DOs share why they are staying in patient care

Patient care encompasses providing access to health care, reconciling EHR discrepancies, coaching patients on addressing financial and social barriers, and facilitating the transition of care. Many physicians are leaving patient care or considering it, with the common reasons including burnout, bureaucratic tasks, long hours and lack of family time.

A recent Medscape report noted that 22% of physicians are considering pursuing a nonclinical career.

With so many physicians considering leaving patient care, I wanted to explore what motivates physicians to stick with it today. I recently spoke to four physicians who shared their reasons for staying in patient care. Their stories shine a light on the meaningful connections between physicians and their patients.

Why patient care?

When I asked our fellow physicians why they’re choosing to stay in patient care, they echoed a foundational reason: they value human connection. Richard Edwards, DO, family medicine physician, shared that it is the “smallest difference you make in someone’s day that makes it worth it.”

Dr. Edwards shared a story about a patient he saw in the ER: “I went to assess her myself, then sat down with the ER attending to discuss my history and understanding of her, and sure enough we safely discharged her home instead of admitting her for a lengthy hospital stay. She was thankful to come home, especially because she had family in town.”

Other physicians share Dr. Edwards’ sentiments. Nick Beechnau, DO, a family medicine physician, grew up in a small town. He shared that he treats the same people who “gave [him] detention or ratted [him] out. It’s good because there’s inherent trust.”

He fondly shared a time when his patient had dysphagia and struggled with a treatment plan that worked: “I called his parents on Thanksgiving and later texted his mom, asking how he was doing. She said the treatment plan finally worked. She brought me no-bake cookies, which were amazing. There’s a lot of give-back and we invest a lot of time in our patients.”

Dr. Beechnau also mentioned that he and his father, who is also a DO, offer patients a lot of reassurance.

“That’s what patients appreciate the most,” he said. “Our patients really do show they care. That’s why my dad is 69 and still in practice.”

Aaron Allgood, DO, internal medicine physician and professor at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA), shared that his initial desire to enter medicine was to help others.

“My whole personal statement was about helping people. When you’re in your 20s, you’re not sure what the whole world is about, but you have an idea about the impact you want to have. I wanted to be in a profession to have that impact and I thought I could,” said Dr. Allgood.

Today, Dr. Allgood works at Circle the City, helping the underserved populations of Maricopa County in Arizona. “Seeing patients and helping them is what I love most about medicine,” Dr. Allgood said. “You’re connecting human to human and you want to be present for your patients.”

Human experience and presence

When asked to expand on what this presence means to Dr. Allgood, he explained: “It starts with putting down whatever you have and paying attention to them. We had paper charts back then, but now it’s a computer screen. It is fighting the urge to talk about yourself first and putting that energy back into the patient. It is not about how much time; it is the quality of time.”

As a former student at ATSU-SOMA, I witnessed firsthand how Dr. Allgood poured his heart into his lectures. The sacredness in the moments we share with our patients becomes timeless when we are fully present.

Regarding his time at Circle the City, Dr. Allgood explained that it is health care for people experiencing homelessness: “Any shift I spend with [the patients], I am always learning something. If you go quickly through their visit, you miss the question that opens up understanding. We teach social determinants for a reason.

I delve further into what unfolds this human connection. Dr Allgood shared, “there is a myth that all people experiencing homelessness are experiencing mental health disorders or want to be homeless. When you take the chance to sit down and talk about how they got to where they are, you learn that these patients are not far from you. They put a mirror in front of you, and you realize the one or two choices that they made could have been you, and you can also spiral.”

Also, connecting with patients from all walks of life helps physicians remember the humanity inside each person, no matter what their circumstances are, Dr. Allgood noted.

“The connection we have with patients is striking, but when we see that person on the corner, we look at that person differently versus if we sit with them in person,” he said.

Challenging aspects of patient care

Dr. Beechnau shared that one of the most challenging times he went through in patient care was during the height of the COVID-19 pandemic. His patients held various views on the COVID-19 vaccine, and he “learned that being angry in your patient encounter never helps. Patients pick up on it and it affects my ability to teach.”

