After many years of hard work and preparation, I finally have a chance to do what I have wanted since starting down the road of Medicine--innovate in Primary Care. And a long road it has been!
Due to some unavoidable circumstances around physician staffing, my current work with Iora Health has offered me a chance to practice Primary care in our first open clinic, the Culinary Extra Clinic in Las Vegas, Nevada. As some of you may know, I currently consider Boston my home, a vexing situation. What we have worked out (we being my wife and my company), is for me to travel to and from Las Vegas weekly, spending 3-4 days practicing primary care in our brand new and frankly amazing practice. By Boston academic standards, this actually has me at full time (8 "sessions" per week, where one "session" is one half-day). The road is long, the travel tiring, and the time away from my wife unbearable. However, I have learned something about travelling to a single to location to work that my younger colleagues may wish to consider.
No matter where you do it, the practice of primary care can be consumptive. Each patient has unique needs, often with much deferred self-care over the years, and in the presence of a supportive primary care system, the "work" to be done is staggering. While my work as a physician is to recognize disease, help to prescribe and decide a path to health, and guide my patients as they walk--the real work lies with each individual to care for themselves and their family. In any case, the days are long and the work both inspiring and tiring. Now add to that the prospects of launching a brand new practice, as part of a larger, new company. As you can imagine there is plenty to do. And I am grateful that I get to do it on the road.
Strange? Surely. I had no idea that the travel would help. It turns out that being stuck in a different city (and Las Vegas is certainly different from Boston), is incredibly beneficial when faced with the prospect of hard work. While I miss my wife terribly, there is no signal other than hunger or fatigue that my day's work is done. I have no plans, no friends calling me to go out, no obligations. While this would be a sad existence in the long term, when faced with such monumental mountains of labor, I find it... comforting.
The ability to focus singly on one task is a gift in some ways. It is certainly a privilege that I did not enjoy as a resident--always pulled in a million directions at work while simultaneously seeking the elusive and ill-defined "work-life balance." But, if you can believe it, in Vegas there are no distractions. I wake up, work out, work all day, eat dinner, work all night, sleep and repeat. I am honing my craft and although the costs are high, I believe the rewards will be as well.
So some advice to my younger colleagues: Get out there. You either have been or are currently struggling in some type of race through medical school, residency, or the ranks of junior faculty. You are trying to make a life for yourself in your chosen home town and all of its attendant benefits. I implore those among you who can, to consider hitting the road for awhile. Move some place different, commute far to work and really dive in to it. The rewards will shock you.*
* I have only been doing this for 3 months, I will have more complete data in 3 more.