Medical Economics, August 2024
For many family doctors, the work they love to do most includes taking care of the sickest patients, the ones that make them feel like a “true doctor”; forming long-term therapeutic relationships with them; and practicing holistic medicine, i.e. having consistent opportunities to treat the entirety of the patient, keeping them healthy instead of seeing them only when they are sick. In other words, what they love to do most involves making an impact, forging human connections, and exhibiting their brainpower. When they cannot do this traditional work they love, many have a difficult time reimagining how they can achieve career fulfillment in new ways. This is facilitated by a training system for family doctors that can mislead them in terms of what is possible for their careers, and what makes a “true” family doctor.
The everyday health care context is hostile to supporting the traditional work that many family doctors love to do most. It is a health care context that involves lower reimbursements for what they see as their most important services such as chronic disease management, preventive medicine and longitudinal care delivery. A context characterized by rising patient demand for cheaper, convenient, and timelier primary care services, producing heavier workloads and sped up interactions for family doctors. A context where some patients come and go because their insurance changes, or because they seek the fastest route to getting needed primary care, which means visiting different providers in a fragmented manner. Part perception, and part reality, this context can shape family doctors’ perceptions about making an impact, forging human connections, and exhibiting their brainpower. It robs them of time. It reduces their feelings of control. It also forces them, if they wish to continue to try and do the traditional things they love most, into impossible situations where they work longer and harder trying to accomplish goals that are less realistic.
