Female Physicians on Creating Alternative Career Paths

Stephanie Cajigal; Jessica Freedman, MD; Farzanna S. Haffizulla, MD; Pamela L. Wible, MD

Disclosures

April 03, 2015

Medscape: What is your best piece of advice from your book, Harmony of the Spheres: Career, Family and Community?

Dr Haffizulla: Your attitude, your mindset, and your approach are going to make the very biggest difference. If you have that mindset and then do a work/life balance plan—I actually give a roadmap in this book, a different element to think of and different questions that you need to have answered—you put that all together to decide your approach. There is validity in that approach, and again, there is no one-size-fits-all career track. Everything is in flux. We know that if you lead with your heart, then you will achieve happiness.

Medscape: As president of the American Medical Women's Association, what is the biggest challenge that you see for the future generation of female physicians?

Dr Haffizulla: Women physicians in general are going to be navigating all of the changes in the healthcare climate. I'm seeing women who once felt compelled to either stay in a traditional practice setting, or one that was created already for them, now shift to owning their own businesses. So again, the issue of work/life balance is central to all of these changes that are happening. It leaves them empowered in the process.

If you remain informed; are innovative in your practice design or in your approach to the practice of medicine; and maintain communication well among colleagues, friends, and other leaders, then you will be very successful in this process. It's not a challenge, but more of a transformation that is happening that we just need to be aware of and go with.

Medscape: Since 2005, you've operated a family medicine practice with a unique model. Could you describe it?

Dr Wible: I decided that I was not going to continue basically working as a factory worker on an assembly line, because that was never my vision when I applied to medical school. Because both my parents were physicians. I was able to see medicine in more of its heyday, before the production-line mentality. I knew from going to work with them as a child that there was another way of being a doctor that involved being in real relationships with your patients and really helping them. What I was being asked to do in my employed positions after residency (I graduated in 1996) was in no way, shape, or form in the realm of healing for myself or my patients.

I thought maybe I would go back to waitressing for a while, just because I could not stand this idea of treating people so poorly in these 7-minute office visits. But then I had this epiphany: I would put the patients in charge of designing their own ideal medical clinic. I held a series of town hall meetings where I invited my community to design their ideal medical clinic. I invited them to write my job description and everything. I wanted to be exactly the type of doctor that they had always dreamed of.

Medscape: How did people respond?

Dr Wible: People were thrilled that a doctor was actually talking to them outside of a 7-minute office visit. Attendance at these meetings ranged anywhere from 30 people in a community center to four people in a living room. I did them over a 6-week period, so I collected over 100 pages of written testimony (in addition to oral testimony) that patients submitted about their ideal medical clinic.

I told them that I was going to open a clinic based on their testimony in the next month and I did. I opened it on April 1, 2005. The surprising thing was they just wanted a human scale experience with a doctor. They wanted eye contact. They wanted 30 to 60 minute visits. They wanted their questions answered. What they wanted was so simple to provide. The thing that was getting in the way was all these middlemen that had inserted themselves in between me and my patients.

Medscape: What were you were doing before this?

Dr Wible: I was in the typical scenario where most primary care doctors are right now. My first job was a 100-doctor multispecialty group, in which I was treated very poorly. Then I worked at a community health center with migrant farm workers for a while. Then I worked at a physician-owned clinic. I worked at a hospital-owned clinic. I worked part-time and full-time.

I pretty much tried every variation on the theme, but these were all assembly-line medical clinics—all about high overhead and pushing the numbers, which is frankly quite rude. It's just rude way to treat patients this way. And physicians never wanted to be factory workers. This isn't a Toyota assembly line. This is peoples' health and life-and-death decisions about what to do for medical conditions.

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