Why I Chose Family Medicine

There’s an old saying, “If you want to make God laugh, tell Him your plans.” Well, I had my whole career planned out by the time I was in high school, at least that’s what I thought. What did I know back then anyway? I now laugh at myself for thinking that way.

Long before I went to medical school I knew I’d someday become a doctor, and I had decided that I wanted to become a pediatrician. Due to my quite phenomenal birth, I figured it was just meant for me to be a kid doctor.

My mother calls me her “miracle baby.” I was born prematurely, nearly 2 months early, and weighed in at only 1 pound and 15 ounces. By the grace of God, I had no major health complications and was sent home from the hospital about eight weeks after birth.

As you can see, I’ve come a long way. Whew, God is good!

When I got older and saw these pictures of how tiny I was, I was like hey, “I’m going to take care of little people like that.” Yep, I had it all planned out. I went on throughout high school and college telling everyone I was going to be a pediatrician when I grow up. This all changed when I got to my 3rd year clinical rotations in medical school.

My first pediatrics rotation was when I discovered that maybe pediatrics was not my thing. Don’t get me wrong, I enjoyed the cute little smiles, the nasty little germ-infested hands, and trying to figure out which characteristic rash matched which virus. However, that enjoyment did not provide true fulfillment. I ended the month thinking to myself, “I like this, but there has to be something more.”

When it came time for me to do my OB/GYN rotation I thought I would hate it, but I ended up falling in love with everything from prenatal exams, well woman’s exams, surgical procedures including c-sections, vaginal births and more. I could really see myself doing this. But (there’s always a but), the lifestyle was very demanding and often unpredictable. I mean, if it’s 3:45 AM and a baby decides he’s ready to make a grand entrance into the world, then baby gets what baby wants.

Being a doctor is taxing, but some specialties prove more demanding than others and OB/GYN is one of those. I concluded that maybe I was stuck again. Stuck between enjoying another rotation, but feeling like there was something more.

Later on into my rotations I completed a month of geriatric medicine. I learned that many of the clinical presentations that applied to most people, did not apply to those of the older population. For example, take a 30 year old who comes in with fever and urinary frequency versus a 70 year old with altered mental status. While their presentations are different, both could have a urinary tract infection. That example was simplified, but the point is that I felt challenged by thinking outside of the norm when it comes to older patients. Did I still want to do pediatrics? Did I want to do OB/GYN? By now I was confused and undecided.

Moving right along to 4th year, I ended up doing one of my rural family medicine rotations with a family doc who did nursing home visits each week before seeing clinic patients. Many of the patients had comorbidities and again, I enjoyed the challenge. Another thing that I appreciated about the nursing home visits was seeing the interaction between my preceptor and the family members, nurses and auxiliary staff who all played a role in patients’ care. Not only was my preceptor a health provider, she became a liaison and ambassador, if you will, for her patients. All of this drew me in to geriatrics.

That month, I also had certain patients who tugged on my heart strings because they had no family and no visitors. It made me think of my own grandmothers, who are still living. Neither of them are in a nursing home, but if they were I would hate to think that they had nobody to come visit them. The short time that I was able to spend with those patients was amazing and most were welcoming of the company they received while I was there.

By now, I was strongly considering going into family medicine. That decision was solidified when I completed another rural family medicine rotation in a very underserved community. Most of these people looked like me; however some didn’t. I can clearly recall the day I walked into an exam room to see an older male patient with a confederate flag t-shirt on his redneck skin. The encounter was awkward initially, but in a few short minutes guards were taken down and we shared a nice conversation.

I saw many patients that month who didn’t have health insurance and many who didn’t even have access to healthcare due to lack of transportation. Growing up in a small town myself, I knew what it was like to have to travel to the next town over to go to doctor’s appointments. I could relate when patients would reveal information of family histories of hypertension, diabetes, and high cholesterol. I could relate to women who cooked their collard greens with neck bones and ham hocks. Having conversations with these patients was like talking to people from my home town. I felt like I knew them. When one patient told me that “they didn’t find no pollens” (referring to not finding polyps during her colonoscopy) I knew exactly what she meant, even if she said it incorrectly.

From that month on, I knew I wanted to practice family medicine in an underserved area. I would get to experience everything I loved about pediatrics, I could still provide women’s health, and I would definitely see my share of older patients. It was like getting the best of all three worlds.

I occasionally speak to my family physician from back home. He took care of me for years, still takes care of my parents, and knows my grandparents and other family members. Forming lasting relationships with patients of all ages, including their family members, while making them feel like I am the best doctor they ever had is what I hope to accomplish.

To my med school peeps, what specialty are you interested in? And to my doctor folks, what inspired you to choose your specialty? I’d love to hear your thoughts. Let me know in the comments below.

-thedoctorjb