Medicine as art appealed to me as a child. Working with families to achieve a state of health was an admirable goal—if naïve. I only went to the physician for immunizations and obligatory school physicals during childhood. My mom employed home remedies and time if I became ill, which fortunately worked.
I had no concept of what a career in medicine involved. Over twenty-five years, I explored every avenue available to a clinician. Private practice, urgent care, community health center, HMO, and multispecialty groups. Only private practice and urgent care provided the creative opportunities I desired to deliver medical care on my terms.
Conscripted medicine dolled out according to reimbursement requirements, and analytics stifles imagination. As a pediatrician, I understand the limitations of treatment protocols. Flexibility and ingenuity are more valuable when counseling a parent on breastfeeding or toilet training. Time constraints choke individuality. There are general concepts in caring for patients, but we must individualize treatment to the specific patient and circumstances to be effective.
After a few years with a large HMO, I abandoned clinical medicine for medical consulting. Do I miss clinical medicine? Every day. If I could practice patient-centered care like I was taught in medical school, I would return to clinical medicine tomorrow. I am no longer that immature young child dreaming of becoming a doctor, though. Medicine today is a computer-generated algorithm where physicians click boxes and scale hurdles of paperwork and bureaucracy. However, society cannot blame corporate America for all the ills in our medical system. Patients, consumers, share a large part of that responsibility.
Before the Affordable Care Act, even when I still maintained a private practice, the symptoms of an ailing medical system were apparent. Patients insisted on health care delivered as if they were ordering a book off Amazon, on-demand 24-7, at rock-bottom prices. As a pediatrician in private practice, I realized I could never fund my son’s college tuition and my retirement on the meager receipts from patient co-pays and insurance reimbursements.
Despite treating patients in the ER, hospital, and office on weekends and evenings, it was never enough. Patients expected me to be available whenever and wherever they wanted. It was unsustainable. Arguing with a parent over a twenty-dollar co-pay that was fifty percent of what I would earn after speaking with them for an hour about their colicky baby. It sounds strange, but I loved it. However, I was—am—a pragmatist. The end of my private medical practice closed the most passionate chapter in my medical career.
For the almost three years I worked for an HMO, my writing languished. Non-clinical medicine gave me a clear, unencumbered mind, allowing creativity to flourish. Within the first year of leaving corporate medicine, I wrote four stories. One of those became a mystery novel I recently self-published.
Life involves regrets, but I have now found peace in my medical career. I miss caring for children and working with families. But I hope my writing will bring happiness, maybe laughter, to someone needing a little piece of joy in this difficult world.
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