Tuesday, July 3, 2007

Why I chose Family Medicine...

I've been reading a lot of posts lately about what's wrong with Family Medicine. Truth be told, it's a long list. But all in all, I love my job. Maybe my tune will change as the years go by and burn out sets in, I'm still a newbie.

I had a lot of trouble deciding between Family Medicine and Emergency Medicine, and went so far as to interview for both programs. I liked Emergency Medicine a bit better, but what tipped the scales in the other direction was the burnout factor. Emergency docs spend more time dealing with unpleasant people than most professionals, and it wears on them. I certainly worked with a few community ER docs who had been in the business 20+ years and were still enjoying it. Unfortunately, they were the exception. I leave my office 4 of 5 days a week feeling great about myself, and great about my patients. I wouldn't have been able to do that as an ER doc (but they still have better blogs).

Here's my list of what's right with Family Medicine:

1. It's Life-friendly. I was going to say family-friendly, but it's more than that. Sure, you can be a workaholic in family medicine, but you don't have to be. It's easy to find an outpatient job where you can spend weekend and holidays with your kids, or your garden, or your fishing pole.

2. It's flexible. Like skin procedures? Great, everyone in your practice who doesn't will send them your way. Hate kids? Avoid them. Love OB? Move to Alaska, they need us up there. You can pick your poison.

3. You're in demand. Unless you are trying to practice in a dwindling population center, you'll do fine. I supposed this could be said of all physicians, but the predicted primary care shortages are looking like job security for me.

4. It's challenging. I knew a family medicine resident who had quit her ophthalmology residency after her first year. She said that she knew within 30 seconds of speaking with her ophthalmology patients which of 5 problems she was dealing with, and was immensely bored. That's a problem I'll never have.

5. The Marcus Welby effect. A lot of patients trust their family doctors more than their specialists. They realize you have a view of the whole person, not just their left kidney. True, some patients treat me like the bottom-of-the-class idiot who couldn't get into a better program, but they are few and far between. It's super-cornball, but you meet a lot of really nice people.

Family Medicine has some big issues to tackle. Reimbursement is right up there. Getting bitch-slapped routinely by the insurance companies is on the list. You've got to be able to handle not knowing. You've got to be able to handle the Monday morning quarterbacking that the specialists will do to you. You've got to be damn good at multitasking.

But I love my job.


moof said...

Dr. Smak, I've been meaning to get over here to RSS link to your blog, in addition to blogrolling you, and to thank you for the comment you left on mine ...

So sorry it took me so long to do it! Having difficulty organizing my time lately.

I've got to say that I really enjoyed this post ... not sure if I want to attribute the same feelings to some of the PCPs I've met recently, or if I want to print it out to mail it to them anonymously! *LOL*

Looking forward to perusing your blog. :o)

Ten out of Ten said...

There's so much negative stuff out there in medical blogs, so I really enjoyed this post about the things you like about your job.

Thanks for doing what you do.

rlbates said...

Kudos to you. Wish there were more of you.

Dr. Smak said...

Thanks for the words of encouragement, all...

Hopefully I can entice some young med school whipper-snappers to join our dwindling ranks.

The MSILF said...


I'm glad to hear this. Another thing about it is that when I talk to family doctors, almost all of them smile and say they'd choose it again. That is something I didn't find in any of the more "prestigious" fields. Doctors who do things with meaning, and get to know patients, get to do diverse things, and aren't sorry they got into medicine overall - what could be a better recommendation?

Anonymous said...

The reason why I do not choose to be family doctor stems from my personality and my clinical experience. There is no hard and true rule whether if this is a good specialty or not.
If you love people- this is for you.
I do not like lifetime commitment and you can not just fire your patients easily.
In my experience, my patients tended to believe and accept my views and opinions rather to their family docs when they come to me referred by their docs. Few instances when they don't believe what I say is because they do not like what they hear- the honest truth.

It is easier for me to discharge my patients after they are well, or even when there is nothing more I can do. And they will go back to their GP demanding to do something about their problems.

GPs or family docs are front liners: some patients will expect and demand you fix their 99 problems in 15 minute period.

GPs can be fulfilling in their practice due to personal nature with patients. But you wish heaven will help you if you get someone with personalty disorder.

It is only the patient factor that prevented me from doing this job, not the money, the paperworks and the long hours.

Good luck and I really hope you won't change the way you feel about family practice. The world does not need family docs like me.