I used to be a doctor.
Maybe that’s a bit of a maudlin thought because I’m sitting at my desk in the completely deserted Moss Clinic - which of course just closed its doors.
Since some 55 year's after that momentous day of becoming a doctor, of graduating from Guy’s Hospital in London, I am now out of what is likely the last job I will ever have as a doctor - though somehow my name has got on some list out there and I am getting solicitations to go be a medical assistant somewhere in BFN, like Slab city California or Monowi Nebraska (which AI tells me are the most out-of-the-way locations in the US).
No longer eligible to puff out my chest and proclaim “oh yes, I’m the Medical Director.” But I guess the debate is, just because I’m not working as a doctor, does that make me not a doctor?
Can’t Hang it Up
OK, maybe I am still a doctor, but it’s a well-known fact that doctors are not good at retiring. Many seem to finish up doing some kind of part time or volunteer work.
A survey cited in Medical Economics talks about the many reasons for it being so hard to hang it up.
Many have been so tied up with their practice that they have failed to develop any interests outside of medicine – all they know to do is to work. Some fear losing social interaction – and of course seeing patients is a never-ending social interaction - though a bit specialized.
Interactions with your doctor tend to be he or she asking a bunch of questions rather than making small talk – which I find much easier (I got fired from a job as a barman once as I couldn’t engage in small talk with the customers).
A prominent reason is loss of purpose. Loss of what Japanese call “ikigai” – a “reason for being.”
Working at Moss seemed a worthwhile thing to do. A source of ikigai.
Loss of earning is another prominent reason cited in the Medical Economics article for continuing to work. They also quote a cardiologist who was worried how he would do “without the work and the status that accompanied it.”
Working at Moss was challenging – I mean what do you do with a patient who insists they have “an artificial chest” and bilateral amputations when their exam is completely normal, including two healthy legs? Or the adult Serbian brothers who don’t speak English who social services wanted us to assess as possible victims of sex-trafficking?
However, fretting over such cases, and having some poor scribe who I could pepper with questions and pontificate to – which was legitimate as they are mostly all pre-med students - has helped keep my brain active. Which will now likely turn to mush.
Going Against the Trend
The irony is that we are in the midst of a crisis in medicine – in primary care especially – due to doctors wanting to get out of practice.
They are being overwhelmed by demands for more documentation by insurance companies, more restrictions imposed by regulators, loss of autonomy by practices being owned by hospitals and corporations and run like widget factories. And particularly galling is the accursed computerized medical records – touted as a boon but in reality a bane.
All with ever less reimbursement.
So, my distress at being deprived of practice is a paradox but I don’t think I could deal with going back into that kind of regular practice milieu again.
But will I still be a doctor?
When I told my sister I was writing about this, she was quite emphatic that I still am a doctor.
