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Working When You Don’t Have to Work

You’re 35 years old, just started a family, bought your first nice house, have medical student loans to pay back, and you’re learning the ropes at work. This is a scenario where you have to work, mixed in with a little bit of what you want to work. But there will be a time when you don’t have to work.

You’re 50 years old, and you have no debt. You’ve paid off cars and homes, and your partner is making more than enough money for both of you. You don’t have to work, but you also don’t want to lose your skills as a surgeon or pediatrician. You also don’t want to depend on your partner because, what if?

When You Don’t Have to Work

I’ve realized not having to practice medicine is a bit of a curse. Took me a few years to learn that but here we are. You wake up one day and realize you don’t have to work, you have enough money coming in from investments or other sources but at the same time the only skill you have is putting your finger inside people, legally.

Maybe it’s as simple as just surrending your medical license and moving on. But it hasn’t been for me or anyone else I know.

Perhaps you can transition into something adjacent to medicine such as consulting, which I’ve done. But I still can’t get myself to give up my medical license or stop seeing patient.

Admitting You Like the Practice of Medicine

It’s like waking up in a miserable marriage one day and realizing you actually love your partner. WTF do you do now? All you know is complaining and bitching about her. You don’t even know how to be nice to her, much less vulnerable.

Ya certainly ain’t gonna have a healthy relationship in the same shitty setting. You’re gonna need a change of scenery, some therapy, maybe some meds, and you probably have to stop watching so much porn.

So, back to medicine. What do you do when you realize that you actually like to practice medicine? Well, you are going to have to change scenery, get some therapy, find a new vocabulary to describe what you do, get rid of some toxic friends, and reimagine what the practice of medicine means to you.

Starting All Over Again

When I started practicing medicine at my first full-time job right out of residency I was 31 years old. I wanted to know how to be a better family medicine doctor and I wanted to learn how to be a good urgent care doctor. I was excited, motivated, and full of energy.

At 31 I believed that western medicine was the path to health and evidence-based research was the source of truth. I would only become a better doctor if I learned more and if I could get my patients to do what I think they should do.

I looked up to the fast doctors, those who could spit some good research articles, and the ones who didn’t complain. So I set out to be just like that.

But that’s not where I’m at now. I’m the shriveled, jaded, hairier, balder, richer, wiser, and gassier version of the 2009 Dr. Mo. To start over again I have to approach the practice of medicine with my current beliefs.

Motivating Myself to Practice Medicine

I think the best way to practice medicine is to be where the patient is, wherever the fuck the patient is. No judgment, just being there for them. No agenda, but also setting healthy boundaries.

Intrinsic motivation is far more valuable than the extrinsic motivators I built up for myself.

Caring About the Patient

So, how do I become better at listening? How do I make the patient feel listened to? How can I be 100% present in the exam room no matter how short the visit time is? How can I get them to trust me and open up?

I need motivation because otherwise, it’s hard the night before a shift. It’s a drudge all day when I work, looking at the clock, waiting for another hour to go by.

Setting New Standards of Care

I used to believe that a good doctor won’t give out antibiotics for viral illnesses. Maybe that’s not what medicine is about. Maybe my metric should be how much I connected with that person and whether they felt taken care of when they were freaking out about a drop from their left nostril.

Connecting With Staff

Dr. Mo 1.0 used to think that nurses should be fast and move meat. Now, what’s important to me is having some meaningful, deep conversations with the staff. Getting to know them a little more and accepting them for however they interact with patients; even the shitty ones who aren’t shitty because I just said I want to accept them which is fucking annoying.

Enjoying The Uniqueness of My Patients

If you have pedal edema, you have pedal edema. So I used to think. But now each edema is unique and the last thing someone wants to hear from me is because they had too much salt. Yeah, thanks, genius!

I would feel motivated if I heard their story of how they were first diagnosed with CHF and why the edema is now driving them nuts. What are they afraid of it could mean? Why is a compression stocking so miserable to wear? Is the lasix ruining their sleep? How are they feeling? Maybe they just need to vent.

What Do I Want From Medicine?

Before, I wanted medicine to give me a sense of purpose, the highest income possible, for administrators to leave me alone, for me to become smarter week after week, and to be smarter than my colleagues.

Now I want to be the compassionate doctor that I would want when I’m sick some day. I want to help the people who need help and just be a listening ear for the other 90%.

Stopping the Countdown

I used to want to work until I saved up enough from medicine so I could walk away from it. Well, I reached that and then some and I’m still here.

I don’t want to figure out how I can walk away one day – not even with lottery wet dreams. I want to stop the countdown and figure out how I can sustain the practice of medicine, I never to want to walk away from it. Drag my dead body out of the patient room as I slump over a speculum!

2 replies on “Working When You Don’t Have to Work”

This was a fresh read
Thank you!
Though not 31 anymore, I’m schlepping myself back to the clinic after years in tech feels heavy with all the problems that clinicians are struggling with (especially lack of autonomy).

I hear you. It’s like living in SoCal, on paper it sucks but something draws you back in every time. And at some point when you’re done constantly trying to leave SoCal you just have to ask yourself how can you change your perspective and find the things about it you love and not pay much attention that you wrote down about it.

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