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About this Blog
My name is Theresa Chan. I'm a family physician working in rural Northern California. This blog is about the small triumphs and everyday drama of making a living in medicine.
I received my education at Stanford and UCSF,and considered myself a city girl for most of my life. However, when it came time to choose a setting for my professional life, I decided to head for the sticks. My reasons for doing so were complex, but included a desire to practice medicine in an underserved area as well as the opportunity to leave the traffic-ridden, overpriced and increasingly soul-less urban settings I'd lived in so long. I did my residency in the rural Central Coast and then, in 2004, moved far to the North of the state to start my first real job.
Since then, I've learned a lot about front-line healthcare in small communities and watched a lot of national social problems acted out within the lives of my patients and their families. I've also done a lot of soul-searching and career-mapping, and, in early 2008, I reluctantly left primary care to work as a full-time hospitalist. My reasons for doing so were motivated by my personal bottom line but also by the realization that the daily work of primary care was simply not for me. I still provide prenatal care at my old clinic, and deliver babies at the hospital where I make rounds on inpatients. The fact that a large number of my colleagues nationwide are also giving up primary care does not make me feel better about my decision, but helps me put it into a context of a national healthcare crisis which cannot be ignored.
There are a lot of good medical blogs to read, and many of them are much better than I am at dissecting the policy missteps that have led to the current collapse in primary care, and at criticizing the government policymakers behind them. However, most medblogs have a decidedly urban/academic/policy-centered focus. What is missing is the voice from small-town doctors such as myself, who are struggling with policy failures in rural settings in which clinical services and political advocacy are severely limited. What is also missing is the personal testimony of individual doctors making career choices that represent disappointing concessions to these same policy failures, all in order to survive financially in the current medical climate. The popular image of doctors as ego-driven, money-hungry, heartless technicians needs to be balanced by truthful self-report of the hard decisions and economic realities we have faced in order to continue the practice of medicine. These are the gaps I plan to fill in with Rural Doctoring, which will be concerned with everyday medical practice as it reflects national policy, personal preferences, and social change.
Please feel free to contact me at ruraldoctoring@gmail.com, or to comment on this blog wherever you feel inspired to do so.
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