Every physician will encounter days during which he or she wonders if the complications and sacrifices of a career in medicine are truly worth it. The trigger may be the thought of onerous medical school debt, the latest notice of a further decrease in reimbursement, Congress imposing another “Stark IV” regulation, the threat of a lawsuit, or having to appeal an insurance company’s repeated denial of justified office visits and procedures. Or it may be having to sacrifice time with your family. Gone, too, are the days of finding comfort in a physician’s lounge or meeting. There’s just too much negativity now.
Through these challenges, one theme endures: You, the physician, want to practice medicine and know that the reason for pursuing medicine — to relieve suffering and help people lead healthier, happier lives — is still relevant. So you ask yourself: Am I making a difference? Do my patients really appreciate what I am doing?
When I first started my practice 40 years ago, I kept a “thank you” file in a desk drawer in my office. The file grew thick over time. Most days I was too busy to carefully read what patients or their families had written. So I would go back to it periodically whenever I started to question my decision to go to medical school or was just having a bad day.
Many of the cards and letters in my file have brought me comfort over the years. The most touching comments came via handwritten letters from patients and their families: from the family of a 90-year-old woman on whose leg I performed a bypass so she could continue to live alone on her farm; from the daughter of an 80-year-old blind mother who was in extremis from a ruptured abdominal aortic aneurysm; and from the son of an Italian woman who continued to thank her doctor for saving her from a stroke with carotid surgery.
There are still more letters that bring tears to my eyes even to this day. They have helped keep me in the game and put negative events in perspective. One such letter, from a patient’s daughter, is one I have read several times over my career. Her father presented with a symptomatic expanding abdominal aortic aneurysm but was also found to have bilateral femoral and popliteal aneurysms and later developed a thoracic aneurysm. I had to operate on him several times to repair them all. Some years later, I used both his arm veins to salvage his limb in a long and difficult procedure. Her letter arrived after I had seen him for the last time.
Over the years, you have saved my dad’s life many times. I do not know if we have ever really thanked you and let you know how much you have done for our whole family. After one long surgery, you came out with a glass of milk and said, ‘He made me miss my lunch!’ That was the first laugh and moment of relief we had in almost seven hours. Not only have you saved a man’s life and legs, but you gave five daughters and, so far, 12 grandchildren more time to love and know a wonderful ‘Pop’ and ‘Opa!’
You also gave him the chance to go back to his home in Holland and get to know his family again. I know this is just all part of your job, but I believe you are a good man, especially when it comes to family. You operated on my dad right before you left for your own father’s open-heart surgery. I am sure your father is very proud of you. I am thankful there are good doctors like you to keep good fathers like mine around! My dad raised me by himself since I was 12 years old. And I am sure he would have been a lot healthier if he had not. Thank you.”
My advice to all physicians is to save the cards and letters you receive from patients and their family members. You are going to need them. They can offer tremendous consolation when you start to second-guess your decision to pursue medicine as a profession. Keep the letters in a file at work and the thoughts in those letters close to your heart. You will need them to maintain optimism and help you recommit to medicine. You might even be rewarded. I recently tore open a half-opened card from almost 20 years ago and a $50 bill fell out!
So to answer the question, yes, a career in medicine is worth it.
What reminds you of the reason behind your commitment to medicine?
Bhagwan Satiani, MD, MBA, RPVI, FACS, FACHE is professor of clinical surgery in the division of vascular diseases & surgery at Ohio State University.
Image by AngieYeoh / Shutterstock