Portraits of People Who Practice Medicine in a New or Different Way 

An Excerpt From the Curriculum of Module 4


Small, Significant Changes Across a Broad Front

For the past several years, I have been working four days a week as a “clinician educator” in a family medicine residency program. Five half-days per week in residency clinic and two half-days I volunteer in a south Phoenix clinic. One prompt for change was (is) my frustration with the academic system and culture. I enjoy teaching and mentoring, but like medicine itself, there is more pressure for medical education to conform to corporate financial decisions, more paperwork and less face time with patients and colleagues. I relieve one pressure valve by seeing patients at the underserved ‘cash only’ clinic and taking residents one at a time with me. This feels like a field trip for them and me and feeds one of the values that guided me in medical school: service. The cost though, was driving back and forth twice weekly. The other prompt for change, was my marriage. Something was wrong, and trying to find solutions to ill-defined problems was like sliding my hand up and down along the wall in the dark groping for the light switch.

My plan for work involved several changes. First, I simply told both offices that I needed to consolidate my schedule. This was met with understanding and within a few months, was easily done. I simply spend entire days at each of the two locations, to eliminate daytime travel. A huge difference in feel for such a small schedule change. The second change involved a decision to do what I do best (care for patients and coach residents one-on-one) and let go of aspirations for advancement. I want to coach my sons’ baseball teams and train for triathlons, so I needed to let go of something to maintain balance. I dropped one committee and will relinquish my board membership from another organization next year. If I end up in a leadership position in the future, great, but I have decided to not pursue this as a goal at this point in my career. It feels as though I am giving up something, but funny how nothing changes in my routine and no one can tell the difference except that I argue less at office meetings! I just feel more calm at work. (I also decided to spend $40 per month on triathlon coaching instead of the cleaners and am now washing and ironing my work clothes). I am spending money on something that is really fun for me.

In my home life, I blurted out my unhappiness and fortunately my wife steered the discussion from divorce to honest examination of our needs. We went to counseling and have emerged much more satisfied. I am convinced that setting a fire was the only way to initiate real change in this regard. We had been managing our forest for years at the expense of new growth. During the retreat, I realized that the only time we are truly able to leave behind our day to day stresses is when we take the family camping. We have been going camping with the boys one weekend per month for six months now and it is relaxing for all of us. And we are not missing anything. The other stressor that emerged during the retreat is money. We met with a financial planner and are working on a five year plan for financial independence so that we can take a family sabbatical for one year in a foreign country.

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