any field of endeavor is associated with increased family discord , divorce , problems with children both at school and home , as well as the financial adjustments that often result in changing roles . All of us become comfortable in our role , and even though the transition we are looking to experience is exciting , it creates a whole new set of stressors . We must get to know the new system , the new colleagues , the new roles , the new infrastructure and the new way we may be perceived by old colleagues , family and friends . We must deal with the stress associated with wanting to be accepted by all these folks in your new role , welcomed by your new colleagues and respected for what you bring to the table .
I have been truly fortunate in having had the opportunity to experience many different roles in our profession . Private practice with some of the best in our profession , enjoying the interaction with patients until my very last day in practice and always so grateful to them and my colleagues for the support , respect , acceptance and sense of accomplishment I enjoyed . In fact , of all the roles I have filled , this direct patient contact and sense of belonging on a team will always be my favorite . In my view , the top of the mountain in terms of all we hold dear in medicine is the private practitioner . Before you leave this role , be certain of your decision . It is especially hard to go back into practice , once you have left - these days , harder than ever before .
Many young physicians go straight from residency to a faculty position . They are energetic , excited and enthusiastic . However , I have generally felt , that with rare exceptions , their lack of experience resulted in students and residents missing out on the years of experience of more seasoned physicians . I believe that significant clinical experience should be a prerequisite for all teaching faculty , and simply completing a residency does not satisfy that requirement in my view . I left private practice after about 14 years and transitioned to the position of Director of a Residency Program in OB-GYN , in Indianapolis , Indiana , accepting the challenge of assuming the directorship of a program put on probation by the residency review committee . I was charged with improving and stabilizing the program to achieve full accreditation , and even get approval for an increase in the size of the program . The challenge was made a little more difficult because I was an outsider coming into a somewhat insulated system , but the ultimate acceptance by my new colleagues and ultimate success in meeting the challenge successfully was worth the effort . It expanded my horizons and provided a new dimension to my medical practice experience .
When I left this position , I felt a great deal of satisfaction and accomplishment , and having begun as an outsider , I ended up feeling a part of the institution . But it was still a stressful adjustment . The faculty of the program was increased , the academic aspects of the program enriched , and the satisfaction and caliber of the residents
TRANSITIONS IN PRACTICE were increased significantly . Specialty board scores increased to a level that had not been seen for a number of years , if ever . This was satisfying , to be certain , but not without some degree of pain . In addition , the financial rewards of private practice most commonly exceed those of a full-time teaching position .
I left this position to assume the role of Director and Vice President of our national specialty society , the American College of Obstetricians and Gynecologists , in Washington , D . C . The move to D . C . was exciting , and the role of leading our specialty organization was both challenging and rewarding in many ways . However , it brought another cut in salary . My years of private practice experience were unusual in this type of role , and enabled me to view issues from a perspective of those on the front lines of medical practice , and not just from the viewpoint of the ivory tower . The opportunity to engage not only with other national specialty societies as well as general medical organizations was extremely enlightening and satisfying . The opportunity to engage with the federal government , both in terms of congressional and administrative departments and to provide information and testimony related to issues of interest to women ’ s health was a wonderful experience and though at times frustrating , was rewarding overall .
After six years , however , I missed the interaction with patients and my colleagues in clinical practice , and in many , many ways , missed the camaraderie associated with them . After a period of time in D . C . it is hard to not feel detached from the real world . My mother even referred to me one time as her son who “ used to be a doctor .” At this point , however , I was a middle-aged male re-entering private practice at a time when males were at a distinct disadvantage in our specialty in regard to patient choice . In addition , though I had for the past six years read nearly everything related to new developments in our specialty and had contributed to almost all current practice guidelines in our specialty , my only recent clinical experiences were with a free clinic where I volunteered in D . C .
I had taken a number of public positions on topics related to patient safety and re-entering practice , and felt I needed to practice what I had preached . I approached the hospital staffs in Louisville and requested that my cases all be proctored for the first few months after re-entering practice . I was told that there was no system for that , and that with my previous practice and reputation , I would be granted privileges as if I had never left . Despite that , I requested my partners in practice provide the monitoring I requested , and they did so , without incident . I was quite delighted to find my previous referring doctors and old patients rapidly return and my practice became quite successful in a very short time , showing it ’ s always good to leave your bridges unburnt . I am pleased to see , in addition , that hospital staffs have become much more diligent in proctoring
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