The French Paradox; or how to NOT dread practicing medicine
Tuesday, July 15, 2008 at 10:15AM 
In the last few days, I have heard several physicians confess to feeling "dread". As in:
"I dread going to work when it is my shift".
"I dread the weekends when I am on call".
"I dread that phone going off as I know it means I am going to have to go in to the ER".
I even had one physician tell me that every day she dreaded going to work!
Having endured that sickening feeling when I was in practice before I plucked up the courage to make a career move, I feel my heart going out to them.
Dread is a most uncomfortable emotion to own up to. As physicians, we are supposed to love what it is we have invested so many years in, and as potential patients ourselves, wouldn't we be horrified if our own physicians confessed to dreading taking care of us?
It's also got me wondering what is at the root of the feeling? Is it:
- fear -- of failing, of being sued, of not doing a good enough job, of not being smart enough?
- disappointment -- in a professional that no longer offers independence, control over your hours, a secure financial future?
- anxiety -- about not being able to handle all the responsibility, balancing the needs of patients and a practice against those of a family and kids, missing an important diagnosis and then paying the consequence?
On our recent vacation in France, we spent a lively mid-week evening with distant relatives, one of whom is a general practitioner in a small village outside of the larger town of Annecy. He arrived home at his usual hour of around 5 PM.
I wanted some insight into life as a solo GP in France (after all, I did see "Sicko!"), and had the opportunity to grill him.
I was astounded to discover that he carried no beeper or cell phone once he left the office. He had no call coverage -- and no-one required that he have it. Instead, he walked out after a day's length of his choosing, knowing that if any of his patients got ill overnight or on the weekend, they sought care from a network of "urgent care" doctors who did house calls, ran clinics or sent them to the nearest emergency room. He was not expected to provide care beyond the hours that he selected for running his practice.
I didn't have the temerity to ask how he was paid (insurance? patients? government salary?), but judging by the situation and appearance of his house and trappings, his family certainly appeared comfortable. He was truly a contented physician who loved his practice, drank his wine in peace at night, and actively raised his two sons with his wife. He had nothing to dread!
In the US, as physicians, we may have a terrific standard of living, but I am beginning to believe that we have a rather poor quality of life!
I realize this is a touchy personal subject, but any thoughts???
Reader Comments (2)
Great post and definitely food for thought. I am not an MD, but a psychologist and have carried the pager, dreaded certain clients or going to work for the reasons you state (liability, work-family balance). Doing "business as usual" just became unbearable for me! So, thanks to you and other inspiring coaches, friends and family, I am building the practice of my dreams, working for myself and positioning myself so I do not have to carry the pager, or be tied to my cell phone nights and weekends!Starting 1/1/09 I will not be taking managed care either. I can do all this, serve more clients in a more cost effective manner and it is thrilling! Thanks, Philippa, for getting me started on this journey!
Susan