According to a recent poll conducted by Doximity, about 63%, or nearly two-thirds, of doctors don't want their kids to practice medicine. The statistic is a shocking one, for many reasons – the least of which is that many of us got into this field because of the influence of a family member, either a parent, grandparent, uncle, aunt, or another person close to us.
I fall directly into this category. My father is a family practice physician. To this day, he still practices in my hometown, where he has been for his entire medical career. Like many other children of physicians, my childhood was "fairly normal" by medical family standards – conversations around the dinner table about the interesting cases of the day, flu vaccines on a regimented, yearly schedule (and sometimes around that same dinner table), and hanging out in the doctor's lounge eating Fig Newtons on the weekend while my dad finished rounding and signing his charts. I knew what a pager was and how it was used before I was 10, and I was intimately familiar with the phrase "on call" and what that entailed. I spent a fair amount of free time helping around the office, whether it was picking up the ubiquitous red "sign here" sticky notes off the floor or later helping to digitize an entire wall of paper charts into a newfangled EMR. In short, when the time came for me to decide whether to go to medical school, I didn't need to be pressured into applying – medicine was in the air I breathed, and it was the obvious next step.
My father and I enjoy a unique bond in the "family business." He (a DO and family medicine physician) jokingly refers to me (an MD and internist) as "one-third of a doctor" owing to my comparative deficiencies in obstetrics and pediatrics. We debate the merits of "why [you internists] have people on so many drugs" and how "back in the day" you had to go to the hospital overnight for an admission. We both delight in discussing challenging diagnostic cases, or that "aha" moment when you figure out what's wrong with someone. One of my favorite moments in life was when he flew down to Atlanta to be with me on Match Day for residency, taking me out for dinner the night before. We discussed why any of the places that I had ranked would be a great place to land – only positives, no negatives. While my entire family would attend graduation a few weeks later, it was only my father there on Match Day. He knew the gravity of the day from his own experience and understood the necessity of being there for it – something I think not many outside of medicine truly comprehend.
Despite all this, I'm struck by just how different the world of medicine I inherited is from that of my father. He purchased his practice from a pair of quintessential 1950s physicians who did it all, from splinting fractures, to delivering babies, to taking care of patients in the hospital. His career has followed the greater trends of primary care physicians over the past 30 years – from individual practice to group practice to a large, independent group, and finally to acquisition by a local health system. Over the course of it, he's done it all – and been a tremendous inspiration to me about what it means to be a "full service" physician. Within the last few months, he recently sold his original practice building and moved to an office smaller and closer to home, after nearly 25 years in the same building. The decision wasn't his, but was made by an executive at the system he now works for.
By contrast, I entered practice in a time where physician-owned groups and offices are rarer, and caring for your own patients in the hospital, let alone practicing obstetrics in primary care, is nearly unheard of. It was a lifelong goal of mine to operate my own office, but coming out of residency, I found few opportunities to do so, as most of the local doctors had already sold out to health systems or private equity. Ownership, for me, was a pipe dream from the start — I began my career with more than six figures in student loan debt, making the possibility of taking out a loan and striking out on my own nearly impossible. In many of these superficial ways, the medicine of today barely resembles the environment he entered in the '90s.
Despite all of this, I believe that the core of the profession and its rewards remain the same. It's for this reason I wouldn't mind if my own son decided to follow my path. The greatest things about medicine are still out there to be found, for those of us who look for them. The thrill of an accurate diagnosis is the same, as is the satisfaction of a long-term relationship with a patient. While I certainly wouldn't pressure my son into a career in medicine, I would be hard pressed to actively dissuade him from pursuing the same craft that my father and I have – one that, to a deep extent, we both greatly appreciate and love. Rather than encouraging him to apply his talents elsewhere, I think I'll take another path – trying to agitate for a better system where we can capture the magic of medicine and pass it on to the next generation. When the time comes, whether it is what my son chooses, I want him to have the option to be a physician and enjoy it, just like his dad.
Have your children followed you into medicine? Do you want your children to follow you? Share your thoughts on the "family business" of medicine in the comments.
Dr. Brennan Kruszewski is an internal medicine physician in Hudson, Ohio. He is passionate about transforming primary care. He enjoys spending time outdoors, especially biking the trails of Northeast Ohio. He is active on social media, and blogs at his personal website. Dr. Kruszewski is a 2024-2025 Doximity Op-Med Fellow. Opinions expressed here are his own and not the opinions of his employer.
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