he gets to continue learning more every day.
Dr. Baker says that shadowing and talking to someone in healthcare is very important. Before going into healthcare, he suggests that students figure out what they are truly passionate about to make sure medicine is what they want to do. He also emphasizes that healthcare providers must be willing to continue to learn and train throughout their careers.

Pulmonary Critical Care Doctor Interview With Dr. Baker

What does a day in your life as a pulmonologist and critical care doctor look like?

My hours vary week-to-week, and what I do also depends on the setting I am working in. Each week, I work in one of three settings: the clinic, the hospital, or the ICU. Depending on the setting I am working in, I always know pretty well in advance what my day will look like.

When I am in the clinic, I work a standard 8:00 a.m. to 4:00 p.m. day. I will typically see patients from 8:00 to 12:00, take an hour for lunch, and then see patients again from 1:00 to 4:00. Every patient gets a 30-minute appointment, so I usually see two patients every hour. This means that a full day for me usually consists of about 14 patients. During my clinical weeks, I do procedures on Thursdays. The procedures I perform involve using a variety of scopes, which are advanced procedures in the lungs. I usually complete about three-to-four scopes on Thursdays.

If I am rounding in the hospital on the pulmonary service (in-patient pulmonary work), I typically start work around 8:00 a.m. I do not have a designated time when I end on these days, so I just work until I am finished. Some days, I might be done seeing patients around 2:00 or 3:00 in the afternoon. However, there are other days when I stay in the hospital until 8:00 or 10:00 at night. It really depends on how busy I am. Usually the summers are less busy than during the winters when there is flu season and other respiratory viruses going around.

When I am working in the ICU, I work a designated shift. I will either work a morning/daytime shift from 7:00 a.m. to 3:00 p.m., a midday shift from 11:00 a.m. to 9:00 p.m., or an overnight shift from 9:00 p.m. to 7:00 a.m. On the weekends, we only need two people, so there is either a 7:00 a.m. to 5:00 p.m. or a 5:00 p.m. to 7:00 a.m. shift.

There are some nights where I do not get to sleep, so this can definitely be a challenge. I try to avoid bringing my work home with me, and I usually only bring home clinical work when needed. Sometimes I get very busy in the clinic and cannot finish all of my notes, so I will bring them home and complete them after I have dinner with my family. However, most of the time I do not need to do this, especially when I am working in the hospital or ICU.

For the weeks that I work on the pulmonary service, I am on call, so I need to carry around my pager because I am available 24/7 if there are questions. Fortunately, our hospital is pretty quiet at night. However, there have been some times when I am working on pulmonary where I had to go in the middle of the night for an emergency procedure or something else that was urgent. This is pretty rare, but I am always available in case something like this happens. When I am in the clinic and not on call, one of my partners works in the pulmonary service in the hospital on call for that week. The ICU is also not a call system because someone is there 24/7 for their shift.

If you average out the days that I work in a week, I probably work about 20-22 weekends every year. Most clinic weeks are regular five-day weeks. However, the weeks that I am in the hospital (ICU or pulmonary service) are usually seven-day weeks. My schedule tends to jump around quite a bit. I usually work one week in the clinic, one week in the hospital on the pulmonary service, another week in the clinic, a week to a week-and-a-half in the ICU, and then maybe a day or two off. I get a set amount of vacation time, so I usually continue on my rotation unless I am taking a vacation or a big trip. When I go on vacation, I typically need to switch around my schedule for coverage aspects for the hospital or clinic.

What does pulmonology and critical care mean to you?

Pulmonology refers to lung problems that are diseases of the lung and respiratory system, and it has a focus on the lungs and airways. I am also required to have training with the heart and other systems in the chest that might affect the lungs, so I would also say that pulmonology encompasses chest medicine.

