Not Missing It
Not Missing It
It took years to decide that I was going to opt for a[ half retirement](http://After five months of leaving clinical medicine behind, I have come to one conclusion. I). While my current role is fulfilling, it is completely free of direct patient care. I don’t physically examine patients anymore, nor do I make diagnoses. I am completely in an advisory role for nurses, chaplains, and social workers. Because of this, I have no real need for malpractice insurance. The only reason I haven’t cancelled mine already is the knowledge that after going insurance less for two years, it is almost impossible to qualify again. Thus, a two year gap means the end of practice as a physician. Although most would feel it important to keep one’s options open, I am not so sure. After five months of leaving clinical medicine behind, I have come to one conclusion. I’m not missing it at all.
Not one bit.
Stress
I’m not missing it. Not missing the stress of being in charge of other’s lives. I no longer wake up in the middle of the night in a cold sweat worrying if I did something wrong. Worrying that I missed something.
I used to walk around in haze, ambushed by negative feelings on a regular basis. I often didn’t recognize why I was feeling so badly. Only later would I realize that I was having negative feelings about some patient encounter or another. Fearful that I had missed a diagnosis, or kicking myself in the butt for choosing the wrong treatment course.
The negative feelings far outstripped the positive. The weight on my shoulders was relentless and heavy. I rarely slept soundly, nor was able to completely relax. There was always something pulling me back.
Fear
I’m not missing it. Not missing the fear that was part of every waking moment. The fear that one of my decisions would cause a patient harm. The pain of dealing with the consequences of my decisions regardless of how hard I was trying to do my best.
The fear pervaded every aspect of the job. Not only that I would would make a mistake, but that even if I did everything right I would be blamed anyway. The worry of being accused of malpractice was a constant companion. It never went away, and colored every patient encounter. Taking the difficult and complex and making it terrifying.
And if that wasn’t enough, Medicare was constantly breathing down my neck. Compliance was fraught with difficulty. Doctors are threatened with punishment, and fear pervades the relationship. Audits are used as weapons to bully providers into underbilling and make us cower.
Anger
I’m not missing it. not missing the anger. I feel like I was the target of so much anger as a practicing physician. Patients and families were angry because death is inevitable. Suffering happens. And we can’t cure even the simple cold.
Hospitals, nurses, and administrators are angry because they are put in the most difficult of situations. Instead of helping people, they are being pulled in a thousand directions by the government, insurers, and business people. Caught between doing what’s right and what’s expedient, the anger spewed out in all directions.
As a doctor, I was often right in the line of fire. I was the one to get yelled at and threatened.
Taking care of people should be hard because life is fraught with the ambiguities of illness, disease, and bad luck. Not because someone isn’t getting the money they think they deserve.
Final Thoughts
I’m not missing it. Not missing clinical medicine. For the first time in the last few decades, I am feeling no stress about work. There is no fear. And no one is mad or threatening me.
I had forgotten what it feels like to be normal.
I doubt I will return to seeiing patients ever again.