“I feel more alone than ever in trying to care for my patients properly.”
[Editor’s Note: One of Physicians Practice’s questions for the Great American Physician survey asks physicians to rate how they feel about the practice of medicine. We invited survey participants to explain their answers in a personal essay.]
I love being a physician. It defines who I am. Yet I truly cannot bear it any longer.
Choosing to become a doctor meant pursuing a career associated with lifelong stress. Medical school was taxing, particularly for me as the mother of a young daughter, and as one of eight women among a class of 93 men. Residency had its own burdens. By then, I was the mother of two. It was a difficult time, juggling family responsibilities with night call every third night, caring for very sick patients, and watching my first patient die.
After residency there were the additional stressors of starting a new practice, learning the business of medicine, borrowing lots of money, and worrying about succeeding. But I loved being in practice.
The responsibility of caring for people who depended on my expertise, wisdom, compassion and availability was at times trying but always rewarding. I worked hard, long hours but my partner and I were in control of the practice. We made sure our staff were competent, well-trained, and hardworking. We covered for each other to allow for family time, and the stress was manageable.
Then the healthcare environment began to change, and we had to close the practice.
I have done many things since my practice closed. Most recently, I have accepted a temporary position in clinical administration, where I hope to make life a little better for the primary care doctors who work so hard. For several years prior, I worked as a primary care physician in a big bureaucratic system. I felt disempowered, having no control over my schedule, what went into my patients' records, what specialists were available to me, or the staff who were supposedly there to support me.
I feel more alone than ever in trying to care for my patients properly. I spend endless hours charting after everyone but the clinicians have gone home. I barely get to examine patients and rarely ask them to disrobe. Too often, in the interest of saving time, I send patients to specialists rather than diagnosing on my own. Then, I am frustrated when the specialists don’t take ownership of the patient.
I don’t feel that I have colleagues whom I can talk to because each of us is in a little cubicle. We are all pecking away at our keyboards with no time to brainstorm about patient problems or to learn from one another.
I do my best but fear that my best is not good enough anymore. I worry that my patients are not getting what they need from me. Though I know it is no longer possible, I wish that I could have continued practicing medicine the way I had been able to years ago, when I enjoyed my work so much more.
Roberta Berrien, MD, MSc, is a primary care physician currently working in New Orleans.