Sep 2004 Table of Contents

BALANCING ACT

Making a Living and a Life



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Fam Pract Manag. 2004 Sep;11(8):70.

“A person should design the way he makes a living around how he wishes to make a life.” – CHARLIE BYRD, CLASSICAL JAZZ GUITARIST.

Family medicine is among the most gratifying of all medical specialties. The variety and clinical challenges it offers are endless, which promises a lifetime of stimulation and learning.

Family medicine also offers flexibility that is hardly matched by any other specialty. This gives the family physician endless career and lifestyle options. Take, for example, location. Family physicians can practice almost anywhere they like, from rural towns to inner-city neighborhoods.

With all the options available, how should family physicians achieve their desired lifestyle? In my experience, it’s as simple as making a list of what you want and then finding the place that fits. The options and flexibility enjoyed by family doctors make almost any list achievable.

Our list

Over 30 years ago, my wife and I developed the following list of things we valued and wanted our work and life to include:

  1. East Coast tidal waters. We like to sail. I like to fish (salt water) and hunt waterfowl.

  2. Family. Both of our families lived in New Jersey, and we wanted to be near them.

  3. Rural life – but not too rural. We enjoyed the rural atmosphere yet wanted to be within striking distance of a city for cultural, social and professional reasons.

  4. Community. We longed for a place with a sense of tradition and pride in its past.

  5. Family medicine friendliness. I wanted to practice in a setting where patient care was family-medicine oriented.

  6. Coverage. I was interested in finding a community in which the local family doctors helped one another with on-call schedules and vacation time.

  7. Obstetrics. I thought delivering babies was the bedrock of family medicine, so it was important that my practice include it.

  8. A community hospital. It didn’t need to be large or high-tech, but it did need to have quality staff.

  9. Land. We hoped to save enough money to make a down payment on a working farm, preferably located on tidal water. We wanted to farm it with our children.

  10. Horses. My wife and I had participated in horseback riding and wanted to continue. I wanted to become involved in the field sport of riding to hounds.

  11. Academic appointment. I love to teach and hoped to teach at a medical school eventually.

  12. Income. We didn’t desire great wealth but wanted an income adequate for a rural lifestyle.

Outcome (30 years later)

It has taken some time, but our list is nearly completed. We live in Maryland about an hour south of Washington, D.C., on a waterfront, 150-acre farm on which we raise corn, wheat and soybeans. We breed and raise horses, and ride them.

My medical office sits on seven acres of land, about five miles from our farm. I have a paddock at the office and occasionally ride my horse to work. There is a riding/hunt club in the area, and for four years I was master of the hunt and had the great joy of hunting the club’s pack of fox-hounds.

For years, I was on the part-time faculty of the University of Maryland School of Medicine and also taught family medicine residents at my office. The residents stayed at our farm in a small cottage with their families.

I still have adequate coverage (one night in four and one weekend in four), but I haven’t done obstetrics for many years.

We have a fine community hospital, which has kept pace with medical science as well as the growth of the community. This rural county is steeped in tradition. It is the place of the original settlement of Maryland, and many families proudly trace their origins to the settlers.

We have raised four children, all of whom learned the meaning and value of a day’s work along with how to be good stewards of the land.

Finally, our church remains an important part of our life. Built in 1736, it sits just across a field from my office.

If you are a family doctor just starting out in practice or thinking of changing your lifestyle, start by making your list. Family medicine provides a great opportunity to fulfill it.

Dr. Guazzo has practiced family medicine for more than 30 years in Chaptico, Md.

Conflicts of interest: none reported.

Send comments to fpmedit@aafp.org.

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