The Day That Made Me Want To Quit Medicine
I wrote this post the morning after the event that took place on 10/29/2022. Yesterday, my daughter was sent home from daycare with complaints of “she won’t stop crying and screaming of belly pain.” Today’s post will be a deviation from the usual post, and I will walk though some of the events and why I’m looking at how I practice medicine with a new viewpoint. I will also explain how it got to the point where the thought of quitting medicine even entered my mind.
First Kid, First ER Trip
Every new parent is anxious. My little girl turns 3 in November 2022. Yesterday the daycare called us that suddenly she was having severe abdominal pain where she was not even wanting to stand up and they called us to get her.
We picked her up and the pain was episodic. There were these 30-minute episodes of severe pain, screaming, then she calmed down for another 30 minutes. She tried to take a nap but woke up 10 minutes into her nap screaming that her belly hurt, so my wife called me, and I told her to take her to the ER. I could hear my daughter screaming in the background.
My office is right across the street from the ER so my wife said she would swing by the office so I could see her. I open the car door and my little girl is shaking in pain, holding her abdomen. I told my wife, nope she must go to the ER this is very unusual.
Cancel My Clinic
I went upstairs and told my staff to immediately cancel my clinic, that I wanted to be there for my little girl. They started to call patients offering to switch them to another doctor or reschedule them completely.
Feeling Not Valued
My next patient to be seen was already in the office by the time I got back upstairs from evaluating my daughter in the parking lot. I was not in the right frame of mind to see them, so my manager offered to have our of our PA’s or the other doctor see this patient while we called others to cancel my clinic.
While I was still in the office, I could hear my next patient cuss out my office manager and tell her “I don’t give a shit what is going on in his personal life, I am here, and I want him to see me now.”
Wow. And there it was. The phrase that made me immediately want to quit medicine.
This patient I had been seeing for 3 years. I had bent over backwards to try to get them their diabetes meds even on the weekend when they called in and needed an urgent refill because they forgot to call earlier. This patient often requested long appointments and monopolized my time. I thought I was being compassionate and going above and beyond to help this patient in any way I could.
When I had a family member with a medical emergency, the true feelings towards me came through (I thought). He didn’t care about me as a person. He was there to get what he wanted, when he wanted, and wanted to use my time the way he wanted.
My next patient was something similar. They left me a 1-star review because I did not give them 24 hours heads up for canceling their office visit. They cussed at my staff while we tried to explain to them that it was a medical emergency and hung up on my staff before they could explain.
Looking For Validation
I posted my frustrations to a group of doctors online on Facebook. Most were kind replies, but one really stuck with me. “Stop looking for validation in your patients.” Stop looking for them to value you. It is a job, and as this person put it…”Your employer and this patient would be searching for a new doctor before your body was in the ground if you died.”
I kept giving into the patients’ demands, thinking that I was helping them and that they would somehow appreciate all the things I was doing above. In my time of need I was looking for validation to make it “about me.” Their illness is not about me. I was enabling entitled behavior by allowing occasional long visits just because they wanted them. I was enabling bad behavior by taking requests after hours for occasional refills to make sure their diabetes is well treated.
Medicine Is A Job
I try extremely hard for my patients. The 99% are wonderful, but it is that 1% that really gets to us. The 1% that says or does hurtful things. On this day I seemed to have a few 1% patients lined up in a row. It was rough.
Even though it is the following day after the event, I feel like this event has changed me.
I’m glad my daughter is doing well now. However, I call out one day for a family emergency and get blasted with several bad reviews online and have patients cussing at my staff that they do not care about my personal life….yeah that will take some time and reflection to get to the bottom of how I ultimately deal with all of what happened.
We Offered To Switch Patients To Someone Else
We did our best to switch these people to different doctors schedules within our practice, but for some that was not good enough. They wanted me to honor the appointment and that was depressing to think about. They didn’t care about my personal life or respect that I needed to be there for my family, my little 2 year old daughter.
I get that patients took time off to see me, that for them this was a big inconvenience. For that, I do feel bad. However, in the medical profession we have to have boundaries to respect our own family time and life. In my opinion we made a reasonable accommodation attempt, but for some it was still not enough.
It happens every day for many doctors. Always feeling like you must be available for your patients. Or you feel guilty for taking time off.
Even when my kids were born, I was answering portal messages the day after. My friend who is having a kid soon, plans to take one day off of work then back to being on call and working his usual schedule with no other planned time off.
The culture that doctors need to be available all the time has really contributed to my own personal feelings.
I feel like this event has really changed how I look at my job. Although I try to tell myself, it is just a job, don’t care about the patients disease more than they do…events like this really make me reevaluate how I am truly practicing medicine and how I want to keep practicing medicine going forward.
7 thoughts on “The Day That Made Me Want To Quit Medicine”
I’m glad you took the time off for your daughter. Corporate medicine has altered the physician-patient relationship. Many patients no longer value doctors in any personal sense. We doctors need to put family and friends first.
I feel your pain because I have been there and I am sure many of your other readers have had similar experiences. I haven’t yet figured out how to deal with these emotions.
I am glad your daughter is ok. The lesson I learn everyday is that you are not replaceable as your daughter’s father,your wife’s husband and your mom’s son so always keep that in mind when setting priorities. I am still learning.
Most people feel that their time is of little value to the doctor/system when they are required to show up early to an appointment because the doctors/systems time is so valuable that the grinder must always be full to maximize profits. Then charging patients for missed, reschedule, cancelled appointment but when the doctor/system does the same the patients wasted time isn’t valued or compensated. I’m not a doctor but like you just found out I learned long ago that I’m only valued for what I can provide my customer and that the customer has paid for the service/product and not my or their valued feelings. The only thing that’s free is the smile and the clean slate I bring to each customer.
I think that this first point is the issue. The reality is that in corporate medicine, patients are treated very poorly as the physician’s time is optimized, phone systems are designed to frustrate, and billing is a complete mystery. What other service or experience is like this?
That said, my advice for you as a physician is to not take it personally. Despite all that you do when you meet with the patient, its only about 25% of their experience with the office, etc. Much of the frustration is from the entire experience.
Understand where you are at! This is the type of patient “behavior” that ultimately led me to retire earlier this year at age 63. Unfortunately, it represents probably 5% (or less) of the total patients, but their repetitive immediate demands, failure to respect boundaries, and expecting me to be available 24/7/365 just eventually wears one down. Glad I retired, now if I can just talk my wife into it!
As you mentioned above, we should not seek validation from others, especially our patients. If we became doctors to help others, it wasn’t conditional on them thanking us; true service is serving without expecting anything in return, which is tough but nevertheless what we must strive for. As others have said, most patients are understanding and grateful for your time and efforts, whereas others are like the selfish and spiteful patient you described above. Those kinds of personalities are like that with everyone, including in their personal lives and with other people, and I know upfront that I need to be extra firm with them, or else they WILL abuse/drain you. I also don’t bother getting worked up when dealing with them because I know who they are and that they’re not capable of anything else. As my tradition teaches us, “to save one life is to save humanity,” so if you can help just one person, which I KNOW we all have, then you’ve accomplished something extraordinarily great! Don’t let a**holes like that drain your energy 🙂
I feel for you. Please always put your family first. These patients will not care about you at all and just want to get what they want. If these people return and they continue to be upset with me, I would have confronted them in their face and asked them if it was their daughter what they would do and dismiss them.
I stopped caring about these reviews…
Good patients will always come if you are passionate and provide good care. This is the beauty of PP-the ability to stop seeing patients that are toxic and draining to you.