Why I Didn’t Do Primary Care

My first residency was actually in a primary care program so this was obviously a field I was very interested in. But I aborted it. Why?

1) Partially it was a problem with my residency and probably a lot of residencies. Most internists who do primary care spend much of their residencies doing inpatient medicine, out of necessity. My “primary care residency” only different from general IM in that we got one month of primary care per year, which was a mix of clinic and urgent care. Enough to feel comfortable being a PCP? I felt it wasn’t.

2) I didn’t like the idea of having to know everything about everything, especially in a field where things are constantly changing and patients were getting more and more complicated. I felt like I’d have to be reading constantly just to stay current.

3) People would keep coming up with random complaints that I had no idea how to address, like, “My belly button feels cold.”

4) It felt like there was a push to see patients as quickly as possible, yet many of the patients were incredibly complicated. When an elderly patient hands you a bag of 30 bottles of medications and four of them are half-filled bottles of atenolol, just sorting through that alone takes like twenty minutes. I felt like I was being pushed to short-change my patients.

5) The reimbursement is not great and just getting worse. Which means being pushed to see more patients in the same period of time.

6) I didn’t want to take hospital call, but I felt like in the areas where I wanted to live, the hospitalist system wasn’t established enough to avoid that.

7) I worked with a PCP during my third year of med school. I will never forget this experience with her: She had an upcoming vacation and the whole two weeks I spent with her, she was arranging coverage and sorting things out for this big vacation. How long was the vacation? Four days. Including a weekend.

8) I kept hearing about high rates of primary care burnout and it scared me.

Ultimately, the “hating my residency” thing may have played the biggest part of all. I didn’t think I could make myself be miserable for another two years for a field that might also make me miserable. I’m pretty sure I made the right decision by switching.

Originally on Dr. Fizzy’s Blog.

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Dr. Fizzy

Freida McFadden is a midwestern physician who has finally finally finally come to the end of her grueling medical training, and at last she has enough time to publish the wealth of cartoons she's created over the years. If you enjoy them, please comment. If you don't enjoy them, then you can just keep your fool mouth shut. Read the rest at Doccartoon.blogspot.com, and make sure to check out her books, A Cartoon Guide To Becoming A Doctor, and The Devil You Know, on Amazon!

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