My blogging is sporadic and random. I have about 5 ideas per day pop into my head for what I think are great posts that never come to fruition. Because, well, life happens as it’s prone to do when married with a kid and working 24/7 while managing a family 24/7. I may get a post in every other month if I’m lucky. At the end of each day I’d rather escape the heavy responsibilities of my mom-doctor life for an hour or so with Netflix or my family rather than type a coherent thought. Overall I can’t say what I write is particularly optimistic regarding the state of affairs in the US healthcare realm or society. That’s probably why my posts aren’t particularly popular. People either want happy or extremism, and I seem to offer neither consistently (well never on the extremism). It’s easy for me to fall into cynicism. But today, a full supermoon of all days, brought something different. It brought me hope.
Usually my motivation to keep going comes from my patients, their families, and the healthcare teams I work with. They let me know how much they value me and it helps me truck on, one complicated patient or family at a time. But today was bigger. There was evidence that society, the greater people, care that I chose Geriatrics and that I have some worthy ideas on how to help our broken system.
I woke up, and checked some of my favorite Facebook physician groups. One is dedicated to Direct Primary Care, which is essentially the name for exceptional yet affordable medical care where physicians get to treat patients without insurance (medicare included) interfering and controlling the relationship or treatment. On it someone mentioned I might be of value in some sort of focus group of Medicare exploring the payment option. It’s unlikely that I can go….but the fact that it’s even happening, that there is realization that physicians not only need to be included but also might know a thing or two about what needs to change, makes me hopeful, just a smidgen, before the cynical voice in me creeps up. Then on another Facebook group Dr. Rana Awdish, author of my now all time favorite medical book “In Shock”, notified us that her book has appropriately caught the attention of people in Washington and she’s been asked to participate in a Bipartisan Congressional Healthcare Solutions Conference. She, in her perpetually humble and elegant way, requested our group input. And the responses were amazing, and hopeful that perhaps the wider perspective from physicians on what needs to change might be heard.
That all happened before 8am. Then I was off to see my patients in their homes and two majorly understaffed Assisted Living Facilities. The initial hope wore off quickly as I received calls about flu outbreaks, issues with family dynamics, new consults, and notifications of orders not being followed, etc, all while providing patient care. Between one facility and a house call I stopped at Target to get TP, detergent and diapers for my family. This is where the Hope Bomb was dropped.
I was wearing the exact scrub set in the picture above. Over my left chest my logo with “Direct Senior Care” and over my right chest my name, “Shannon Tapia M.D.” I routinely have to run errands or go out in these scrubs. People usually don’t say anything, or, if they do, they ask if I am a nurse or CNA. Even in the facilities where I have many patients I get asked by strangers if I am the NP or PA when I have my white coat on. People rarely read the engravings. Mostly they see I’m a youngish woman and in scrubs and go immediately to nurse. Today was different. I paid for my items and the cashier, in her likely early 60ies, and I exchanged the usual pleasantries of “have a nice day.” I was gathering my bags, my mind thinking about my patients. Yet before I left her checkout lane and prior to her next transaction, she paused, looked me straight in the eyes and said, “And thank you for your service.”
I was, quite frankly, blown away. This has literally never happened to me, ever. Normally when I tell people I am a Geriatrician they naturally comment on how glad they are that I chose Geriatrics and how needed I am. However it’s usually without any understanding of what it means to be a Geriatrician in the context of the difficulties faced by the medical community today and the discrepancies between how physicians are paid among specialties (largely due to medicare). I honestly find it more frustrating than hopeful that lay people know my specialty is needed and yet nothing changes to create more Geriatricians. But this was new….this moved me, deeply. The clerk, whose name I didn’t catch, didn’t ask if I was a Geriatrician. In the time it took to check out, she observed. Maybe she says that to anyone in scrubs, but I doubt it. Most scrubs aren’t engraved and someone wearing them could be anything from a patient transport to a physician. No, she read my engravings. She noted I take care of seniors and saw the M.D. and she validated what I have always known but never heard acknowledged by society. Becoming a physician, particularly one who is not just doing cosmetic procedures for the big bucks but truly in the thick of life and death and relationships and emotion, is a service. It is a vocation of sacrifice.
There is a lot of negative and misleading media, from op-eds to dramas on Fox, about what physicians are like. It can be extremely discouraging as a physician. More so, in a field like Geriatrics, we physicians are frankly not compensated monetarily for our professional service. I can name at least 20 Nurse Practitioners or PA’s that make double or triple what I do without the student loans, time commitment, heavy responsibility or years of training to go with. But today, just that one comment was all it took for me. Knowing one random person recognizes that what I do 24/7 is indeed a service….it fuels me to face another crazy day as a physician for her patients and her society. And it makes me think, “Damn, I am so lucky to be a physician and happy to serve.” So thank you, Target checkout clerk, for giving me the final booster of hope I needed to serve another day.
And to all the good physicians out there: THANK YOU FOR YOUR SERVICE!