As I sat day after day in primary care office, I realized I was looking for some other path for myself. I could not believe that this will be the end of the line for medicine for someone specializing in Internal Medicine. I refused to be one of those doctors looking for another 20 to 30 years of seeing patients every 10 minutes like innocent victims on a conveyor belt. With the small amount of time, the quickest medication was the best answer.
What is it Ms. Smith, your blood pressure is high? Lets try a low dose of lisinopril. No time to sit there and go through her lifestyle, her exercise routine. No time to council on salt intake. Nope, just put that in the after visit summery for her to read on her own. That's not what primary care should be, but sadly, that's what I was practicing as time was limited.
Many times, I will get patients with cysts that can be drained. Well try draining in 10 minutes, nope to the urgent care or emergency department. How I was jealous of my older colleagues who prior to the days of making money were practicing real medicine. Heck, some even were able to deliver babies in office.
Then, as I sat in my little cubicle munching on left over dinner from yesterday while at the same time clearing what seemed like millions of patient questions, going over a gazillion lab results and then refilling a trillion medications, atleast that's what it felt like. I was thinking, I don't think this is right. How can I really be seeing so many patients. 1200 patients a year is a lot. Some I knew well as they came often, other times I remembered by my sticky notes. I can't imagine, how can primary care really think outside the box if they are stuck in the box.
I ran across a book called Startup DPC by Dr. Paul Thomas. I was amazed at his ability to open and practice medicine free from all pressures. That's someone who used critical thinking is what I thought to myself. That's what you should be doing. I have a deep passion to help my patients. Not put a band aid on their problems. Any doctor or nurse practitioner can prescribe medication according to the latest guidelines. There was even a joke by us doctors at work that a monkey can do this job. Well maybe not all of it.
Today as I ordered flooring for Crabtree Health, I have a sense of jubilee in my heart. Finally, I can freely help patients, spend time with them, treat them through logic and not fast prescription. I think this is the beginning of my journey as a critical thinking physician. Going deep into each and every patients roots and solving problems that are based on true science based analysis. Working and reasoning and not just prescribing according to the latest guidelines. I am grateful for all those who have signed up and plan to sign up.
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