I answer every phone call from every patient myself. I have no staff to respond to issues that come up during the day. There are no colleagues that take my calls after hours. This was my choice in response to what everyone knows: Health care is broken.  I needed a radical change from the bureaucratic system that I experienced daily as a physician however I had no idea how to fix it. I felt helpless.

As a child and adolescent psychiatrist, I spent the first decade of my career working in academia and non-profit settings. Here, I felt that my contribution would be the greatest by providing care to those who were least likely to receive the help they needed. To some extent this was true. I was touched and inspired by the lives of the children and families I worked with. I was motivated by the changes I perceived in lives previously marked by the struggle and frustration of poorly understood and inadequately addressed mental illness or life challenges.

However, as the mounting demands of these systems led to significant increases in patient volume (with limited visit time), encounter goals, and administrative demands, I felt suffocated.  It felt impossible to provide the care my patients desperately needed with shrinking resources in the face of these unending demands. So I quit.

I didn’t quit my job because I envisioned a perfect career path. I didn’t quit because I had a magical solution to the mess that health care has become. I felt powerless and ineffective. I was simply frustrated, disillusioned and, worst of all, I was numb to my clinical work. I looked at my colleagues’ work lives and saw anger, burnout, and resignation. I saw innovative and impassioned physicians who were once excited to heal, now tired and disillusioned. Most of us who have chosen medicine, started our journeys with the dream of helping others through our specialized knowledge of illness, disease, and healing. We imagined a career where we could partner with our patients to find health and wellness in their lives. We didn’t foresee workdays of endless paperwork, negotiating access to care and justifying our medical care to non-medical managerial personnel.

For a while, I struggled to find a place in medicine, the only life path I’ve ever known. I couldn’t see through the brokenness to a place where I could become the physician that my patients deserved. I contemplated stopping clinical practice.  After all, how could I expect to heal anyone else’s dysfunction, when I was stuck in my own? Except, my inner voice told me patient care was at the core of who I am and that I must own my role, like every physician in healing health care.

So now I am a solo physician in a small practice answering my phone and scheduling my patients.  My relationship with my patients is once again the center of my work. I believe that if physicians can focus on connecting with patients, we can bring meaningful improvement to the physician-patient relationship. Patient health outcomes are better. Physician job satisfaction and well-being improve. Health care can actually start to heal. Physicians don’t connect with encounters. We treat and connect with the people who are our patients.

This is my story. I realize that many of us practice in settings where there are always charts to complete, patients are double-booked, and there is a basket of messages to address. However, at the core of health care is the physician-patient relationship.  This is what motivated most to undergo the long path to become a physician.  Our first step towards reclaiming medicine is for we physicians to be more intentional about how we connect with our patients. Every physicians’ daily practice allows for countless moments to connect with the people who have entrusted their health and well-being to us. We can take the time to sit down when we talk to our patients, allow them to talk for a couple of minutes before we start questioning them or asking something about something other than “So, what brings you in today?” For me, healing health care simply starts here, just between me and my patient.

Tracy Asamoah is a child and adolescent psychiatrist.

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