Why I Still Do What I Do

June 28, 2010

While I still love the mental challenges of navigating the endocrine system, I have to admit there are many days that I ask myself why I do what I do. Between the non-medical part of medicine - the patients who think they are sick but aren’t, the prior auths, the record audits, the denial of payments, the phone calls, the faxes, and so on - there’s barely any time to be a “real” doctor.

I have always wanted to be a doctor. I vividly remember being 6 years old, sitting in Mrs. Williams’ first grade class and drawing a woman with a stethoscope around her neck, with the words “I want to be a doctor” printed on the bottom. I remember this little tidbit not because I have many vivid memories of my early childhood, but because George, the boy sitting next to me said, “You can’t be a doctor. You’re a girl.” But that’s a matter of another discussion.

All through my childhood and teens, I was certain this is what I wanted. And even when my mother (I’m sure with her fingers crossed) said I don’t have to if I don’t want to, I could think of nothing else I’d rather do. So off I went to med school, idealistic and with lofty humanitarian goals. Med school was challenging, and there were days when I felt like I was going through a really, really long initiation rite. I suppose in a way I was. Residency was often physically, emotionally, and mentally exhausting. Fellowship was like an oasis, more intellectually stimulating, less tiring. And then I went into practice.

And while I still love the mental challenges of navigating the endocrine system, I have to admit there are many days that I ask myself why I do what I do.  Between the non-medical part of medicine - the patients who think they are sick but aren’t, the prior auths, the record audits, the denial of payments, the phone calls, the faxes, and so on - there’s barely any time to be a “real” doctor.

And even more disheartening is the feeling that the patients that I once cared about so much treat me like hired help. Hired help they don’t want to pay. Let me rephrase that. I still do care about my patients, but on many days, not with the passion I once did.

Let me put this in this context, too – I went to med school in the Philippines, where doctors are respected. Physicians are probably the most respected members of society there. Patients are grateful for the care they get. They are eager to please, and to the best of their ability (often hampered by financial woes and lack of education), are compliant. There is no insurance, so patients pay out of pocket. And if they can’t afford it, they very humbly, politely ask for a discount or an installment plan. They bring you little gifts of gratitude (I once got a bucket of mussels from a fisherman after I helped deliver their baby, who they named after me, and I was just a third year student at the time.)

I don’t expect that to happen here.  But it would be nice to at least be recognized as someone who is trying to help, not just a “healthcare provider” that they begrudgingly hand their $20 copay to.

Years ago, back in pre-med, I received what I thought was the best compliment.  I was told that I make people feel special, because when they talk, I listen. I give them my full attention. I have always treasured that statement, more than any awards or honors I had received in school and thereafter.

Last week, a really hellacious week, at the end of a visit with one of my patients, he stopped me to say that he was glad I was his doctor. He had gone to many for himself, his wife, his kids. He has met the burned out, the cranky, the rushed. He said that I really listen, that I motivate him, and he was grateful I was his doctor. He has no idea how grateful I am to him right now.

Yes, I have always wanted to be a doctor.  I guess I still do.