Tuesday, March 24, 2015

If you had to do it over again, would you choose medicine again?

This will be part of a work/career/medicine series -- I've gotten several questions related to work, but often feel overwhelmed about writing such a 'serious' post.  Instead of writing one monstrous (and potentially boring) post, I am going to address a work-related question/topic in brief every week or so for this series.

Okay, back to the question above, which is such a difficult question on so many levels.

The fast and easy answer is yes.  This may be in part because the harsh memories of med school/harder residency rotations are getting fuzzier, and in retrospect it doesn't seem like it was that bad (except really, sometimes it was).  And the 'prize' is pretty nice -- I now have a job that has lots of autonomy, uses complex (and therefore interesting) decision making, and always provides opportunities for learning and personal growth.   It is also a job that feels meaningful a lot of the time, which is really rewarding.

I generally enjoy my days at work, and they go by quickly.  I am not one of those people who feel like the EMR killed medicine, and in fact I credit EPIC (our electronic system, and a common one in many hospitals) for making my work easier and more pleasant, because with paper charts records were often unwieldy and unreliable.

This is a sticky thing to post about, but I do feel like I am decently compensated for what I do, so that helps me feel more confident about my decision to work outside the home full time (i.e., paying for childcare does not eat up all of my salary).  

Finally, I feel like there is a decent amount of flexibility/opportunity for growth.  For example, our hospital system is adding a pediatric residency program, and I'm interested in being involved in that on some level.   I could see myself in a position with some leadership responsibilities someday, too.  There are always research opportunities -- and while I will never go back to bench science, there are clinical trials that would be exciting to be a part of.  

All of that sounds nice, huh?  But there are some significant downsides.  First of all, medicine is stressful.  Honestly, whether you are a radiologist or an ED doctor heading up a level 1 trauma center (. . . or a pediatric endocrinologist or a vascular surgeon . . .) -- this job is high pressure.  The health (and potentially lives) of our patients are at stake, and therefore all of the decisions a doctor makes matter.  With every short stature patient I see, I'm trying not to miss the one that with a brain tumor.  And yet I don't want to put every child through 93423 unnecessary tests, putting them at risk and wasting everyone's time and money.  Decision fatigue is real, and I feel it at the end of every day, even my easier ones.  

Perhaps the above will get easier with time, once I've had 10 (or 20) years of experience under my belt. However, I don't think it will ever be truly simple or stress-free.

The second major downside is CALL.  Ugh, call!  It comes in many forms, but it's a universal part of almost any physician's job responsibilities.  As I've written about before, in our practice we take call one week at a time -- that's 168 hours of "any time my phone rings, I have to deal with whatever is on the other end of the line."  At 10 am.  At 6:20 pm, to put in diabetes orders, while alone in the house with A&C (that happened yesterday).  At 1 am.  Luckily, it's only 20% of the time (I'm in a group of 5) and in general, as call goes, peds endo call is sometimes very benign.  This past weekend was so quiet that I nearly forgot that I was in the hot seat.  But you never do get to fully forget/relax when on call, or at least I don't.  

SO.  I suppose I need to provide a real/more complex answer the question I asked above, but honestly?  I don't really know the answer!  I'm happy with how things are now, and I am not planning on a career change.  But I also think I could have been a very happy:

- pharmacist
- writer
- nurse practitioner/PA (many don't have call)
- corporate pawn -- kidding, but in all seriousness I could see myself enjoying a position in something like marketing or project management 

I do have a promise to myself that if I do ever become miserable in my career, I will make a change.  

If you are in medicine, would you do it over again?