Seven years ago, I officially became a doctor. After years of hard work, sacrifice and insecurity, I finished my residency and passed my board certification exam in internal medicine. I was a fourth generation internist in my family and was so eager to begin my career in a new city with my fiancé. My first job out of residency seemed perfect. I had a set outpatient schedule, administrative support, and great salary and benefits. I was ready to hit the ground running, managing chronic disease and promoting preventive health. What I did not realize was that the next two years at this practice would be some of the most gut-wrenching and difficult in my career, making me regret my decision to enter medicine more than once.
Going from a resident to an attending physician is a difficult transition for any doctor. You no longer have a safety net — you are it. In addition, you are learning how to manage your time, code and bill appropriately and wrestle with insurance companies. For me, the greatest struggle was my patient population. Over 50 percent of patients that walked through my door were on one or more controlled substances, mainly opioids. As an internist, I had some experience prescribing these medications to my patients in the hospital but rarely had to manage chronic pain in the outpatient setting. I had trained in New York City where specialists were abundant, and pain management doctors were largely involved. Same went for psychiatric conditions. Most patients on stimulant medication for ADHD or chronic benzodiazepine therapy for anxiety were managed by their psychiatrists.
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