Outpatient Medicine is at Odds with Motherhood

The other day, I had the opportunity to volunteer at my daughter’s end-of-year splash day party. Six months ago, I could never have imagined being able to be there for this. I know being there for these small things is not going to make or break her or my relationship with her. The girl knows that she is loved and special, but I still can’t shake how much it meant to me.

My daughter has been through so much with me. She has been my rock, my strength, my passion. She bore with me as I pushed my body and her’s to their limits during my pregnancy with her. She tolerated being juggled with a pager at 3 a.m. many nights. She made me stand up to an orthopedics resident who wanted me to come in with her in tow at midnight for a routine consult “just because” while my husband was moonlighting out of town. She has been the last baby picked up at daycare more times than I’d like to admit. She has been forced to come to lectures, conferences, pharma dinners. She’s been left at home crying when I’ve left her for work so many heartbreaking times.

Yet, she still looks at me and says, “I love you my precious mommy,” and, “Mama, can I braid your beautiful hair?” It amazes me that a person can love so fervently and forgive so effortlessly. She’s the absolute best, and she deserves the best mom in the world and that day, each time she ran up to me and hugged me just for showing up, I felt like the best.

It made me reflect on why outpatient medicine feels at odds with motherhood. Anyone who knows me, knows that I absolutely love being a doctor. I still believe that being able to practice medicine is a great honor, privilege and joy, and I started my own DPC practice to preserve those feelings. However, not long ago, I was a physician working in the typical outpatient setting, and there I felt like every day was completely out of my control. I felt like no matter how early I arrived, how efficiently I worked, how much I did right, I still could never guarantee any predictability or sanity to my schedule. Perhaps this was where I worked, but I imagine, this sentiment is shared by many. My schedule was so easily thrown off by a hold up at the front desk, lab, a patient being late, an add-on procedure. An almost perfect day could be completely destroyed if my last patient was checked in late, which happened every single day. So many things had to go right for my day to be sane, but they never did, and mostly it had absolutely nothing to do with me.

Being able to make the decision to take a couple of hours off without having to ask anyone else was absolutely freeing. It reminded me of how it used to feel to constantly be at the bottom of the totem pole. I remember being denied weekends off for so many important weddings, family get-togethers and feeling like I could never show up for my friends and family during fellowship. Even as an attending, I remember making up clinic time for OB and pediatrician visits and feeling so guilty every time I needed to. I remember being denied switching a half day in order to make it to my dad’s 70th birthday party. I felt like someone was doing me a favor when I asked to use my accrued vacation days. I even remember feeling guilty for having to pee because a patient would have to wait.  

Now my schedule is far more in my control, yet I still have that tiny pit in my stomach on my clinic days, and it makes me wonder how I withstood having an unpredictable clinic every single day and how having no autonomy in my schedule made me feel out of control of my own life.

How do other people cope? I guess for me it was so go, go, go, that I never had time to think about it, and I wonder if that’s the case for many of us.

Arti Thangudu, MD, is an endocrinologist and a 2018–2019 Doximity Author. She specializes in Endocrinology, Diabetes, and Metabolism and is a mom of two beautiful kiddos under three! She has started her own lifestyle and preventative medicine clinic called Complete Medicine in San Antonio. She has also contributed to Medscape and KevinMD. Outside of work, Dr. Thangudu enjoys traveling, cooking, and spending time with her husband and two children.

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