Our Proust Questionnaire

Dr. Robert Trimble gives insight into his practice, what brought him to medicine, and his philosophy on independent pediatrics.

A Proust Questionnaire is a survey aimed at understanding one’s personality.

To help share your stories, The Independent Pediatrician created our own version of the Proust Questionnaire.  We hope you enjoy this small window into other pediatricians’ personal and professional challenges and aspirations.

Why did you become a pediatrician:

I became a pediatrician because, from a young age, I always wanted to be a scientist. I remember asking for a telescope at age 4, a chemistry set as a young child, and asking my father *questions* for hours about the nature of the universe.

As a teenager, I struggled to decide between studying engineering and becoming a physician. I liked understanding the natural world, but the idea of interfacing primarily with a computer for the rest of my life worried me. I enjoyed volunteering and working with people in high school, and moving away from that seemed counter to my purpose.

So, as an early college student, I decided to study biomedical engineering and pre-medicine. Initially, I thought of becoming a pediatric hematologist/oncologist, but I found everything about pediatrics intriguing. I liked the medicine and getting to know patients and families.

What do you like most about being an independent pediatric practice:

My patients are my own; my practice reflects my values and not corporate values. I have autonomy and can also untether from a family if I feel we do not have the same prevention and treatment direction in caring for their children.

My favorite qualities in a patient:

I make this statement irrespective of the parents, as the question concerns the patient. My favorite qualities in a patient are curiosity, patience, and trust.

My curious patients ask questions so that they can understand their health better and become informed. My patients are willing to wait when sometimes things get behind, and appreciate/understand it can be worth staying at times. And that goes into my last response – if a patient trusts me, then they trust I’m going to try to keep them from getting sick or injured, and if they are sick, to determine what I can do to help them and then are compliant with their evaluation.

What is my ideal state of mind:

My ideal state of mind is a state of “no mind,” or what many refer to as flow. When you lose track of time because you are so engaged in an activity, that is an ideal state of being. Flow state is not something you can flip a switch and enter. It simply means that your efforts match the task at hand. In this state, optimal performance and learning take place.

Which living person do you most admire:

I admire my parents. They both went back to school after having children. They both ensured the world’s problems did not enter my thoughts as a child. They provided for me the best they could, and without their oversight, I could not be where I am today.

What do you believe is the most essential business aspect for an independent pediatric office:

The most crucial business aspect is knowing what business you are engaged in. In independent practice, you are in an “infinite game,” as Simon Sinek would say. That means the game’s name is not to win or accrue as much influence as possible. Nor is it to expand to be as large as possible. The game we are in is to keep playing: survival. We are in a game of keeping the doors open and keeping everyone paid. Everyone must understand what game they are engaged in. Therefore, not forgetting who you are as an organization and your organizational identity. What sets each practice apart is what draws people to their organization. If you try to be a large conglomerate, you’re missing the point.

Do you prefer sick visits or well visits?

I prefer sick visits for the efficiency they provide in time per visit in solving a problem for someone, but overall, I like checkups for their service. Preventive care in pediatrics is something special. Accept no substitute.

How do you address urgent/after-hours care?

We have Saturday morning urgent care each week. We have vaccine clinics seasonally. We close on Sundays and major holidays. As a practice, we allow urgent care, emergency rooms, and after-hours clinics to fulfill their role in the medical home. We give our providers the much-needed day off to spend how they wish at the end of the week. We utilize a call service for after-hours calls but give families the tools they need on our website or other online resources.

How do you manage the most challenging patients, families, or caregivers?

Speaking only for myself, in my practice this can occur in many forms – the child or adolescent wearing headphones and tuning out of the appointment, the parent on the phone, the argumentative parent who came to the office anticipating an argument. I rely on being patient and waiting before engaging in the visit.

If someone is unhappy with the service provided or guidance given for any reason, I ask what they want done. If we can accommodate them, if their request is reasonable, it is discussed. If not, they are free to seek care elsewhere.

What is your policy on vaccination?

As a private practice, we see it as our job to provide the best care in alignment with the AAP, ACIP, and CDC guidelines. We respectfully decline to accept or continue to care for patients who do not wish to comply with the recommendations.

What is the one thing you want each family to know when they enter your practice:

I want them to know we take our oaths as doctors seriously. We did not get into medicine for the money. There are much easier ways to make money. We are not here to make money off of other interests. Outside of the educational lunches that reps may provide, most of us do not entertain outside influence in our organizations. Primary care pediatrics is about providing excellent care for children above everything else. Unfortunately, it is a team effort to provide care with many parts, and so, sometimes, it is not as efficient as our culture would like. We are all here working for the care of children and take that calling seriously.

What is the most significant change in pediatrics you have seen in your career:

Medicine changes in so much as what we know about it changes. And what we know changes all the time. Regardless of the transition to EHR, COVID, telemedicine, or other technologies would have us think. Medicine will not stop changing. And that’s okay as long as you realize that you change, also. What’s important is that you are flexible in understanding what is “known.”