Can't really sleep and have to get up in a few hours.
Been laying awake in bed with my dog beside me.
Earlier I was thinking about how I started out motivated to help other people and put myself through so much stress and grew so distant from my family to just end up as a person who is struggling and needing help psychologically just to make it to the next day.
Medicine isn't for everyone. It's so productivity-based now with emphasis on the bottom line and making money for the hospital and patient satisfaction scores in a very consumerist patient culture. Even though I'm a physician, I don't tell my doctor what to do and I don't demand prescriptions or procedures. I think physicians all over the country feel like they're losing their autonomy to the hospital that employs them, insurance companies, the formulary, and demanding patients who may not have a full understanding of how much thought goes into seemingly simple medical decisions.
I wonder if I can be happy as a doctor as those things invade my life more and more.
You mention your family--do you want to spend more time with them too? It may feel difficult to break the ice, but I think if your family is supportive you'd feel better after discussing your difficulties--it brings people closer together.
ReplyDeleteHave faith that things will get better. You are an educated patient and certainly know yourself better than your doctors can in a 15 minute appointment--it's ok to ask if they think a particular solution would work for you. I do--sometimes they say yes, sometimes they say no and give their reasoning and suggest something that works better.
I really feel like OpenNotes could benefit more patients--when I do read a note or letter (not often), I do see the thought processes that lead people to particular decisions, that there's a background of working with particular issues and interrelated medical issues that lead to a decision. There's not time to do it in appointments, but I wish patients knew how much time is spent on EHRs, paperwork, and documenting conditions.
I don't remember what specialty you're going into, but some of my drs have given me copies of letters written to PCPs after dx, for a first appt only--a rheumatologist and geneticist come to mind. Reading those helps my memory and makes me feel included in information shared, and it's been helpful to take to additional drs--it might be something to help if you have longer-term patients.
Depending on specialty, boutique practice might be an eventual goal? I've seen 3 doctors who practice this way when I can afford it/had better out-of-network coverage--and they have more time and aren't as bound by coding guidelines to order tests and can spend more time with patients. These doctors seemed happier--and honestly, for a few appts with a year with some specialists, esp when labs are still in-network, it's worth it.
It's ok to think outside the box--people are doing some creative things in medicine too, despite being hemmed in so much by insurance, hospitals, etc.
Medtwitter might help with connections to others? Choose a pseudonym and dive in. I do sometimes see some problematic ways of thinking there, but also a lot of good and a lot of people working for change, for patients and themselves.
What activities make you feel most joyous? Is there a way to engage in those again some, even if just on occasion, or nature while the weather is good?
As so often happens, I feel I could have written this post myself. I'm not a hugging person, but sending virtual hugs! I also entered medicine to try to help others but now can barely get by myself. If things aren't different after residency, I will probably try to pay off the loans ASAP then do something else entirely. There are people who, for whatever reason, are more cut out for this environment.
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