By Norm Clothier, MD
I have carefully observed that we as family physicians are a rather hard-working group. The demands on our expertise and time are extraordinary. It is a true calling of service to our fellow man. Many days bring joy! Alas, many days do not. Some days we wonder why we do what we do, and how much longer we can carry on.
I would guess that you have felt one of these emotions in the past six months:
1. Overwhelmed by the number of patients, phone calls, emails, and patient portal comments.
2. Harassed by an insurance system requiring a prior authorization on a generic medicine or the annual change to a “formulary” product, rather than stability, for your patient.
3. Frustrated by your EMR (I know this is a stretch).
4. Pressed for time and desirous of more efficiency.
I was blessed with the opportunity to take about 30 high school students on a mission trip to Nicaragua last summer. We went to the town of Jinotega, where we worked from a mission compound that spreads its reach and influence over the entire region. Among the many services to the people was a dental and medical clinic.
I worked primarily in the medical clinic while in Jinotega. We had a room partitioned into three small treatment areas, separated by sheets hung from the ceiling. I’m accustomed to washing my hands frequently, what seems like 400 times per day, and I apparently do it well, according to my patients in helping with my board certification activities. In this clinic, there was no sink.
I worked with two very good translators, thankfully. We saw many people daily, mostly with acute illness, but two things seemed to always be tacked on at each visit. The first was the length of time since the last parasite treatment, due to the lack of a clean water supply. The second was essentially “I hurt all over.” Physical labor is ubiquitous to the region. The people wear themselves out, and the aging of the body is clearly accelerated. If one sits at a computer all day here in Texas, the wear and tear just isn’t the same (although a “happy medium” would seem to be best!).
About halfway through the week, I realized that most of the patients I saw had walked as far as four or five hours to come to the clinic. The reputation of the clinic was one of compassionate, free care, with no restriction on what would be evaluated. Nearly every patient asked if I was an American. I found it incredible that they trusted me so much, when they really knew nothing at all about me, and we couldn’t converse except through the interpreter.
I also found Jinotega to be quite interesting. The most ornate area of the city was the cemetery. Jinotega is referred to as “The Eternal City of Men” or, perhaps more interestingly, “The City of Eternal Men.” Quite a reputation! It turns out that the name “Jinotega” in the native historical tongue means “mangy tree.” There certainly were mangy dogs! I don’t know of many towns that would trade for the “mangy tree” reputation.
My trip helped me realize most things I complain about are petty. I get to serve patients that drive to see me, that have a clean water supply, and that have resources for their care. And we can both wash our hands at any time we wish during the visit!
I started with the list of things we often feel. Here is what I want to feel, and that I believe we all can feel, as Family Physicians:
1. Blessed by the joy of having patients who put their trust in my hands and actually want my opinion.
2. Blessed that I get paid for what I do.
3. Blessed that we have electricity, even if it means EMR, and that we have sinks and clean water.
4. Blessed that I have the time that I do, although it never seems to be enough.
Count your blessings, colleague! And keep on serving, and serving, and serving, those to whom you have been called.