I remember when I was in medical school, my residency counselor asked me if I was sure if I wanted to be a family medicine doctor. She reminded me that the pay was poor compared to surgical specialties and that it would be hard to practice in an inner city environment doing OB like I wanted to. As a medical student, my favorite rotation was family medicine and I enjoyed it because each patient had a different story. I had the opportunity to treat children, adults as well as seniors. I knew that if I decided to become a family physician I would never get bored. I loved solving problems so much that when I did my internal medicine rotation, the doctor who I worked with for almost 2 months refused to fill out a reference letter for me for family medicine because he thought that I would be a great internist. While I enjoyed hospital medicine, too much of it was exhausting. Long surgeries were not my thing but I learned a lot about consenting patients for surgery, wound care and how to do proper postoperative checks.
When I started my OB/GYN rotation, I did not know what to expect. I was fresh off of Christmas break and had heard horror stories from other medical students about how tough the environment was. I decided that I just wanted to survive the rotation but that I would learn as much as I could about OB/GYN to know how to be a bridge between my patients and their OB/GYN as their family doctor. I remember a young woman coming in toward the end of my rotation who was preparing to have her first baby. She was so excited but scared at the same time about what labor would be like. I remember how she breathed through contractions but was smiling in between them because she knew that she would soon meet her baby. After asking my triage questions, I reported her back to the resident I was working with and she was moved to a labor room. It wasn't an extremely busy day so I spent most of my day at her bedside, getting to know her, her mom and the father of her baby. She showed me pictures of the nursery that I they designed and shared with me how she still hadn't found a pediatrician yet. I was so excited when it was time for her to push. I was allowed to push with her until she started to crown and I ran to get my resident hoping that I would have the opportunity to assist in delivering the baby. However, that resident did not allow me to help but I had a chance to deliver the placenta. I left that rotation that day wanting more.
Fast forward almost 8 years later, I am in private practice as a family physician and I am so proud. I still perform birth to earth care but I also practice obstetrics. Since the coronavirus started, I have seen so many patients are usually so strong become vulnerable and afraid. So many of them are worried about their immunocompromised loved ones, their employment security which translates into job security and insurance coverage and many of them are questioning what will happen next. When I designed my practice, I wanted the focus to be on patient care and not bureaucracy. Although I accept insurance, I have found ways to streamline the process for things that are normally headaches for some of my colleagues. I am presently the only primary care provider in my city that accepts the one of the affordable care act insurance plans that our state has available and I plan to continue to accept it because it's critical for some. HMO plans require your Primary Care Physician to refer you for any specialist that you need to see and it can be a pain if you don't do it right. The stories that I hear from patients about how they got this type of insurance either through life changes, changes in employment or even turning 26 and being kicked off of their parent's insurance really taught me to look beyond the patient's insurance type and to look at their heart. This is the same with Medicaid. In my city, I am one of 3 physicians who accepts medicaid for pregnancy. I recently had a couple of patients who were establishing care with me for the first time and were nervous because of the experience that they had at other offices. They were so surprised at how the patient the process was of getting registered for an appointment as well as how quickly their prior authorizations were completed for the treatments that they need. The left my office smiling and I was proud of that.
In addition to doing OB and outpatient, I also admit my own patients to the hospital. I had a patient who I sent to be evaluated and admitted at the hospital. She was ultimately discharged and after looking into it more, I decided that she needed to stay. Since I live 5 minutes away from the hospital, I got a my car at 9 PM and drove to the hospital and walked her in myself. I did not leave until she was situated in a hospital bed with medications started. That was truly one of the highlights of my career. If that was not sure why I was a family medicine physician in private practice before, I knew then. Another highlight of my week was that I saw to patient through video visits were uninsured. Both of them had been under financial hardship due to COVID as well as other life changes and I was able to make the decision to not charge them for their visits so that they could use that money to pay for their medications and for other essentials that they may have needed.
Through a personalized approach, I feel like I have been able to help a lot more patients than I would have if I was working in a large practice with time constraints. I run my small practice efficiently and and am constantly educating myself on health policy so that I can be an advocate for my patients and also share with them about how they can advocate for themselves.
If you do not have a primary care physician who you trust, I suggest getting one. I also suggest that you support private practice family physicians because often times, we are working overtime to make sure that you have what you need. By no means is family practice easy. It requires studying so many different things on a regular basis to stay up-to-date with the most recent guidelines and changes. Has one of the 16% of family medicine physicians who still perform OB, there are often sleepless nights but I would not trade it for anything. I am also proud to be preceptor for high school students who are interested in the medical field through the HOSA program at one of our local high schools as well as pre-med students at the university near by. I also accept medical students to work in my office with me. Education is key and exposing students to my practice model to show them what their potential has has been very rewarding.
If you are a pre-medical or medical student considering family medicine, I encourage you to go for it. I encourage you to not let your specialty assume your happiness. You control your destiny. Create your ideal practice around your needs and those of your patients and make a difference in your community. That part, you will not regret.
I look forward to discussing why healthcare is so expensive on the next podcast episode.
Dr. Jessica Edwards
Family Medicine Physician with OB
New Braunfels, TX
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