The sacred profession of doctoring

My heart goes out to the doctors who write about the unbearable burdens of doctoring in a corporate setting, feeling driven to see more patients than they want to within the span of an 8-hour clinic day. They’re tasked with dividing their time into shorter and shorter clinic visits, devoting more time to inputting data points into the EMR rather than engaging in meaningful patient conversations.

I have experienced both ends of this kind of care—being a provider and a recipient. The human element often becomes obscured. You don’t truly get to know your patients. Instead, you must seize upon a treatable aspect from their assortment of complaints so you can prescribe something and swiftly send them on their way.

Yet, sometimes a more nuanced conversation might lead to a better outcome. A dialogue like, “You appear stressed. I can certainly write a prescription, but have you considered discussing with your husband that you need an hour to yourself each day? Whether for a walk, reading, or a relaxing bath. Let’s follow up in a week to gauge how you’re feeling.”

Writing such a prescription can be quite fulfilling. I’ve done it on a few occasions. It’s worth exploring whether it proves helpful and whether it prompts family members to ease up on their expectations of the patient, often a mother.

The practice of medicine can be considered sacred, akin to being a lawyer, rabbi, or priest. People entrust you with their most extraordinary stories. You’re bound not only by the Hippocratic oath but also by HIPAA, compelled to safeguard their confidences. It’s a position of profound trust, one that merits more respect than it presently receives.

I retired from medicine at the age of 71. While I still found enjoyment in it, COVID-19 emerged, leading the clinic where I worked to close. This was likely the case for numerous small privately-owned clinics. Without access to tests, masks, or telehealth visits, we all vividly recall where we were on March 13th, 2020, when the Trump administration finally acknowledged the reality of the COVID-19 pandemic. Schools shuttered, and doctors needed to exercise caution.

I spent two decades in rural medicine and chronicled my experiences in a book titled, Yankee Doctor in the Bible Belt. The patients I grew acquainted with, the intricate clinical conundrums that challenged me, and the profound lessons my patients imparted about life and death—these were the themes I predominantly explored. In hindsight, I predominantly focused on the positive aspects of being a doctor. Perhaps some disheartened physicians should read it, those who are growing disillusioned with the profession. It’s an arduous field, one that exacts a toll. The tales patients share can be heart-wrenching, and losing patients can be emotionally devastating. However, the patients whose lives you positively influence can serve as a counterbalance to the heartbreak.

Moreover, maintaining a life distinct from medicine proves beneficial. Having a family, raising children—these facets offer a perspective outside the realm of physician identity. Medical school and residency fail to equip you with the skills to achieve emotional equilibrium; instead, they resemble boot camps that train you to endure lengthy shifts and sleep deprivation. Nonetheless, that equilibrium exists; it’s a personal quest to discover it. It might also entail locating a clinical environment that affords you adequate time and latitude to genuinely converse with your patients.

Janet Tamaren is a family physician.

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