Dear medicine: I’m breaking up with you

I’m breaking up with you.

I fell in love with you when I was just a child sitting in my grandfather’s family practice office. He put that magical white coat on me, sat me at his desk, welcomed in my first patient, and I was smitten.

I grew up playing medical guessing games with him and his best friend, the town surgeon. They told stories of home visits, generations of families they cared for, and being given eggs when patients had no money. They loved medicine. Medicine when diagnoses and treatment plans were made based on the power of a history and physical. And they warned me you had changed. They never wanted me to be a doctor.

But I did it anyway. Because I loved you.

Or, I loved the idea of you. You were exciting and challenging. I learned and grew. I dreamed of you — answers to diagnoses I was puzzling over, faces of patients I cared for, and even that awful panic of sleeping through and missing a page, call, or a text.

You were everywhere. But that is also the problem. You are everywhere.

You took over my days, nights, and weekends. Emails, texts, and coding queries invaded my days off. Typing notes became the homework I did alongside my kids at the kitchen table. Each year I was scheduled for more shifts. I have missed more bedtimes, birthday parties, dinner invitations, movies, soccer games, and life than I ever imagined was possible.

I tried to change you, but you’re too stubborn. You don’t want to hear about increasing volumes, increasing complexity, or the multitude of issues with EMRs. You looked at me like I was crazy when I tried to explain the misery and exhaustion of 15 years of post-call days. Yeah, post-call is still not the same as a day off. And call nights need to be compensated whether or not I get a chance to rest.

Or maybe you just don’t care about me the way I care about you?

I don’t want to be the doctor who walks into and out of a hospital shift without knowing my patients.

Hospital medicine used to have its own continuity, but now the patients don’t know me — they know Dr. Google. I spend so much of my time trying to gain their trust and convince them that I really do know what I’m doing when it doesn’t match exactly what yesterday’s doctor, their aunt’s sub-specialist friend, or the internet says. And forget trying to explain the diagnostic ability of a physical exam, patients want a test. The sacred trust patients used to have in their doctors is not what it used to be. That hurts.

I tried to change me. I took the QI courses. I wrote the case reports. (Yes, it was pretty cool to see my name in print.)

I tried to tackle the EMR problems.

You tried to tempt me with the promise of non-clinical work leading to a better schedule. But what I really want is to just take care of my patients. I became a doctor to heal and help people. I don’t want to sit in meetings or do research. Why does it seem like you have to become part-time or change to administration work to survive in medicine? I studied my butt off, swore, and swear to, do no harm in order to spend my hours at the patient’s bedside.

Medicine, you harmed me. I am tired, frustrated, overworked, underpaid for my time, and under-appreciated. I miss my family and friends. I miss me. So, I’m leaving you. I’ve been looking for a place where other people are happy, healthy, and creative — a place that values both the bread and butter staples and the innovations. A place where people are excited to share ideas and tips and want feedback to keep improving. I think I found it. Trader Joe’s, are you hiring?

This MD is signing out.

The author is an anonymous physician.

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