When asked if this helped him in his parenting, he laughed and said, “being a parent has translated more into my practice than the other way around. My threshold for loud noises has increased, and now I’m able to tolerate anything.”

Dr. Beechnau further elaborated: “A lot of doctors don’t enjoy being physicians because their expectations and reality are different. They thought people would treat you nice and they’d call you ‘doc,’ but that’s not always true. You still have to chart, make phone calls and do other things you don’t make money from.”

Meanwhile, Cynthia Ochs, DO, a medical director and board-certified family medicine physician with a certificate of added qualifications (CAQ) in geriatrics, shared that EHR has changed the way we practice medicine: “I used to spend a lot of time engaging with patients, looking them in the eye and face to face. In a small town, you get to know everyone. Seeing my patients while using EHR, you’re on your laptop and not as concentrated on the person. Patients tell me all the time that they wish they were more face to face. It’s amazing what you get out of people when that happens. All the screening requirements take away from the power of patients and what they need.”

Double duty

Many physicians choose to take on a different role while they are still actively seeing patients. Through her experiences with her own patients, Dr. Ochs learned the importance of medication reconciliation, and now spends some of her time providing medication reconciliation in the EHR for patients. This is a vitally important task for patients when they transition into and out of the hospital, especially when they are geriatric patients.

To illustrate the importance of medication reconciliation, Dr. Ochs shared that a patient was admitted to the nursing home, and they called her for his atrial fibrillation. He was then sent to rehab, and then to the ER for reasons independent of his atrial fibrillation. Changes to his medications were made between that time; however, they were not logged into the EHR because a hospital he was at previously did not use the same EHR.

“He was not on Eliquis as he should have been, and when he returned to my clinic, he developed a stroke 12 hours later, and that was because the EHR was not updated,” Dr. Ochs recounted.

She stressed the importance of being cognizant of medication changes when patients are transitioning between care settings. Dr. Ochs has spoken to AOA leadership to help raise awareness of the importance of medication reconciliation.

Being there for patients

Dr. Ochs also spoke of the importance of rich longitudinal relationships in primary care. Dr. Ochs, who practices with her brother, husband and sister, noted that when a physician really knows their patients, they are able to remember many details, which translates to better patient care.

“My patients know that I know them. I have a good memory and so do members of my family who are in the same practice,” she said.

Dr. Edwards feels he has the greatest impact on patients when he is able to be there for them when they are passing away.

“I have conversations early with families and I encourage them to keep the patient’s goals in the back of their mind,” he said. “That way, when a patient is about to pass away, it isn’t new to their family. Being able to support them through that is what I truly appreciate.”

What our patients teach us

Dr. Beechnau notes that seeing patients heroically handling awful challenges has changed his perspective on life.

“The amount of stoicism and dignity my patients have is insane,” he said. “We have a strong community. Watching my patients and their families handle terrible things with strength helps me with smaller, mundane things.”

Dr. Ochs says her patients have taught her the importance of listening.

“Even in people with dementia, if you listen, they’ll tell you what’s wrong,” she said.

I couldn’t help but go deeper; I asked, “What is the most humbling thing a patient has said to you?”

She reflected, placed her hands to her chin in thought and said, “I think of the people that have worked so hard their entire lives, and they just tell me, ‘I thank you for just giving me your time.’ You have people in their lifetimes that have given so much to other people, like veterans who fought in different wars, women raising children alone, and you can help them by giving them your time. They’ve given their time to help more people than I have.”

How do you hope your patients will remember you?

When asked this question, Dr. Edwards said, “Out of all the people who see them or walk in or out of their room, I hope my patients realize that someone actually does care.”

Dr. Beechnau says he hopes patients will remember his sense of humor and that he cares.

“The only time when I’ve been hurt as a physician is when someone thought I wasn’t doing my best,” he said. “As much as I joke around, I don’t stop thinking of my patients who aren’t doing well.”

Dr. Beechnau also shared that he hopes to make the community he lives in better: “I just want people to interact nicely, to make it a brighter place for people around me. I want to be accessible and I’m happy people can approach me.”

Related reading:

The day I learned about the secret DO handshake

DOs vs. MDs: Do patient outcomes favor a side?