Welcome back to part 2 about the The Doctor Life. My son , John and I are talking about various aspects of the doctor’s life as part of a book I am writing for young doctors. Please join our discussion.
Blind Spots
Dr Inc: There is a lot required of you in process of becoming a doctor and, I think it creates blind spots. Honestly. I know for me by their vary nature blind spot is hard for you to become aware of.
Often you are unaware that your blind spots even exist. Many medical students, residents, and even attending physicians simply don’t know what they don’t know, because you are so hyper-focused during your training that you tend to underdevelop some of the other life skills that are necessary to holistically succeed in life.
Whether that be your financial under-development, your social relationships, and even your physical health. They are neglected during your training experience, and therefore become underdeveloped because of the sacrifice needed to become a doctor. John, have you found yourself sometimes feeling like you’re a little blind in some areas?
John: I think that’s definitely true that our training process leads to blind spots. For me, I’ve never been a huge social life person, so that’s not as big of a deal to miss out on social events. But my wife cares about having a social life. I could just have a couple of close friends and call it a day. So we do have to find the balance, and that is probably a benefit of being married at this stage is that it forces me to be more well-rounded. Face it, a spouse will definitely help expose your blind spots, but also can help cover them up. I know my wife is socially very strong and she is able to help me in various social environments. Basically, she has a way of making me look good.
But I think physical health is the thing that’s the most challenging. Just finding the time in the day to work out is tough. Throughout my whole life, I’ve pretty much worked out or did some sort of activity or played a sport just about every day. Now I know if I am not scheduling it into my day is not going to happen. I have to be intentional and proactive for it to happen because there are just not enough hours. I can see the difference in my functioning when I haven’t worked out for a couple of months. For example during my internal medicine clerkship and it was just 5:00 AM to 6:00 PM in the hospital and clinic and then on top of that was the studying, so you don’t, have time to work out. It was miserable. You are really forced to sacrifice something due to the time crunch. For example, am I not going to see my wife at all for the next two months? Or am I going to not work out? And so I guess I’m not working out. It’s a forced rank order.
Dr. Inc: I have to compliment you on the fact though that you were wise in your adaptive processes by marrying an accountant. If you thought that you were going to have some financial blind, spots, you compensated for that by choosing someone who was good with money.
John: Yes, that was a really good move on my part, my wife is really smart a great money manager.
Generational Differences about the Doctor’s Life
Dr Inc: So you are part of generations. Z right?
John: I’m right on the line so I can be considered a millennial or generation Z
Dr Inc: How do, you think your generation views the life of a doctor any differently than my baby boomer generation views it? You grew up watching me, and saw how my identity as a doctor has been fully integrated into every element of my life. Being a doctor was central to who I was. But I don’t think most millennials or generation Z are embrace the medicine the same way that I do. Do you think it’s different?
John: Yes, I think that there’s definitely a greater prioritization of balance. My generation cares more about having a life outside of medicine. For us medicine is a means to an end, rather than being the end.
Dr Inc: So I’ve heard people in the physician FIRE(Financial Independence Retire Early) movement mention the same thing. Can you talk about the idea of using medicine as a source of reaching financial independence so that you can retire from it? Isn’t that the kind of stuff you’re talking about or are there other things that you’re talking?
John: It’s hard to say. I think probably FIRE is part of it. But I think the fundamental piece of this is about identity. A lot of doctors deal with and identity crisis, and can’t imagine viewing themselves outside of medicine. Those people often don’t know who they are and don’t know what they want from life. People in this generation are trying to find themselves, and being a physician is just a part of that identity if we have chosen to be a doctor. It’s high income of a physician that gives us the ability diversify a balanced life outside of medicine.
It’s a Job, not a Calling
Dr Inc: It seems to me that among the medical students and residents that I interact with most of them see their medical more of a job and less of a calling. This is just the opposite of how my generation viewed our medical lives, it was our calling. Thus to consider retirement or leaving it was akin to turning our back on something deeply connected to our identity. But I believe your generation’s view is partly why we’re seeing a movement towards physician employment too.
The most recent stats show that most graduating residents about 90% or so she chose to be employed as opposed to going into private practice where one’s identity, purpose, and personal life are tightly connected to one location. But now it’s just a job that provides a nice paycheck in while you live in a desired location. This allows for a more balanced life outside of medicine, and affords greater mobility in regards to job changes.
