It is both a privilege and an honor to be a primary care physician

With all of its frustrations and challenges, I love my job.  In fact, the very things that make primary care so difficult and often times exhausting are also what make it in my opinion the most awesome field in medicine.

When I was in grade school, I wanted to be a physician.  My parents would take me to the pediatrician for routine check-ups or when I wasn’t feeling so great and I remember admiring my pediatrician like no other.  To me, he was amazing.  I was of course always pretty nervous going to see him, like that time my legs and face were covered in the itchiest rash I had ever experienced with overlying fluid-filled blisters.  I was a mess.  My cheeks and forehead were swollen so badly I couldn’t even open my eyes so I wore sunglasses so no one would hopefully notice.  I was scared and miserable and even more so because I was going to see my doctor.

He calmly sat there and listened to me explain my story to him which consisted of a weekend shooting hoops in the backyard—I kept having to go retrieve the ball from the bushes which were situated behind the basketball net.  He then asked me to pop up on the exam room table.  After he had thoroughly examined me, he calmly diagnosed me with poison ivy and gave me a prescription for prednisone.  I left and within one week, all of my symptoms had resolved.  Gone were my excoriations as well as my sunglasses and life was back to normal.  Looking back, he represented all that a real doctor truly was.  He listened, empathized and healed.

When I was in medical school, although I entered certain that I would pursue a field in primary care, I found myself gravitating towards the ROAD (radiology, ophthalmology, anesthesiology, dermatology).  For everyone who is not familiar, these are considered to be the “sexy” fields of medicine with lucrative pay … the so-called “lifestyle” fields.  I don’t know exactly how it happened– perhaps it was the confused look on the faces of my attendings as I rotated through the ROAD fields when they asked me what field I planned to pursue and I proudly stated internal medicine.

Or maybe it was the flat-out “WHY would you do that when you could be a radiologist?!” that had an effect on me.  Whatever it was, come match time, I found myself swayed down the most sought-after ROAD.  I had applied and matched in radiology.  Me, of all people!  Someone who loves patient contact and dreads vitamin D deficiency!  I had ended up from the furthest place I could have ever imagined myself happy.  But I was in a hot field and everyone told me radiology would eventually make me happy—that I would be able to get home on time and patient contact was overrated anyway.  Right?  Well, I did get home on time.  While I was at the gym and planning the menu for dinner that night, my internal medicine counterparts were moaning and groaning about call schedules and wanting to gouge their eyeballs out because they were getting out around 10 pm on non-call days.  This of course led to not having time for the gym and scarfing unhealthy food down their throats for most days of the week and needless to say lots of undesired weight gain and baseline agitation.  I figured I had clearly chosen the right field for myself.

I should have noticed that this was not the case early on because it was pretty obvious, at least to an onlooker.  When many of my colleagues needed to actually interact with a human — like place a phone call to clarify what study they had actually ordered or locate a physician with the results of an abnormal finding — they were visibly irritated.  It was as though this was the most painful part of the day.

Whereas, this was the highlight of mine.  Abnormal appendix?  I would call the surgeon and ask him/her to bring the entire team down to the dark reading ream to go over findings.  I yearned for human contact. I secretly wished every medicine team would conduct “radiology rounds” and come visit me in the dark room so we could discuss cases together.  And I looked forward to rotations like breast diagnostic imaging and interventional radiology where I would have the opportunity to actually speak with a patient and find out how they were doing.  I always knew something was missing but I couldn’t quite put my finger on it.  And years later, it dawned on me.  That something was … people!

I ended up switching fields finally to internal medicine where I was able to develop and nurture long lasting relationships with my patients.  To me, internal medicine is both the most challenging and the most rewarding of fields.  We have the privilege to become involved members of our patient’s lives and to advocate for our patients so that they receive the best care possible.  As internists, our ultimate goal and desire is that each and every one of our patients is happy and lives well.  By dedicating ourselves fully to overall patient wellness, in return our patients reward us by sharing their life experiences with us.  This in turn makes us better humans.

Solmaz Amirnazmi is an internal medicine physician who blogs at All is Well That Eats Well and can be found on Twitter @DrSolmazA and Facebook.

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