This piece was posted on KevinMD.com on 3/20/2013: I'm a part time physician, and I'm not sorry
This is my reaction to "Doctors who work part time: I'm sorry that I'm ruining medicine."
http://www.kevinmd.com/blog/
I began the medical school application process 10 years ago. I was 23, single and most of my role models worked full time. I had no idea that a part-time medical career lay in my future. Quite a bit has changed since the days of hoping and praying and crossing my fingers for a medical school acceptance letter. In the past 10 years I have, at varying times, declared the following:
1. I will join a private practice in primary care immediately after residency and never move (as a former Navy brat, this would be quite the luxury).
2. I will not marry a doctor.
3. I will definitely not marry a surgeon.
4. I will not have kids until after residency.
5. Sparing you the details, I had an exact plan for when I would deliver all of my children such that they were born after residency and before I turned 36.
6. I will definitely not ever work a job that requires me to be awake at night on a regular basis.
7. Specifically, and most certainly, I will never go into Emergency Medicine.
The reality? I married a surgeon, had a baby half way through residency, lost a child to stillbirth during my chief year and fell pregnant with my third child 2 months later. I fell in love with Pediatric Emergency Medicine and, for many of the above reasons, I am awake at night on a regular basis.
So, yeah, I work part-time. It is awesome and I am a great doctor to my patients. I think the fact that my schedule is so symbiotic with my family life enhances my abilities as a physician.
In the big picture, when home life is good, it is easier to focus on others.
In the details, I had time to grieve the loss of my second child (something I had not allowed myself to adequately do during the demands of my chief year) and figure out how to navigate pregnancy after loss.
My schedule is flexible enough that I can trade shifts and cover for coworkers without difficulty. I love being able to do this without sweating whether I am sacrificing time with my kids.
Finally (and perhaps most importantly) it helps with my patient interactions. My son spent a year in full time day care. I know the pain and stress of the incessant viral infections of the first year of day care. After a particularly bad week home with the kids last month, I picked up and drove three hours to my parents' house. Literally. I left dishes in the sink, wet clothes in the washer and 2T Mickey Mouse underpants on the floor. Being at home with kids is no cakewalk. If a rough week of stay-at-home parenting is capped off with a trip to see me in the Emergency Department, I can totally empathize.
Some might argue that these benefits are unique to the world of pediatrics but I disagree. We all care for parents and spouses. We counsel people who are trying to lose weight, minimize stress and make ends meet. Life is about balance. Finding balance is a constant process and it is not easy. By recognizing how we have found it (or not) we can better empathize with our patients and their families.
I understand that if there are x number of individuals accepted to a medical school, one might expect y number of hours of doctoring out of them when they graduate. But these are people, not widgets. People change. As my high school English teacher used to say, "The exigencies of life impinge." Moreover, the product of our labor is difficult to quantify. Sure, my hospital is aware of how many people I see in a day and how many procedures I do, but the people I treat remember my ability to listen, to engage, and to understand. I can tell you this: My best patient care is delivered in 9 eight hour shifts a month. Five years ago I could not have predicted this. Five years from now, it may be different.
I began the medical school application process 10 years ago. I was 23, single and most of my role models worked full time. I had no idea that a part-time medical career lay in my future. Quite a bit has changed since the days of hoping and praying and crossing my fingers for a medical school acceptance letter. In the past 10 years I have, at varying times, declared the following:
1. I will join a private practice in primary care immediately after residency and never move (as a former Navy brat, this would be quite the luxury).
2. I will not marry a doctor.
3. I will definitely not marry a surgeon.
4. I will not have kids until after residency.
5. Sparing you the details, I had an exact plan for when I would deliver all of my children such that they were born after residency and before I turned 36.
6. I will definitely not ever work a job that requires me to be awake at night on a regular basis.
7. Specifically, and most certainly, I will never go into Emergency Medicine.
The reality? I married a surgeon, had a baby half way through residency, lost a child to stillbirth during my chief year and fell pregnant with my third child 2 months later. I fell in love with Pediatric Emergency Medicine and, for many of the above reasons, I am awake at night on a regular basis.
So, yeah, I work part-time. It is awesome and I am a great doctor to my patients. I think the fact that my schedule is so symbiotic with my family life enhances my abilities as a physician.
In the big picture, when home life is good, it is easier to focus on others.
In the details, I had time to grieve the loss of my second child (something I had not allowed myself to adequately do during the demands of my chief year) and figure out how to navigate pregnancy after loss.
My schedule is flexible enough that I can trade shifts and cover for coworkers without difficulty. I love being able to do this without sweating whether I am sacrificing time with my kids.
Finally (and perhaps most importantly) it helps with my patient interactions. My son spent a year in full time day care. I know the pain and stress of the incessant viral infections of the first year of day care. After a particularly bad week home with the kids last month, I picked up and drove three hours to my parents' house. Literally. I left dishes in the sink, wet clothes in the washer and 2T Mickey Mouse underpants on the floor. Being at home with kids is no cakewalk. If a rough week of stay-at-home parenting is capped off with a trip to see me in the Emergency Department, I can totally empathize.
Some might argue that these benefits are unique to the world of pediatrics but I disagree. We all care for parents and spouses. We counsel people who are trying to lose weight, minimize stress and make ends meet. Life is about balance. Finding balance is a constant process and it is not easy. By recognizing how we have found it (or not) we can better empathize with our patients and their families.
I understand that if there are x number of individuals accepted to a medical school, one might expect y number of hours of doctoring out of them when they graduate. But these are people, not widgets. People change. As my high school English teacher used to say, "The exigencies of life impinge." Moreover, the product of our labor is difficult to quantify. Sure, my hospital is aware of how many people I see in a day and how many procedures I do, but the people I treat remember my ability to listen, to engage, and to understand. I can tell you this: My best patient care is delivered in 9 eight hour shifts a month. Five years ago I could not have predicted this. Five years from now, it may be different.
Katie this is wonderful! I completely agree. Another thing I think should be addressed: how much of what some doctors do is in fact "doctoring?" Cosmetic surgery? Medicines for thinning eye lashes? Those are hours spent both 1) not doctoring and 2) not being a parent/spouse/daughter/son/community member.
ReplyDeleteHi Ann,
ReplyDeleteThanks for reading! You bring up an interesting point. Motherhood certainly sounds more noble than eyelash enhancement. It definitely seems that those who promote "full-time" doctoring to combat the physician shortage would take exception to med spas, calf implants and the like.
I have to go back to my original argument. People need to be free to make their own decisions. While some may wax poetic about the altruistic nature of medicine, the only true commitment the most medical students make is a promise to pay Sallie Mae back with interest. With the loan burden that many graduate with, it is hard for me to judge those who take advantage of higher paying opportunities.