Clinical work feels meaningless to me – this is the best way I can phrase it. And when I read it out loud, it really slaps me in the face. Since 2006 I have been practicing medicine with an independent license, and a part of me could care less.
It wasn’t always like this, but I don’t want to sit in the way-back-when machine. Today I want to vomit my feelings about clinic medicine onto this page and discuss a few solutions I am considering.
I’m a board-certified family medicine physician. I do a mix of primary care and urgent care and often wield medical questions from friends and family.
In the urgent care, I’ll remove foreign bodies, work people up for chest pain, diagnose chronic severe conditions, and even offer pain relief.
In the primary care setting, it’s a little less exciting; I juggle medications and tell patients that if they change their habits, they’ll get some possible future outcome.
For family and friends, it’s a little more straightforward. Ironically, what I enjoy most about medicine is what the medical boards tell me I shouldn’t do. Playing doctor for family & friends is taboo.
In the past, I enjoyed meeting new patients, and I would build friendships. Both the urgent care and the primary care clinics were places where I felt at home. I wanted to make my patients feel welcome.
Once I checked out my job, the work felt meaningless; it was hard to connect with patients. I instead tried to keep a sterile distance. And it’s never felt good ever since.
I constantly fear that if I get too close to a patient, I’ll get screwed over somehow. Where is this fear coming from other than me making it up in my head?
Pride in Clinical Work
I used to feel a lot of pride when doing clinical work. I reveled in my good outcomes and would follow my bad results to determine what I could have done better.
Then, de repente, there was a shift – almost overnight, it seemed. I didn’t care and was tired of measuring so much of the outcome without being able to do much about it.
Even worse, I had identified so much with being a doctor that I lost that pride I had being a doctor. It’s like I burnt out that flame. When you drive exotic cars every day, they stop being exotic to you.
But I also question why I need to feel a sense of pride in my work. Why can’t I clock in, clock out, and be content? Why do I expect so much f
Detesting Clinical Medicine
It feels like this sometimes, genuine hate for clinical medicine. A part of me is upset that I love medicine in some ways and that it has such a stronghold on me.
I hate that I feel like I have no control in this field. I could lose my license or get sued, or any crazy patient complaint could take me down.
This is, of course, totally irrational. All the fears in my head are just that – fears. The chance of them coming true is meager.
Regardless of what I have gotten involved in in my life, an emotional engagement and connection have been an enjoyable part of it.
When I rock climb, I plan my day around it. I am excited when I touch the boulder for the first time, and I daydream about a particular climb for the rest of the day.
While sitting here at Cafe La Flor writing this article, I genuinely enjoy the process. I have my reader in mind, sipping my coffee and imagining what my reader can learn from this writing.
I wonder what it would take to turn around this current wave of viewing my clinical work as meaningless. How can I connect with my patients and feel engaged when interacting with them?
It’s as if I’m in a career rut in clinical work. And what’s the best way to remedy that? In my opinion, you have to start from scratch and build things back up. I have to go back to the basics.
When clinical work feels meaningless, it’s easy to detach. Suddenly everything feels pointless. This is the time for me to note what clinical scenarios help me feel engaged.
Often, it’s when a patient has a question for me and they feel empowered. They want nothing more from me than my medical expertise. Their expectations are appropriate and more realistic, without being dependent on me.
If I can complete some of these visits successfully, I’ll be able to reengage with my patients. Next, I’ll have to focus on finding more of such patients and slowly expanding my comfort zone.
Once you get to hating clinical medicine, you know you have to take drastic actions. It’s not like I don’t enjoy the art of medicine – it’s the patient interactions that drain me.
A traditional medical practice where I am medically responsible for the patient is, for me, at the heart of the problem. I project my fears of lawsuits or medical board investigations on the patient, going south from there.
If I can take on the role of a clinical expert, it’s less likely for me to feel vulnerable or sensitive. I’ll perhaps offer more value to my patients.
In the role of someone who offers up their expertise without entering the professional patient-doctor relationship, I feel safer, perhaps even more effective.