Dr. Junaid Malik is a board-certified pulmonologist practicing in Cincinnati, OH at Trihealth Pulmonary Medicine, affiliated with Good Samaritan Hospital and Bethesda North Hospital. In our "Meet the Specialist" series, we highlight the unique perspectives of various medical specialists on the types of patients they see, and what they find rewarding and challenging in their daily practice. As a pulmonologist, I see a wide range of patients with difficult-to-treat conditions. Pulmonology is the branch of medicine that deals with diseases affecting the lungs and respiratory tract, including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and bronchiectasis. While I see all kinds of cases, I focus on how to advance therapies to treat these diseases using non-invasive procedures in the most effective way for my patients. A Family Tradition Coming from three generations of physicians, a career as a doctor was as a natural choice for me. My grandfather was general practitioner in the 1940-‘70s in rural India, my father is a surgeon, and my mother works in family medicine, so I was exposed to different sides of the field of medicine at a young age. But independent of my parents’ careers, science has always made sense to me. And once I began working with patients, I realized that practicing medicine is an art as well as a science. This balance is what I love about being a doctor. During my residency in internal medicine, I realized that I wanted to work in critical care. Critical care is the specialty that deals with patients in the intensive care unit, or patients that might need ventilators or have suffered from a heart attack or a serious infection. Since critical care often involves the need to understand pulmonary diseases, it wasn’t long before I decided to extend my training to specialize in pulmonology and sleep medicine. Narrowing In On My Passion The investigative aspect of pulmonology is part of what drew me to specialize. In a way, pulmonologists are detectives. Part of the doctor-patient relationship in pulmonary medicine involves investigating a patient’s life history, as environmental factors have a major impact on many pulmonary diseases. So it’s extremely important, as a pulmonologist, to learn the detailed patient history in order to make an accurate diagnosis. I really enjoy exploring all possible clues, triggers, exposures, and other factors that could have led to a condition, and then working with a patient to find the right therapy. The set of diseases that pulmonologists study and the procedures used to treat them fascinate me. My interest in these diseases led me to explore the use of new machines to help patients breath better, especially when they’re asleep. Most of the patients I see suffer from COPD, a progressive lung disease characterized by shortness of breath and wheezing, and these machines have been especially impactful for them, as well as for patients with other forms of chronic respiratory failure. Since there isn’t yet a cure for COPD, using breathing machines can greatly improve patients’ quality of life. But there’s a gap between the technological advances in the treatment of pulmonary disease and physicians’ knowledge of how to use them effectively, so that’s the niche I’m exploring in my specialty. Advances like these are exciting to see in the realm of pulmonology, and over the years I’ve also seen my own growth and development as a physician. Because pulmonary diseases are complex and can vary greatly in cause and treatment from patient to patient, I’ve learned the value of communicating simply and clearly to my patients. Using ‘doctor language’ can sometimes cause confusion, but taking time to break down my explanations into laymen’s terms goes a long way in preventing miscommunication. I also think some doctors are uneasy about conveying the severity of a patient’s case and being direct. With patients who are suffering from severe COPD, for instance, I try to strike the balance between not withholding even uncomfortable information, while still offering them hope with a viable treatment plan. When To See a Specialist I counsel anyone who has needed oxygen for treatment or who’s been in the hospital for a pulmonary-related issue to see a specialist. In mild cases, when patients experience minimal symptoms of airway obstruction and haven’t had any severe complications from an illness like COPD, for example, a primary care doctor or other physician may be able to treat it. But when a patient experiences more complicated exacerbations and can’t control them with appropriate prescribed medication, then it’s time for a specialist to step in. Pulmonologists can take a closer look at the issue, and may have more time to identify other causes and offer patients more education on their symptoms. And pulmonologists will have greater access to subspecialists with specific expertise in pulmonary conditions. When I get patients with pulmonary conditions I don’t specialize in or aren’t as familiar with, I refer them to other specialists for a second opinion. And because of my specialization, I can help my patients get faster access to the providers they need. As a pulmonologist, I enjoy both the research side of my work as well as working with patients. I’m motivated to continue to stay on the cutting edge of pulmonary medicine so I can give my patients the best care possible. If you have difficult-to-control symptoms related to a pulmonary condition, I recommend seeking out a specialist for care.