• Speaker: LPW Changed Me for Better

    May 21, 2024, David Mitchell — James MacDonald, M.D., M.P.H., FAAFP, has been teaching medicine for more than two decades. As he recently prepared for a physician well-being presentation, though, he sounded as though he might have been an English professor instead.

    “There’s nothing quite as powerful as a story,” said MacDonald, deputy editor of the Clinical Journal of Sport Medicine. “That’s how people remember. When I talk to potential authors about what’s going to make a paper resonate, it’s not the data. It’s Can you tell a story? Even in dense scientific literature, you want to have a story arc.”

    MacDonald and Lauren Brown-Berchtold, M.D., FAAFP, will present a free webinar at 6:30 p.m. Central on May 22, exploring the power of personal narratives and the importance of sharing stories related to burnout and resiliency.

    “There’s good evidence for telling your story on an ongoing basis to yourself, like journaling, and how powerful that is,” said MacDonald, clinical professor of pediatrics and family medicine at the Ohio State College of Medicine and director of research in the Division of Sports Medicine at Nationwide Children’s Hospital. “I’m going to talk about accountability and having an accountability buddy, or coaching, and the idea of meeting someone every month to talk about meeting goals. Lauren is going to address the system’s end of well-being. For example, if you’re going to try to get your hospital administrators to do something, are you able to tell a story about what is happening to doctors and what is needed?”

    Brown-Berchtold recently shared the story of how losing her mother during medical school put her on a path to be a leader in physician wellness. MacDonald’s entry into that space was less dramatic.

    “I love what I do,” MacDonald said. “I’m 60. I’m not burned out, but a lot of my colleagues are. I know several people my age who’ve already retired. They’re leaving some of the best years of their doctoring on the table because they’re burned out. They’re done. I’m not that guy. I got into physician wellness because I wanted to be a different person. I didn’t like my reaction under situations of stress. I didn’t like the colleague I was around other people. I have a picture on my laptop that says, ‘Be a fountain, not a drain.’ I think I was too often a drain.”

    That doesn’t mean MacDonald was quick to jump on the physician wellness bandwagon.

    “I remember about four years ago I would get emails from our hospital that said things like, ‘Hey, we’ve got a new free yoga app.’ And I thought, ‘I don’t need another yoga app. I need to see less patients. I need more support. I need a scribe.’ I was very dismissive of it. I was very much: ‘It’s them, not me.’”

    MacDonald changed his mind in 2022, when he participated in the AAFP’s Leading Physician Well-being program, a 10-month certificate course designed to help family doctors develop the leadership skills needed to spearhead change in their practices or health care organizations.

    “When I started the LPW program I quickly bought into the notion that you can’t change the system until you can change you and your reactions,” he said. “That’s the thing you have most immediate control over. Even if you start working on the system, you may see change potentially, glacially. But you can see change very quickly if you can start addressing your own reactions to the stuff that happens in life.”

    MacDonald said it has been a privilege to work with leaders such as Catherine Pipas, M.D., M.P.H., FAAFP, and Mark Greenawald, M.D., FAAFP, core faculty for the LPW program who also were speakers at the first Physician Health and Well-being Conference that MacDonald attended.

    “It was the first physician conference I ever went to where I cried, basically, every day,” he said. “I know sounding like a zealot can turn some people off, but it was almost like a conversion. I got it quickly, the connection that, ‘Hey, this thing I want to do for myself is actually what it’s all about in terms of changing things for everyone.’

    “I really love this world and what I’ve learned. It’s changed me. I’m more excited than ever about medicine. I’m ready to keep going for another 10 years.”

    MacDonald’s route to medicine wasn’t direct. He graduated from Harvard with a degree in biology, but he wasn’t sure what his next step should be. He joined the Peace Corps, teaching math and science in Swaziland (now Eswatini) for three years.

    In his hut in Africa, MacDonald discovered family medicine in John McPhee’s 1986 book Heirs of General Practice, which tells the story of family medicine residents in rural Maine.

    “It’s about a residency but also about the history of family medicine, why it started in the '60s as a reaction to specialization and going back to the roots of medicine,” he said. “The movement was very countercultural.  I was really inspired. This wasn’t the medicine I had been exposed to. I came back from the Peace Corps, and I wanted to go to medical school.”

    Despite his alma mater not having a family medicine department, MacDonald returned to Harvard for medical school.

    “I was dissuaded from family medicine from the get-go,” he said, “but no way.”

    MacDonald matched at Maine Dartmouth Family Medicine Residency, the same program he had read about in McPhee’s story

    He spent a decade at the University of California, Santa Cruz, as a physician in the student health center and a team doctor for the school’s athletic programs. During that time, he completed a sports medicine fellowship at Boston Children’s Hospital. MacDonald, who was a track and field athlete at Harvard, has been a pediatric sports medicine specialist since joining Nationwide Children’s Hospital in Columbus, Ohio, in 2010.

    MacDonald said the LPW program has helped him feel more connected to the AAFP and to family medicine. As a former LPW scholar, he’ll attend the Family Medicine Experience, Sept. 24-28 in Phoenix, for the first time in more than a decade.

    “I love what I do, but I’m interacting with orthopedists or pediatricians in my world of sports medicine,” he said. “It’s football season in the fall, and so I haven’t been to FMX in forever. This fall, I feel like I’m coming home. Thirty-five years ago I was in this little hut in Africa, reading about this specialty. The book is what got me into medicine because I wasn’t going to come into the profession otherwise. Heading to FMX, I feel like I’ll have come full circle.”