Dr. Michael Steven Myette, MD

My Healthcare Practice

I am a Pediatric intensivist. This means I take care of children in the hospital who are critically ill. I do not have a clinic and do not see patients in an office. Instead, my office is the Intensive Care Unit. I decided to do this because in my training to become a pediatrician, I realized that although preventive medicine and routine care are extremely important, working in the intensive care unit brought me immediate satisfaction. Each and every problem which arises in the I.C.U. must be dealt with immediately. When in the I.C.U., I make decisions and undertake interventions which can be life-saving or life-sustaining in nature. Very little of what goes on in the I.C.U. is trivial. All pediatricians have made a commitment to the health and well-being of children. As an intensivist, I am often the last in line in protecting the life or well-being of a specific child. I take pride in that and derive tremendous satisfaction from my job.

I spent 3 years as a …fellow of the Cardio-Vascular Research Institute at the University of California, San Francisco. I am also a member of the:

My Practice Philosophy

My practice philosophy can be summed up as a balanced, goal-directed, collaborative, and flexible application of the art of medicine. In intensive care medicine, there is a spectrum between more aggressive and more passive style of intervention. I attempt to strike a balance between these extremes. Being too passive means not doing the necessary interventions to insure optimal care of the patient, but being too aggressive means performing invasive procedures and placing a patient on medicines and treatments which might not be necessary. A balanced approach does everything which is necessary but works to minimize any unnecessary procedures or interventions. This is the mean to which I strive.

I follow a goal directed approach to each patient. My goals can be immediate (get IV in and antibiotics running), intermediate (wean patient off of ventilator over next 12 hours), and long term (restore patient to level of health enjoyed before admission). Each day as I see my patients, I develop specific and concrete goals which will culminate in restoring health and getting a patient back home. I maintain constant communication with my families, nurses, and other staff to make sure we are all working toward the same goals.

In intensive care medicine, patients are usually very complex. Often there are many doctors and other staff involved in the care of a single patient. Collaboration is the key to effectively caring for a patient. I strive to communicate and collaborate with the sub-specialists in pediatric medicine on a daily basis. Each doctor has a unique perspective and area of expertise, and together, our ability exceeds the sum of our individual abilities. By working together, we really can deliver world-class care to our patients.

Lastly, flexibility is a key part of my practice philosophy. A critically ill child is constantly changing, and plans and interventions constantly change. New goals must be made, and others must be discarded or made less of a priority. Adapting to the ever-changing environment in the intensive care unit is vital to taking care of patients. Also, I understand that there are often many solutions to a single problem and that different pathways can lead to a common goal. Because of this, I always discuss and, in as much as it is possible, negotiate with families and patients about the nature and plans of care.

Practicing Medicine at Kaiser Permanente

I joined the team at Kaiser Permanente after completing my training in the summer of 2005. Kaiser Permanente is a unique organization. My field of medicine is notorious for exhaustion and physician burnout. As I interviewed with the physicians and staff at Kaiser, I realized that the broad concepts of "well-being" and "thriving" apply not only to patients and customers but also to doctors and their families. As my schedule was negotiated, Kaiser placed a priority on my family and making sure I was not overworked. This i