Dr. Welby Isn’t Well: My Journey to Being a Healthier Primary Care Doctor
Doctors today aren’t so well. Trust me, I know. I remember waking up each day dreading going into my primary care practice. I’d check my appointment schedule and literally feel sick to my stomach, with 25 patients to see – every day, day after day – and only 10 minutes with each, 15 if I was lucky.
Patients faced long wait times for appointments and in our waiting room, sitting there longer and longer as my day backed up. It was far from an ideal healthcare experience.
That was 10 years ago. I was completely burned out. I’d get up at 4 a.m. to make it to rounds at three hospitals, then rush to my practice at 8 a.m. to see patients. I’d walk up to my practice door eating the donut or two I’d grabbed from rounds, and instead of enthusiasm I’d feel my neck tense and a daily recurring stress-migraine take hold.
Every morning, I’d look in the mirror: “It’s show time, here we go.” For primary care doctors, the sad thing is that all day every day is show time. My patient visits were rushed. No time to get to the bottom of the matter. No time to do immersive research or even read. I’d get out my prescription pad too easily, “Take these and let’s see how you do.” I worried I might have missed something. I felt I was letting my patients down.
They were feeling it, too. Patients need time with their primary care doctor — time to ask and have questions answered, time for advice and coaching, time for a real relationship. With only a few minutes in an appointment, they weren’t getting that from me. I had no time at all. If you were unfortunate enough to be my last patient of the day describing your headache symptoms, I’d be more focused on my own, barely listening. Like 85 percent of primary care doctors, I wanted to spend more time with my patients, but I had no idea how to do it.
After doing hospital admissions, it would be 7 p.m. by the time I’d finally make it home. I’d walk through the door not a very nice person, taking my day out on my wife and kids, just wanting dinner and bed.
There I was, 40 pounds overweight, no time for my own health, fitness, family, recreation or a vacation – while telling my patients they need to eat right and exercise to get fit and healthy. I was miserable, and my family suffered.
In 2009, I couldn’t take it anymore. My practice was doing well, but I was ready to give up everything because I didn’t want that kind of stress any more. I felt like I was on a treadmill that continued to speed up, a sentiment shared by two-thirds of primary care doctors. I’d considered selling my practice or just quitting. But I had a very personal reason, and still do, to keep my practice going.
My dad started it in Louisville, KY back in 1968. He had a very Marcus Welby-type practice. Dad made me promise to keep the practice open and take care of his patients after he was gone – some he’d been treating all their lives. I was trying, but this was not how our family wanted to practice medicine. (I’ve been a physician myself for 33 years and my brother is in practice with me.)
I looked around, did my research and decided to become an MDVIP affiliate. I reduced my patient load from 2,500 to fewer than 600, giving me more time for my patients. Now I can really research the problems they face and give them the attention they’re due. I also have more time for myself. I enjoy being a doctor again and having my life back. No more migraines. I’ve ditched the donuts, I’m eating right, I take vacations, spend time with family and I’ve lost those 40 pounds – all by practicing what I preach to patients. Literally, I feel I’ve stepped off the treadmill at work and onto the treadmill at home.