It seems I come across a pessimistic article like this at least once a week. There is a sad sameness to these articles: it takes years of sacrifice and lost earning years to become a doctor, after which our lives are stressful, frustratingly full of administrative garbage, and not rewarding in the way we had hoped. We aren’t as independent as we thought we would be, don’t have enough time with patients, don’t get the respect we deserve, and don’t earn enough money.
There’s certainly an element of truth to what these articles describe. The training is long and stressful and takes a personal toll. Medicine - and certainly primary care - does not confer godlike status or respect, and there are easier ways to earn lots more money. But, if I had it to do over, I would still go into medicine. And pick family practice. And love it. Why? Because of patients.
This week, for example:
- I got a message from a patient with a repetitive strain injury in her wrists from data entry at work. She had been seen and accurately diagnosed at the local occupational health clinic, but felt she was not improving and came to see me. The twenty minutes we spent involved equal parts teaching about the pertinent anatomy/physiology, discussing the job, and planning a recovery program based on not just medication and physical therapy, but also an educated patient who could self-manage an appropriate balance between load and recovery. She was 90% better, she said. Next time she plans to come to me first.
- I changed a mother’s understanding of her 4 year old’s behavior by discussing the difference between learning words about time and understanding time.
- I helped a patient understand that his grief and loneliness at losing a parent 20 years ago as a young teen was normal - and did a ‘warm hand-off’ to the counsellor in our office to work on his unfinished mourning.
- I spoke to several patients about what their neurologist, cardiologist and surgeon said, explaining test results and helping them understand the treatment, solve problems about how to make it work, and what to expect. I chose to feel good about helping these folks rather than resentful that I was doing what the specialist had already been paid to do.
- I spent 30 minutes on the phone with a woman the day after her husband had died in hospice, mostly letting her process things by telling me how things had gone during his last 72 hours, providing her with some specific tips about how to manage her grief short term, and setting up a follow-up appointment in the office to make sure she was coping.
Every day I get to work with patients who trust me with their personal information, and are willing to work with me on ways to get healthy or stay healthy. Every day I get to enjoy the benefits of listening to and learning from people as varied as snowflakes and as unpredictable as the weather. Every day I get to build deep and respectful relationships. Every day I go home exhausted – and exhilarated. And every morning I get up enthusiastic about the chance to do it again.
Sure, the bureaucratic bullshit is a drag, the idiocies of the EHR are infuriating, the inefficiencies of my institution can be irritating, and the stress is humbling. But I wouldn’t change my calling for anything. I picked primary care medicine and have no regrets about the choice.