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Saying Goodbye to Patients

Article

Over the last year, I've felt pulled in another direction and started to consider leaving academic medicine. When a great opportunity opened up a few months ago, I accepted the offer. This is my last week in my academic practice.

A few months ago I made a big decision, surprising myself. Since I graduated residency, I've been teaching in a residency program - first in Georgia, now in Wisconsin. Teaching, doing research, constantly being challenged by young physicians have been key parts of being a doctor for me. Over the last year, though, I've felt pulled in another direction and started to consider leaving academic medicine. When a great opportunity opened up a few months ago, I accepted the offer. This is my last week in my academic practice. 

Over the past weeks, I've been saying goodbye - to my wonderful colleagues, the resident physicians, the nursing and administrative staff, and my patients. I've also been saying goodbye to scholarship, research, and teaching, although I hope to continue all of these roles to some degree in my new job. It has been difficult to start the leaving process, but drawing my patient relationships to a close has been the hardest of all.

Many of my patients have great needs and understandably depend on their primary care doctor to know them, be familiar with their history, and be a constant. I was nervous about how some of my patients would react to the news of my departure. Most were disappointed but understood the pull my family and especially my four young children have on any career decisions. While stating their own reticence to have to “train” a new primary care doctor in the details of their diseases and idiosyncrasies, they uniformly wished me well.

What surprised me the most was their recognition that I'm a person too, so to speak. They accepted without question that while my role as a physician is important, my role as a mother and wife is even more so. They've been supportive, encouraging, and grateful.

In transitioning my patients to their new primary care doctors, I wrote up brief notes on each of them describing the parts of their history that aren't present in a medical record. I rarely had to consult my own notes to refresh my memory. For most of my patients, the key components I needed to convey were readily available to me just by recollecting our recent visits. I recalled my patients who struggle to afford medications, those who have greater concerns than the level of their hemoglobin A1C, and the ones with personality problems or fears or insecurities that prove to be a barrier to achieving better health. It was a bittersweet task - making me sad to leave this group I've come to know so well but grateful for the opportunity to become familiar with them in all the little details of their lives that make them unique.

With all the roles I play as an academic family physician - teacher, researcher, administrator, supervisor, scholar - I remember the one I love the most: doctor. Fortunately, I don't have to say goodbye to that role and have the opportunity to meet and get to know a whole new group of patients.
 

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