I was an overwhelmed family doctor. So at age 45, I called it quits
CBC
This First Person article is the experience of Dr. Marc Cotran, who until last month was a family physician in Montreal. For more information about CBC's First Person stories, please see the FAQ.
On April Fool's Day, I turned in my medical licence. It was no joke.
A sense of deep relief immediately replaced the weight on my shoulders. It was the weight of thousands of stories heard over 18 years of medicine. The weight of empathy and patience, of responsibility to do no harm and of personal sacrifice.
Leaving my practice at the age of 45 is bittersweet. There are things that I already miss, like the privilege of being part of the lives of 2,000 people. I'd made a point early on to take on patients from all walks of life: language, religion, socioeconomic status and, importantly, health challenges.
Being indiscriminate added an extra dimension of challenge, but it was well worth it to discover the richness of Montreal's people.
However, often I'd leave my clinic in Montreal's Notre-Dame-de-Grâce neighbourhood exhausted, drained of emotion, unable to form full sentences. I'd come home after midnight to face my partner, children, the dog and the chickens, feeling like I had nothing left to give them.
I felt sorry for short-changing the people I loved the most and tried to convince myself that I was acting out a sense of duty to my community. I knew early on that this could not continue, but braved through it under the false impression that I was in some way irreplaceable.
Never being great at long-term planning, work at my family medicine clinic soon spiralled out of control. I had learned at a medical conference that it's best to shake your head while saying no, yet I was a hopeless yes man. Before I knew it, I had 1,000 patients. And between 2014 and 2018, that number doubled.
I was healthy, stable and privileged. So many people were not. I should have been able to help them all, right?
The adrenaline rush of a busy clinic always felt as though 50 ropes were pulling me in separate directions. It was a juggling act, but with profound consequences when a ball was dropped.
Between a poor referral network and personnel shortages, I felt compelled to take on the roles of dietitian, physiotherapist, psychologist, nurse and spiritual adviser, to name a few.
But what disappointed me the most is the lack of technological progress in medicine. The app that controls my robot vacuum cleaner is far smarter than the electronic medical record (EMR) system I was forced to use. And I know about apps — I spent seven years building my own records system.
So many times I sat frustrated, begging my USB dongle to contact the mother ship to get results for the patient sitting in front of me — typing my password eight times in a row to finally get a partial response. My partner was exasperated when we would receive, by snail mail, three copies of the same result. Other times, the results never came.
When people ask me what I'm going to do now that I've retired from my practice, I have a simple answer: Not that.
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