Critical care doctors are really like the “cowboys” of the hospital. They are the doctors that are usually brought into cases where everything is breaking loose and nobody is certain of exactly what is going on. As critical care doctors, it is not uncommon for us to see patients crashing because we have seen so many different cases of varying severity. Pulmonary critical care doctors tend to be especially calm under pressure because they care for very sick patients all of the time.

Critical care doctors are also the kind of providers that families tend to count on a lot when they need guidance about the hard things they are navigating through. The nice thing about working in the ICU is that we are very localized. When I am in the ICU, I typically never leave, so families can usually get into contact with me easily. The nurses carry around phones, and they can usually just call me over if something is going on with the patient or if families want to talk with me.

Can you tell us about yourself?

My name is Dr. Seth Baker, and I am a pulmonary critical care doctor with Alina Health. I practice in both in-patient and out-patient settings. Originally, I am from Chicago, and I went to the University of Illinois for undergrad before attending Rush University Medical Center for medical school, residency, and my fellowship. After completing my fellowship training in pulmonary critical care in 2010, I moved to Minnesota. I married a Minnesota girl who I met in Chicago, and we have three kids. One of our kids is in college, and our other two are in high school (one freshman and one senior).

My medical practice is a mix of out-patient and in-patient pulmonary medicine, as well as critical care/ICU medicine.

In-patient medicine involves caring for hospitalized patients. Depending on these patients’ reasons for being in the hospital, I can use my role as a doctor to get involved and care for them. Some of the patients that are hospitalized for pulmonary conditions are people that I have previously seen in the clinic. In this case, I might get called in to see the patient if the hospital doctors want my input and evaluation. However, I might not know the patient and they might have come to the hospital because of a pulmonary issue. I am fellowship trained in all ICU care, so I have seen some very sick patients while working on the in-patient side (the hospital). I do everything I can to evaluate and treat these patients, and perform procedures as needed.

My out-patient work is entirely in the clinic, and it is what you would think of when patients schedule appointments to see me. I work in a few different clinics. In our group’s main clinic in Coon Rapids, I see a variety of pulmonary patients who might have chronic conditions like asthma, lung cancer, etc. Although this is the main clinic where I work, I also go to some outreach clinics in Buffalo. We also have a specialized lung nodule and cancer clinic near the hospital that I go to once a week when I am working in the clinic. In this role, I care for patients with lung nodules (spots in the lungs) or lung masses that raise concern for cancer and require a biopsy.

Full Q&A With Dr. Baker

What is the career outlook for a pulmonologist and critical care doctor?

It should be really good. They are always shy on the number of pulmonary critical care doctors. It is a field that will still be needed because people still smoke, the ICUs are constantly full, the population is getting older, and the aging population is getting sicker. Even in the time that I have been in the ICUs for the past 15 years, the patients now are much more sick compared to when I first started. This is only in the course of 15 years, so the trend will definitely continue. Part of the reason for this is that the population is aging because of improved therapies and the technologies that we can offer to patients that we could not offer a decade or two ago. Because we can try to do some of these treatments to extend more lives, we see more elderly people in the ICU. As a result, this is definitely a field with a positive career outlook.

How did you become interested in being a pulmonologist and critical care doctor?

I initially went into medical school thinking I was either going to be an infectious disease or GI doctor. However, in my fourth year of medical school (when you do a lot of rotations and electives), I did an ICU rotation and loved it. However, I did not know if I loved it because of the infectious disease and GI things that were going on or if it was just something that I was truly interested in.

When I got into my residency, I was called an intern during my first year. Because I went to residency at the same place as I went to medical school, I started in the ICU for the first month. This was because I already knew how the hospital worked as opposed to other people coming in from other hospitals that were in other medical schools. I loved my first month in the ICU and thought it was fun. I even started to trade a lot of my floor rotations with people who wanted to give up their ICU shifts. I was in the ICU a lot more frequently, which allowed me to meet and become mentored by the attendings and fellows that were there. At the time, I was thinking of doing either critical care or infectious disease in critical care. I told them about my goals, and they all encouraged me to go into pulmonary critical care. This was because it would incorporate both of my passions and would make the most sense for me to do a fellowship in.

