I have always felt that I was in the mainstream of medical thought and actions. Recently, however, I have been subjected to a barrage of articles on physician burnout, depression, and even suicide! I am happy to be working in my medical practice. What is wrong with me?
Like everyone, it is difficult to drag myself out of a nice, warm bed each morning. But as I begin to dress for the office, a pleasurable anticipation comes over me. At the end of each day, I leave the office conscious of a job well done and a day well spent.
Don’t get me wrong. Weekends are a welcome respite from the daily routine, but on three-day weekends I find myself on Sunday night feeling disappointed about not going to the office on the holiday Monday. From enjoying what was once the standard feeling about practicing medicine, it seems I am now an outlier. I always dreaded being an outlier in coding or fashion or anything!
I don’t think I am going to change. I am 84 years old and have been a family practitioner in the same community for over 50 years. Perhaps that has something to do with my outlier status. So, I was thinking that perhaps I could be pompous enough and arrogant enough to analyze why I feel as I do, and perhaps young doctors and medical students could avoid a career of burnout.
First, after finishing training, is to be an independent practitioner. Have enough confidence in your own abilities and the institution of medicine to take a risk. I know there is no guaranteed salary and job position, but there are also no bosses or supervisors, no quotas, and no rivals trying to get up the corporate ladder by stepping on your head. The risk is not great. Have you seen many doctors who are homeless or on welfare? Of course not; it doesn’t happen. “If you build it, they will come” (Field of Dreams). In independent practice, you can pick your own boss (you), your coworkers, your office, your appointment schedule, etc. So there is nothing to cause you to feel oppressed or get burned out!
Secondly, it is to stay in the same community. Without looking to find new jobs, that becomes easier. How many initial histories and physicals do you want to do? Having a database in your head when you walk into the exam room makes things so incredibly easier … and more enjoyable! With each successful treatment, the patients become more grateful and more willing to follow your instructions! No yelling or threatening to force your patient to do what is necessary to get him/her better … so less effort on your part!
One major cause of burnout is boredom. Dealing with the same limited number of illnesses can be tedious. When I finished my Navy General Practice residency, I was sent to run a 40-50-bed hospital on a small base in Newfoundland. I also was in charge of all the OB-GYN, including C-sections and other non-elective surgeries. The GYN clinic each afternoon became boring, and I found myself (for the first time ever or since) dreading going to the clinic, having extra cups of coffee, or dealing with other problems, any other problems! So one thing you can do is to become a family practitioner! The age range of my present patient population is four months to 105 years! The richness and variety of complaints are incredible! Boredom would be impossible.
If you are going to be an FP, be sure to include obstetrics in your skill set. I have delivered over 2,000 babies. Once you deliver a baby, you will soon see the mother, the father, and the siblings!
Recently a 39-year-old male came for his annual physical. This time, he brought his wife, somewhat unusual. Usually, wives accompany their husbands to ensure they tell the truth about their unhealthy drinking/eating/work habits, but she never spoke. At the end, I asked her for questions, and she said that since I delivered him and have been the only doctor he has seen, and he spoke so highly about his care, she just wanted to meet me! I was speechless! (A very rare occurrence.) My head and ego were so swollen I could barely get through the exam room doorway!
Make your office comfortable and inviting. I have many pictures of the history of medicine, but there are five large (3 x 5 foot) frames, each filled with a collage of 40-50 patient photos, mostly gleaned from Christmas cards over the years. The child patients, into their late teens, delighted in finding their picture each time they came. Children were never a problem to examine or deal with. I am sure the kids picked up on their parent’s warm feelings toward the doctor.
When I have a medical student for 2-3 months per year, I will say to them when they have been with me for a week or two: “I don’t come to the office each day to see a bunch of patients; I come to visit with a bunch of old friends! And I get paid for it! What a racket!”
I am honored and privileged and don’t ever want it to stop!
Addendum: A poem by a patient
There is a wonderful place to go
It’s been there for many years
When you’re upset or even scared
They eliminate your fearsA cold, sore throat, or maybe the flu
The baby’s coming, don’t know what to do
Relax and don’t worry
This great team will pull you throughThe caring, the love, all the gentle ways
Needham Family Practice does it all day
How very lucky for this fine staff
A great big thank you on my family’s behalfBut this poem wouldn’t be complete
Because I have love in my heart
For the incredible doctor
Who gave this place such a start.
So when it’s my kids or maybe me
It’s so nice to be seen by Dr. C.
How many businesses have clients write poems about them?
None of them are run by burned-out people.
Gerald P. Corcoran is a family physician.
