Taking a Break From the Medical 'Service Industry'

John L. Marshall, MD


June 07, 2019

Editorial Collaboration

Medscape &

Hi, everybody. I'm John Marshall for Medscape. You may have heard that I am going to do something that many doctors don't ever do or get the chance to do: I'm going to take a sabbatical. I'm going to take 1 year off from seeing patients. I've been very excited about doing this.

The main reason that I'm taking a sabbatical now is because I'm very excited to be engaged in a global outreach project focused on working together with our partners around the world to increase access to cancer care, to lower costs, to increase precision medicine around the world, and to really try to drive cures faster for all of us. This is good work that's going to require some focus for a year.

Taking a sabbatical also has had many unintentional consequences. I never really thought how hard it would be to take a break from patient care. As we've been preparing over the past 6 months and notifying patients of this change, one of the biggest things that's come forward is a sense of abandonment from my patients.

They are happy for me, excited for what we're doing, and they see it maybe as a benefit to them. However, they recognize that I'm going away and many of them, of course, can do the math and figure out that they may not be here when I get back—that is the nature of our business in GI cancer. Of course, that is going to be very difficult.

I will confess that part of why I'm doing this now at my age is because I want to keep working as a doctor and doing patient care, but I'm a little burned out. It's not so much the EMR, although I'm tired of all of that, too. It's honestly the fact that all of these young people are developing bad GI cancers and I'm tired of watching young people die. Although we help them through that as best as we can, I'm tired of that.

There's another side to it that I've only recently realized is irritating me, which is that, increasingly, physicians are being treated as servants. Now we are just part of the service industry, whether it's a need for prescription refills or preauthorizations from insurance.

In the old days, we used to be valued for the work we put in to become physicians, including the work, study, and sacrifice for the extra decade so that we would be smart enough to do this, which most of our colleagues in other lines of work didn't do.

In the old days, we were valued for that. People would acknowledge that hard work and it came with a sense of respect. Now it has shifted in our service-industry world, where we are just one more stop on the tour from the drive-through at the burger place to the person on the phone helping you with your credit card problem. We are just more of those people, and honestly, I've become worn out from all of that.

I think the break is going to be very good for me in that way. I'm nervous about coming back, but I'm eager to come back and see patients. It will be, in effect, a fresh start in some ways from the patient care side of things. I'm hopeful that I will feel refreshed after my sabbatical.

I feel obligated to do this. I realize that it's a pain for everybody to help me through this transition while I spend time collaborating around the world. I'm looking forward to the break from patient care, but I'm scared about how I'm going to be without patient care. This is a time of unsettledness for me.

You should keep a nose out. We'll keep blogging, and maybe it'll be from around the world, but we'll keep communicating in the world of oncology today.

I'm John Marshall for Medscape, and I'm heading out on sabbatical in 3 months.


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