by I. Monet Ouwinga, MD

Dear Brothers and Sisters in the Health Care Field,

How are you?  Really, how are you?  Nearly every day I discover how ironic medicine has become.

I feel as if  my entire life I have been opening a big gift box with a promise that the next one will have a prize in it and now as an attending family medicine provider I have finally gotten to the last box and guess what…it’s empty.

Growing up we were all inspired one way or another to become a doctor, one of the most prestigious careers and titles you can earn.  Not to mention that all doctors are rich, have nice cars, big houses and go on monthly elaborate vacations; if you actually do have all those going for yourself, congrats and stop reading this blog because this will not apply to you.  Or maybe you do but at what cost?  How many family functions have you missed, how many 1st’s, little things then but now you see how big there were. Do you have a family or do you still engage in your favorite pastimes? How many divorces or resentful children/family members do you have? You get my point.

Society and our medical systems have really let us down.  Between the loans (what happened to all the loan repayment or forgiveness programs), increased numbers of patients panel, Press-Ganey (I will revert to the rule “If you don’t have anything nice to say, don’t say anything” on this one)…we are no longer graded on what a good job we did, what zebra diagnosis we made but instead on how satisfied the patients are.  Did your doctor smile with you, did they call you back every time your histrionic self-called, did you have a long wait?  Did you feel rushed during your visit? Really??!!  I have a dream of surveys that asks, “Did you get better, did your doctor treat your illness?  Has your HbA1c improved?  Since your blood pressure has been treated do you still have headaches?  Was your colon cancer caught because your provider encouraged you to get a colonoscopy?”

We have been reduced to a customer service agent (no offense to them).  Review the patient’s chart prior to entering the room, introduce yourself, do your interview and physical examination, discuss your results to the patient and complete your charting by the end of the visit in 30-40 minutes?  No! 15 minutes. Review and address all abnormal labs and imaging, and come back the next day and do it all over again. Even as an outpatient provider, I have had to pull a double just to catch up on paperwork. I don’t know about you all, but I constantly go back and forth from feeling like I am staying afloat to drowning.   I haven’t hit the main land in years.

Meetings! (dinner will be provided…FYI admin, I have dinner at home.  How about you pay me for the 2 hours I’m there listening to discussions/decisions you and the board have already made?)

CME, BCLS/ACLS, Boards, Oh My!!!

Where are the days when a physician’s opinion meant something?  We are being told how to practice medicine by businessmen, the ones who punch in at 9am (10am or 11am) and leave at 5pm, take the day before and after a holiday off  but want us to work.  These people that have never have never had to tell another person that they are dying or their loved one is (unless it’s a photo op).  They don’t understand the emotional and mental burdens we take home.

It’s a mystery, an enigma why we all haven’t left the healthcare field… we are to meet all these standards, all the while trying to give quality care, not get sued, take care of ourselves and our families.  How ironic a field dedicated to taking care of people is the same one that frowns upon a doctor calling sick.  Duh, we’re exposed to bacteria and viruses that most people never are on a regular basis but we are not allowed to be sick.

Ok, enough with the Bitch Fest… to be honest attending life isn’t where it started.  For me I was first diagnosed with anxiety and depression while in residency.  Luckily, I was supported by two women that I still hold close to my heart and a very attentive psychiatrist and received the appropriate treatment. And of course I was just a few more boxes from the grand prize of being an attending.

Yea, the joke was on me.  Becoming an attending, I was now also not only responsible for my patients but for my residents and their patients as well.

In between I got married, had a baby, went back to work 3 weeks after giving birth because “we” were short staffed.  I should have realized then that “we” weren’t short, “YOU” are short.  I didn’t realize that going into Family Medicine meant that I would have to give up my own.  As physicians we give up our basics needs, the selfishness of our own needs and identity.  At times my husband would say “I wish I was a patient of yours, because I would be able to see you more.” We use to do Bikram yoga together and go to church. Now our 4 year son, not yet baptized into any religion, doesn’t want to thank anyone other than his “daddy” for our daily blessings.

So anxiety, depression, shift work sleep disorder, overweight, guilt for not being the best mother, daughter, wife or friend of the year and drowning in paperwork, tasks, and meetings are my daily struggles.

Who’s the Doctor’s Doctor? When do you make your own appointments?  If you mention to your employer that you need help, that seeing 30 patients in a day is too much or you’re overwhelmed, you’re looked upon as weak and a possible liability. Or my favorite, you’re ignored. You don’t even get a response to ask, “Are you ok?”  or “How can we help?”

I’m back to asking myself, “What do you want to be when you grow up?” because this can’t be the pot of gold at the end of the rainbow I’ve been chasing this entire time…or is it?

So what’s the solution?  Are we all going to quit medicine and write books?  Become life coaches?  Or just run way?  If we are all running away, let’s keep in touch so we can meet up and give each other the support and thankfulness we all long for.