Because I was selected as chief resident during my second year of residency, it gave me more time to decide on my fellowship (most people have to decide after their second year in residency). This helped me to transition into pulmonary critical care. The pulmonary critical care doctors, attendings, and the fellows got to know me a lot better and offered me a spot in the match for my fellowship.

How much education is required to become a pulmonologist and critical care doctor?

I first completed four years of undergrad and majored in biology. During this time, I applied to medical school. However, I did not get in, so I did a few years of public health school at the University of Minnesota to earn my master’s of public health. After earning my master’s, I reapplied to medical school and got in.

After completing four years of medical school, I did my three-year residency in internal medicine, which is one of the bigger general medicine fields. I completed both my medical school and residency at Rush University. I was then selected as a chief resident, so I ended up staying there for an additional year. Afterwards, I completed my three-year pulmonary critical care fellowship at Rush University. In total, I ended up spending about 11-12 years at Rush University between all of my education and training. I started medical school when I was 23 or 24 and finished my fellowship when I was 35.

Every field is a little different because some of the surgical fields have about four-to-five years of residency. Fellowships are also different, and even the pulmonary critical care fellowships are not the same. For example, the fellowship program that I attended had a very clinical focus, so it was three years long. However, there are some pulmonary critical care fellowships that are more research-based and are usually four-to-five years.

I was more of a “non-traditional” student at the time when I went to medical school, which I think is becoming more of the norm. This is because less people go straight from college into medical school and instead take a gap year to get some extra training or work another job before going to medical school. My graduate school kind of acted as my gap year between undergrad and medical school.

What advice would you give to someone who is interested in the healthcare field and is trying to figure out what profession is best for them?

I think researching different fields, shadowing, and talking to people in certain fields is great. If you have relatives in any medical field, it is beneficial if you can talk with them. This can give you a lot of good insight because a lot of healthcare workers are happy to talk about the pros and cons of their field. For example, my wife is a PA. She was smart enough to go to medical school, but she did not want to have total responsibility over her patients. However, I did not personally know much about PAs when I was going to school. That is why I think it is so important to educate yourself about whatever careers you are interested in.

I also would say that it is important to find out what you like to do. Working in medicine is not for everyone, but if it is something that you think you are interested in, you should definitely shadow or talk to someone. By getting this experience, you might find out things about a certain field that you had never even thought about before.

In my field, for example, I have learned how to do some advanced procedures. I was never previously trained in some of them, but I took it upon myself to learn them. I also went and took a couple of extra courses on these kinds of procedures. Medicine is definitely a field where you need to have humility and the ability to continue learning.

What is the biggest challenge of being a pulmonologist and critical care doctor?

Generally, it is the administration and insurance. On the in-patient side, it is usually just the limits of what we can do either because of technology or the administration putting caps on certain things we can or cannot do. This is beyond my payroll and my decision-making a lot of times. In the clinic, there is definitely a challenge with the insurance aspect of things. This can be frustrating when I want to order certain medications for a patient but they are not covered. When this happens, we have to do prior authorizations, see if we can get it covered, and write letters and call insurance companies to try to get care for my patients. This is by far the most frustrating aspect of my job, but it luckily does not happen much.

What is your favorite part of being a pulmonologist and critical care doctor?

I would say that it is the people that I work with. I love my job and the people, whether they are my colleagues or my patients. It is definitely a job where you need to enjoy interacting with people because we are all a team. I love the nurses and doctors that I work with because I think we are all very collegial.

I would also say that it is a really rewarding field to be in. You are always learning something new because there is so much new information that is always coming from different fields. You try to learn every day, which is so amazing.

Every day I love something different. Sometimes I love learning about a certain disease and other times it is a specific patient that I get to see. You really never know what you will see and what will peak your interest every day.