Kathryn Freeman, MD
This past spring, I consciously moved away from learning clinical skills and spent time at two conferences: the National Medical Legal Partnership Conference, and the Family Medicine Advocacy Summit. There, instead of learning about medicine, I learned about stories.
When I reflect on what I learned in medical school, it was all about taking a patient story and converting it into a formal presentation. We spend years training our residents to boil down a patient’s history into discrete facts in a defined structure, using medical terminology to convey a message that only other physicians can understand. But that only allows us to communicate with each other, not with the world around us, or with the people, partners, groups, and leaders who have the potential to make a larger impact our patients’ health.
Medical students, especially those with little exposure to careers in medicine, have great difficulty imagining a career in medicine other than what they see and experience through their rotations.
Antoinette Moore, 4th-Year Medical Student
And shortly after rotations, they are asked to make choices that place their careers on certain trajectories. And while the scope of someone’s ideal practice will grow and change, the choice of specialty defines us in a way that is undeniably powerful and far reaching into our professional careers.
As I wrap up my third year of medical school, what has become apparent to me is that there are two often unnoticed—and often under-promoted—qualities that influence whether a student chooses one specialty over another.
These two qualities are physical and metaphysical. Physical describes the more brick and mortar/billable procedure/patient population aspects students are exposed to during rotations, such as “Is the preceptorship in a small town or a large urban setting?” and “Does this rotation expose students to a wide variety of patient presentations, procedures, and demographics?” The metaphysical is a bit harder to quantify but importantly demonstrates how happy employees are with their chosen line of work. It speaks to the culture of the rotation environment, which, to the student, serves as a representation of the profession as a whole.
Kathleen Rowland, MD, MS
Change is here, and more is coming. In medicine, we often perceive change, especially external change from hospital systems or payers, to be a threat. We feel a loss of control, which can lead to anger, resentment, and burnout.1 A survey of 3,000 US physicians done by a staffing company found that 58% of physicians who left medicine in 2013 reported doing so because they didn’t want to practice in an era of health care reform. This is more than stated they left because of economic factors such as malpractice insurance or reimbursement concerns (50%).2 The changes we face can feel overwhelming, and we have to take measures to make the changes less daunting.
Being resilient does not mean that we become pushovers. The goal of teaching resilience to change is to increase the sense that we are able to react to, triage, and adapt to changes while maintaining the core of who we are: physician teachers and healers. We can fight unwinnable battles or choose good ones. We can hold out on changing until the demand to do so is punitive, or we can adopt the change at a comfortable pace. We often do not choose the changes we face, but can choose the way we respond. As we restore that independence, we can reduce our risk of burnout and increase our satisfaction with practice.