Physicians are very closely vetted. From the very beginning we are closely watched, our backgrounds checked, our references double checked, and our behaviors watched and scored.
Of course, the news is not without stories of terrible physicians who commit all the standard immoralities and crimes typical of humanity. We healers are fully capable of dealing drugs, assault, murder, abuse, larceny, embezzlement, and so on. It does make you wonder just how well we're evaluated after all. But that's not my point.
Most of the doctors I know are pretty straight shooters. Most of them put their heads down from day one, did what they were told, did it well, worked hard and succeeded (at least professionally) by tamping down and subverting any behavior that might derail their goals or sabotage the careers for which they worked so long and hard (and for which they owe so much in loans).
It was with this in mind that I was working on some credentialing for a little side-job in an emergency department. I filled out the requisite forms online, and listed in painful detail every job I've had as a physician. Having worked as a physician since 1993, and having done "locums" (independent contractor travel work) for about 10 years, I have accumulated some 30 hospitals in my life experience.
They were all listed, as was my training, and other relevant work details.
When I went to close the application browser, I was met with an alert in bold letters:
"There is a gap in your work history from June 1990 to July 1990. Can you please explain this?"
What, pray tell, was that gap? To what nefarious end did I commit that 30 day period of unregulated, unsupervised time without education or productivity?
Well, that was the first month of my marriage to my wife Jan, and it was the month between 4 years of rigorous medical school ending and the subsequent 3 years of intense residency training beginning.
Good thing somebody caught that! I mean, I could have been up to almost anything! Walks in the park holding my wife's hand! Cooking in our temporary apartment! Moving my worldly goods from West Virginia to Indiana! Sleeping uninterrupted nights in a warm bed by a warm wife! Visiting my parents and grandparents!
I could have been -- brace yourself -- exercising. I might have simply read a book for pleasure. Or stared at a flowing creek in the woods in peace.
The sorts of things that people do. And have always done.
There are many things in medicine that make it a wonderful profession, and a worthy way to spend a life.
And there are a few that contribute to our exhaustion, anger, and burnout at least as much as the stress of seeing suffering and pain every day. Being endlessly monitored and expected to have an explanation for everything...well that's near the top of my list as I bump up on my 30th year in practice.
It was a nice morning. In case anyone is watching, I'll be at work at 12 pm today, doing my job as expected.
Edwin Leap, MD, is an emergency physician who blogs at , and is the author of and . You can read more of his writing on his Substack column, , where a originally appeared.