So, I'm leaving the private practice world.
It feels good to say. No, it feels GREAT to say. I'm going back to academic medicine... massive pay cut, terrified medical students, new residents, the whole 9. I can't wait.
This year has been transformative for me. Working out in a private ER is so different from academic medicine they might as well be two ends of the same beast. I'll really miss this place. The nursing staff is fantastic. The money, equally so. My colleagues, uniformly, have been incredible to work with - supportive, intelligent, no-nonsense.
The problem is, I've never been able to internalize the feeling that I've "arrived." Private practice in many ways is the culmination of everything. K-12, college, medical school, residency... it has been school for 24 years if you count it all up. Then suddenly you graduate from residency and they tell you you've made it. You're ready to do things on your own. No supervision! You're an adult! You know everything!
But I know that's not true. I've always been inquisitive. I still listen to ER podcasts to and from work, two hours a day. I learn new things every single shift. I suppose that's why they call it practicing medicine. And I want to be on the forefront of medicine; learning, teaching, researching.
I've taken a lot of things away from this year. I have immense respect for anyone who practices community emergency medicine. It's honestly one of the hardest jobs I can imagine. No matter how fast you are, you can always be faster. No matter how thorough you are, you can always be more thorough. There are twin pressures at play in the ER - see patients quickly enough to not let someone die in the waiting room, but spend enough time with each patient so you don't miss something life threatening. It's exhausting, unbelievably stressful, and difficult.
I've also had more free time this year than I've ever had before. I work 12 shifts per month. Initially I was bored. Then I found a passion for cooking and the gym, dropped 35 pounds, and now I'm in better shape than I was in high school. I'll take this forward with me through my career - being healthy is important to me, and I was too busy in medical school and residency to learn how to do it right.
Perhaps most germaine to the rest of my carer, I've learned about my own personal practice style. I'm a big believer in patient-centric care. I ask people if they think something is broken before I x-ray it. If they say no, that they just want to know what to do for the sprain, I'll forgo the x-ray. A lot of physicians are over-testers, in large part thanks to malpractice liability. It's a shame, really. Many of the best physicians I've known are impeccable clinicians not because they overtest, but because they carefully listen to patients and take the time to properly examine them.
And so, friends, it is with great excitement that I announce... I'll be leaving the south for the midwest in July. Goodbye, pork BBQ. Hello, beef BBQ!
Dr. Zac, Academic ER MD