• Don't Forget Why You Chose Medicine in the First Place

    Why do you go to work each day?  

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    Why do you work in a hospital? Or why do you work in an office?

    Why do you see patients?

    Why do you teach medical students? Why do you teach residents?

    Why do you do research?


    Has your answer changed over the years? Maybe it used to be that you wanted to help others. Is that still your motivation today? Or have other reasons gotten in the way?

    Maybe we should each reconsider our "why."

    You might have started out as a family physician with the idea that you could help others and make a good enough living to take care of your family. That, at least, is where I began.

    The motivation might change for some physicians as the years go by, but for the most part, I think my "why" remains the same.

    I have good days and bad. We all do. I find my good days often are when I focus my attention on others, and bad days are when I focus on myself.

    I can tell a lot about my day based on what I say to others and what I think to myself.

    On good days, I ask, "How can I help you?"

    On bad days, I usually think, "What are they trying to do to me?" I find that I can correct my course on those days if I go back to my "why."

    Think about your "why." You might find it in the personal statement you wrote for med school. It should have carried over to the reason you wanted to match into a family medicine residency.

    We need to keep our "why" in front of us each day, as well as that of our practice if it's stated in a mission or vision statement.

    I was reminded recently that we all have a "why" when I read Sen. John McCain's final open letter to the American people, which was released after his death. In it he said, "Our identities and sense of worth were not circumscribed, but are enlarged by serving good causes bigger than ourselves."

    He certainly did that.

    And we do, too, because serving the health care needs of our communities every day is certainly a cause bigger than ourselves. Helping those in need is not just honorable, it is a wonderful "why."

    As Albert Schweitzer, M.D., PhD., said, "The purpose of human life is to serve, and to show compassion and the will to help others."

    At my medical school, we are halfway through an eight-year study of empathy in medical students. We are looking at attitudes at entry to med school, again after basic science instruction in the first two years and then again after the clinical years. So far, we have found that students entering medical school are mostly empathetic, but there is a slide toward less empathy after basic sciences. We will gather more information this year -- for the first time, after the clinical years.

    We're not yet sure why students are less empathetic toward patients after two years of medical school. Do they become more callous because they know more about basic science? Or does their "why" change?

    Has your level of empathy changed? Are you working day after day only for the paycheck? Do you long for something else? Do you feel trapped with no options before you? If so, you could be suffering from burnout, but there are ways to recover.

    Been there, done that.

    I was able to change directions when I reflected on my "why." Teaching at my old residency allowed me to not only take care of patients, but also to help train others to do the same. When that role became a grind, I went back to my "why" and opened a medical school campus in my hometown to train students to take care of more patients than I ever could alone.

    I still see patients at the free clinic, where I serve as board president. I teach medical students to take care of people, not diseases, and I help others in the field of family medicine through my work with the AAFP. Those efforts comprise my "why" today.

    Why do you do what you do? I am not saying it is easy to serve a cause bigger than yourself. I am not saying it is a path clear of challenges. But don't let those who come into your life to challenge you pull you away from your "why" -- your purpose, your core value.

    "Values are not just words; values are what we live by," former senator and secretary of state John Kerry once said. "They're about the causes that we champion and the people that we fight for.”

    We all need to revisit our "why" from time to time, because each of us knows what we do and how we do it, but we also should remember and understand why we do it.

    Leonard Reeves, M.D., is a member of the AAFP Board of Directors.


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