I spend a lot of time thinking and talking about our derailing/derailed health care system and what we can do to get back on track. Lately, I've been asking myself: Why did I pursue a career in medicine? And if I had to go back and do it all again, would I?
Medicine was a legacy calling me - my dad, a family doctor, showed me a path to a career as opposed to a "job." He showed me that it is important to recognize and follow your calling - that it is important to find meaningful and stimulating life work; work that allows you to utilize and share your unique gifts with the world; that there is a sense of security here. Medicine, to him, was as meaningful, intellectually stimulating and secure as you could get.
Notably, security was of no small matter to me. A traditional, stable life as a physician would be a way to get that elusive security in a world I always sensed is anything butsecure. And I wanted to make sure I could always take care of myself. Medicine offered a stable income and a stable lifestyle. My parents drilled into me that I should never be in a position of depending on anyone—to always take care of myself because that's all you can really depend on.
By my fourth year of medical school, and nearing the time to make a decision, I was between Surgery, Interventional Radiology and Primary Care (specifically: Internal Medicine, Pediatrics, and Family Medicine). I was a talented surgeon and enjoyed procedures but it was fear of "losing myself" into the world of surgery that requires so much, particularly from females, that largely made my decision for me. I wanted to have a family and feared that the process of becoming a surgeon would (in my case) suffocate my femininity and maim my abilities to be a loving wife and nurturing mother, which were both big priorities for me.
I also instinctively knew that primary care (Family Medicine in particular because you train to treat both adults and children) would give me the biggest launching pad to pursue interests in health other than clinical care.
In practice, having one-on-one impact on precious lives was wonderful. The relationships and the people were what mattered to me. But what did I dislike?
It's the current model of the business of medicine. Monetizing suffering does not sit well with me and it is, in fact, a job after all. And the instability of the health care system environment also felt ironic to me, given my priority placed on exactly the opposite. I also felt constrained—constrained in the ultimate impact I would be able to have and constrained by the professional limitations of being a clinician in today's environment. I use an analogy of "the worker mule" - whip that old, broken-down creature, work it to the last breath, and once you've gotten all you can out of it, dispose of it. A life in primary care is like that in some ways, in today's world of "employee physicians.” Compensation for quantity of patients is often emphasized more than work quality, outcomes or relationships. My sense is that we are on the cusp of re-routing this aspect, at least bringing focus back to quality and outcomes. And my hope is that the relationships become the center focus again, as well.
So it's not turned out like I planned, like I thought it would, this career path of mine. My path has led me more into the land of health communications and patient education than staying with hands-on patient care. But I wouldn't have it any other way. And would I choose the same career if I had a chance at a do-over? Without a doubt.
I was, and I continue to be, called to it.
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Published On: August 19, 2013