John: I think it’s definitely believe more of my generation simply work in medical jobs as employees now rather than tying themselves down in a business model that forces them to stay in one place, or burdens them with management responsibilities. We don’t want to have to deal with all the overhead and the managing of staff. We would rather just sign a contract and get a pay-check every few weeks, and then be able to do we want want outside of work.
So when I am at work, I am a doctor, but when I am not at work, I am whoever I want to be in that space. In other words, my medical life does not have follow me outside of my job.
Dr Inc: . It seems like your cohort are less engaged in the community. That’s not to say that they don’t care about people or have a sense of responsibility about the quality of life in their community. .
John: Definitely not. Doctors are altruistic as a whole. Using my doctor position outside of the hospital to benefit my community is a good idea. But my doctor identity does not have to follow me everywhere. In fact I prefer that others don’t always know that I am a doctor. Sometimes I might be vague if they ask what I do, and say something like “I work at the hospital” or “I’m in healthcare”.
Urban anonymity
Dr Inc: You are right, among the medical students and residents that do rotate with me they all seem to prefer at term that use, called “urban anonymity.” This is the exact opposite of what I do in rural, non-urban setting where everyone seems to know me. Most of them can’t imagine working in small town where everywhere you go, people know you as the doctor. In fact, this scares them. For the few who have interest in rural medicine, they prefer an outpatient only practice that allows them to more easily commute from a larger urban area that offers more options for them, but also provides them greater personal anonymity when they are off work. It took me a long time to understand and embrace this idea. But after I began to understand their frame of reference and their need for balance outside of medicine, it made a lot more sense to me. It also seemed wise on several levels.
This is issue is one of the fundamental issues associated with trying to recruit doctors to rural areas in the US. The landscape what medical practice and the doctor’s life looks like in a small town has dramatically changed during my medical career. Beyond the business of medicine changing that landscape, the progressive sociological changes of each generation has also changed things as well.
It’s important to recognize that young doctors prefer the richness of the lifestyle and anonymity that comes in the urban life. They simply want medicine to be a job and they don’t want it to define their whole life anymore.
John: Figuring out what you want your life outside of medicine to look is something you get to develop as you go. To some extent I don’t think that happens until you’re in residency, when you can relax a bit more after having chosen your desired specialty.
I think as you go through the training, you turn yourself into what you want to be. So still consider it a calling to go into medicine, but I also see the merits having a balanced life whose identify is bigger than medicine. In this mode, my job is a little bit more of what I do and is not necessarily who I am.
I thought there’s a nice, in-between spot, a sweet in-between spot where it’s who you are but it doesn’t have to take over your entire life. And I think that’s where I to be, where it’s a part of my identity, but it’s not all that I am. I want more depth to my life than just medicine.
The Best Doctor’s Life
Dr Inc: As we wrap up today’s session, I want to reiterate that doctors get to live a great life. I love everything about my life as a doctor.
But I also realize that my ideal doctor’s life was shaped imperfectly and this placed me in great peril for burnout as an employed doctor. Due to my generational biases, I’ve had to reconsider and reflect on some of the things you and your generation have advanced about the importance of a more balanced life. The more balanced life actually leads to a better doctor’s life. I have actually sought to correct my built in blind spots as a result of your generation.
This is why so many current and future doctors will continue to move towards employment. It’s just a simpler model that allows a cleaner separation of your work world and your non-work world. This separation is the critical space where balance is found.
I would like to circle back around to something your wife said that she wishes sometimes that she had married a doctor rather than a medical student.
John: I know what she means by that. A lot of people look at the doctor’s life and all they see is the end results. The high income, prestige, and the ability to help people.
Dr Inc: That’s what your wife alluding to. She would prefer to avoid the harder stuff, and fast forward to the good stuff at the end. I am not at the end of my career, but I definitely love my life.
John: Actually have my wife’s grandparents stopped asking me when I was going to get a job and start making some money. When am I going to pull my weight? It’s true, I do look forward to that. I can’t wait to finally have some autonomy and ownership over what I do. In training, I never feel like I have any ownership over the patients or control over much of my whole life.
Autonomy is the Secret Sauce
Dr Inc: Professional Autonomy and control are the secret sauce to your best life in medicine. Especially when mixed with a balanced self identity and financial independence.
And for our audience out there I think that this conversation about the doctor’s life has forced you to think about your version of the doctor’s life. What are your ideas and thoughts? I welcome your comments and questions on our website at a doctorincorporated.com where you can find the truth about employed physicians.
You can ask questions you can use our speak pipe at the website. I also invite you to join our FB group called the “The Employed Physician’s World“
