High-Tech and High-Touch: Consider a Career in Family Medicine

Maureen Murphy, MD, FAAFP

Disclosures

March 15, 2018

Editorial Collaboration

Medscape &

Editor's Note: Maureen Murphy, MD, is a family physician with Cabarrus Family Medicine in Concord, North Carolina. In 2016, she was recognized as the AAFP Family Physician of the Year.

AAFP 2016 Family Physician of the Year Maureen Murphy, MD

I was asked to share some thoughts for Medscape Medical Students about why medical trainees should consider specializing in family medicine. The best way I know to start is by sharing what I learned many years ago.

In medical school, I liked nearly every rotation. I loved the challenges of differential diagnoses, bringing babies into the world, caring for them afterwards, using my hands (as well as my brain) during procedures, and seeing patients in the hospital and clinic. I wanted to do all of these things, but what I loved most were the personal interactions with patients. I loved knowing about their lives and how that affected their health. Every note I wrote in their chart was a chapter in the book of their lives.

I knew that I couldn't confine myself to one organ system, one gender, or one age group. My interests were just too far ranging.

So, you see, I knew that I wouldn't be happy spending most of my days in a lab. I knew that I didn't want to interact with patients who were asleep 90% of the time. I knew that I couldn't confine myself to one organ system, one gender, or one age group. My interests were just too far ranging. I guess you could say I was predestined for family medicine.

I still love knowing that behind each examination room door is a new life story, a new problem, a different presentation. Behind each door could be a simple case of otitis media, a troubled teen, or even a patient in florid congestive heart failure who needs to be admitted to the emergency department (ED). I also love working in the hospital and seeing patients from our practice. I love making sure that they receive the appropriate care from the healthcare team, including the subspecialists with whom I consult. I love being able to make sure that the person I am caring for does not get lost in the layers of the hospital.

I spend time with patients and families. I celebrate births. I see them growing and changing. I guide them to the best health practices. I even hold their hands at the end. This sounds like a TV show, doesn’t it?

But what about the negatives, you ask? Yes, well, it can't be all Norman Rockwell paintings.

If your self-esteem depends on the size of your house, the zeroes on a paycheck, or becoming 'the next Dr Oz,' then family medicine is not for you.

You will find many who denigrate a student who declares that they want to specialize in family medicine. The strongest negative influence may be encountered in medical schools and academic centers, where students are still told, "You are too smart for that; you need to be an 'XYZ' kind of doctor." You may be told that you will never make the kind of money subspecialists make. Perhaps you won't have the biggest house compared with others in the country club. Your great aunt may even dismiss you by asking, "Oh, you want to be just a general practitioner?"

I know all of this sounds familiar. Honestly, if your self-esteem depends on the size of your house, the zeroes on a paycheck, or becoming "the next Dr Oz," then family medicine is not for you.

But let me counter the above arguments: For many reasons, family physicians are actually in great demand. Just ask any recruiter or hospital representative; or better yet, ask the patients. Ask people out in the community who are desperate to see someone like you. You can choose the area of the country where you want to live and the type of practice you want. Wherever you live, and whatever type you choose, we need and want family physicians everywhere.

Although you may not make the mega bucks that someone like perhaps a cardiothoracic surgeon does, you will be very comfortable . As an added benefit, you may actually have more time to enjoy your family, your house, and your life!

Consider attending a family medicine meeting, such as the Family Medicine Experience (FMX) or the National Conference of Family Medicine Residents and Medical Students. Both meetings are hosted by the American Academy of Family Physicians (AAFP). Also be sure to check out your state Academy of Family Physicians chapter meetings. You will meet a vital group of friends and colleagues who value their lives and relationships, both inside and outside of medicine. Remember, you will not be a "general practitioner." You will be a family physician who is residency-trained and board certified.

In his essay titled, "Choosing a Medical Specialty: Location, Compensation, Talent, and Temperament," one of the previous writers for this series, Dr Andrew Wilner, said that "... stepping through one door means shutting all the others...." I counter that by reminding you that choosing family medicine means keeping all doors open. You do not limit your choices by choosing family medicine.

I tell medical students that family physicians are "the stem cells of medicine." We have the ability to become so many things. We have the ability to recreate and regenerate. In my 30-plus years of practice, I have worked in major medical centers and 25-bed critical access hospitals. I have worked in urban, suburban, and rural areas. I have practiced the full spectrum of family medicine—from womb to tomb—performing more than 1000 deliveries. I have had the honor of educating medical students and residents while also serving in various administrative and leadership roles.

I still practice both inpatient and outpatient medicine. My family medicine colleagues specialize in areas like sports medicine, geriatrics, maternity care, dermatologic procedures, and wound care in their practices. What physicians do in their 20s and 30s often changes when they are in their 50s and 60s. As family physicians, we have the pluripotential to become something new at any point along our journey.

I have never believed I was "just" a general practitioner. Not when I delivered a baby outside the door of the ED while the ED doc stood there helpless. Not when I cared for the hypotensive, hypoglycemic, septic older gentleman on a plane while the "other" doctor on the flight simply wrote down the meds I was pulling out of the airplane's emergency kit. And certainly not when I cared for my neighbor, who showed up on my doorstep in the middle of an anaphylactic reaction.

While high-tech medicine is fast-paced and exciting, I still have the grounding factor of a field that is high-touch.

That "Norman Rockwell doctor" simply didn't have all of the advances we have now, or those paintings would have been much different. At times, medicine seems to be racing ahead with new drugs, new procedures, new technologies, new challenges, and new solutions. The electronic medical record is always revealing some surprise. It is exciting to be part of that, to learn new things and incorporate those changes into my practice. That's high-tech.

And yet, I still have something from the personal doctor of the past: long-term relationships with patients and families. I am an essential part of my community. I am a servant leader. While high-tech medicine is fast-paced and exciting, I still have the grounding factor of a field that is high-touch as I travel down the winding paths of life with my patients.

I guess what I'm saying is that family medicine is the best of both worlds. Students, I hope you join me in the endless adventures of being a family doctor. I promise, you will mean so much to so many.

Students, please use the comments section to add your thoughts; and fellow family practitioners—we invite you to share your own stories about why you chose family medicine here as well.

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