Choose primary care and follow your heart, not your brain

Reams have been written on how medical students ought to select their field of medicine.

There are even personality-type tests that ask questions about what kinds of situations you like, how you react to problems, and your working style that purport to predict for which specialty you are suited. (I came up as an oncologist or a nephrologist.)

Others have opined that once you crunch the lifetime salary numbers, and then compare those to the intangible lifestyle factors, avoiding family practice and other primary care specialties is a “no-brainer.”

I beg to differ.

So much of life has involves things you can’t count, add up or analyze on a spreadsheet. In terms of financial return, no one ought to be going into medicine when there are so many faster, more effective ways of simply amassing the benjamins. For all the hullaballoo about the sorry state of medical education today, there is still altruism aplenty to be found in the candidate pool. As tired and trite as it sounds, people really still go into medicine to help people.

I’m not saying that all doctors don’t help people, but the opportunity afforded by family practice and other primary care disciplines to form long-term relationships with patients makes our job qualitatively different from that of other medical specialties. Despite the fact that so few students are actually entering family practice, I cannot help but believe that many more of them would find it incredibly rewarding. It seems to me that too many of them are scared off by “rational” discussions from their peers and immediate superiors about the financial and alleged lifestyle drawbacks.

I also believe that there are plenty of specialists out there who aren’t exactly unhappy with their career choices, but who may have the sense that they aren’t as happy as they could have been if they had had the nerve to follow their dreams, shaking off the “logical” arguments of the naysayers they encountered earlier in their careers.

Not all decisions in life are strictly logical. People marry completely unsuitable partners for love all the time. Parents of children who dream of careers in the arts and professional sports often try to dissuade such “irrational” career choices, frequently producing unfulfilled adults who may never have made it big, but who wouldn’t have to spend a lifetime wondering “what if?” if they had only been given the chance to try.

The choice of primary care as a career isn’t nearly as precarious a decision. Family practice may not pay as much as other medical specialties (and absolutely deserves to be paid more) but it’s hardly the life of a starving artist. Those for whom this purest form of medicine is a true calling should not be afraid to follow their heart.

When it comes to choosing a career in primary care, I agree it’s a no-brainer. Some decisions should be made with the heart instead of the brain.

Lucy Hornstein is a family physician who blogs at Musings of a Dinosaur, and is the author of Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

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