As I am finishing up my Internal Medicine residency, I realize that 8 years of school and 3 years of training have made me cynical.
I expect the majority of my patients to not follow my recommendations, I know I will be exhausted now and every day of my life FOREVER, I know I will give more to this career than I get in return, and I wholeheartedly believe the medical system is broken. This is not what I thought medicine would be!
My Image of What a Doctor Was
As a child, and even in my undergraduate years, I pictured a doctor as someone in a clinic who was smiling and happy. My only doctor duties were to care for the patient, listen to them, and help better their lives. I would get to enjoy medicine as a science, as well as help my patients be healthier. I would be saving lives.
Then Reality Struck
The reality check started happening in my third year of medical school, but it really hit in residency. First off, I do not want to do outpatient medicine so there goes that vision of a smiling doctor working 9 to 5. Next, I quickly learned I spend the majority of my time doing non-clinical work, not so fun. And third, while I still have some very appreciative and kind patients, the majority look at me with skepticism and rebuttal my every move with a google search. Throw in the hours and stress of residency, the medical school debt, and the constant stress of making sure you are practicing only the best medicine possible, physician burnout is inevitable.
There Is Hope!
Now with Internal Medicine residency comes some electives. A month away from the hospital working with a specialist. In the second half of my 3rd year I had the pleasure of working in a Dermatology office. I learned quite a bit from this one month, including that my previous skin exam was quite terrible! But more importantly, I learned that medicine does not have to cause burnout.
From the moment I walked into that office, I was hit with that image of what I thought doctor life is. Everyone was smiling, this was a big change by itself. The doctors each had three nurses assigned to them and the nurses followed along to each room, writing the clinic note and ordering any labs and medications. After the doctor left, the nurse stayed behind to provide the patient with more education and set up a follow-up. It was like magic!
After this glorious month of dermatology, I wondered if I would ever experience a similar lifestyle. I have no intention of becoming a dermatologist, but that isn’t the only way, right? Looking at it now, I see it was all about the support system. The doctor was communicating with the patient throughout the whole visit and this created a better doctor-patient relationship with more compliance and respect. The doctor is doing what they love, without distraction, and the patient is happier as a result.
Keep that “Doctor Lifestyle” Illusion Alive
So to all you budding doctors and residents that feel like “why did I do this???”, there is hope! No, not in residency. But after. When you start looking for your job, ask about support staff, mid-levels, assistants… Anything that takes away distractions from patient care and allows you to do the job you were trained to do.
I know many people think that only derm can do this because they can afford to. I disagree. With the proper support staff, you can see so many more patients than if you did everything on your own. These dermatologist had patients scheduled every 5 to 10 mins for follow ups! We got into medicine because of our love of science and the strong desire to help others. It is possible to enjoy this career, even with a broken system. Physician burnout is real, but keep going on your training, there is hope!