Saying Goodbye

by Joe Novak, MD

A huge paradigm shift when transitioning from medical school to residency (especially residency in a primary care specialty) is being assigned a patient panel. In medical school, I only saw patients who “belonged” to another provider. If we ordered labs or images, I almost never saw the results. I never received messages from patients asking questions. Only rarely does a medical student see the same patient twice.

In residency, I was assigned a group of patients who are “mine” – if they have a question, it comes to my inbox. I decide what to do with their results. As much as possible, I schedule them follow-up appointments with me.

Over the course of 3 years, I have seen my patients go through ups and downs. Some have gotten married or divorced, some have died or had children, some have recovered from illnesses while others have developed new ones. I have started to see their emails with medical questions as (in the words of one of my role models) “messages from friends”.

But, as I approach the end of residency, I have had to start telling patients goodbye.

Depending on the patient, this conversation has a wide range of impacts. There is a frustration (shared, I’m guessing) when I have recently met a patient and we have just started the process of figuring what is causing a particular symptom of theirs. I know that I won’t be the one to see the test results or plan the next steps of their treatment.

Some patients have been on my panel for almost 3 years. We spend a portion of the visit talking about their medical concerns, but often chat more about our lives or the state of the world. I will be sad to no longer hear their stories, and to not be available to help with their health concerns.

A major motivation for people choosing family medicine as a career is this continuity with their patients. I aspire to be like one of my attendings, now in practice for a period of time measured in decades, who can tell you an anecdote or back story about almost every one of his patients, and how that contextualizes their health. 

Overall, I am glad that we get the opportunity to follow along with our patients in this way, but it makes the end of residency more bitter than sweet.

Dr. Novak is from Saint Louis Park, MN. He completed his undergraduate education at Luther College before going to the University of Minnesota for his medical degree. His medical interests include medical education, behavioral health, inpatient medicine, quality improvement, and preventative medicine. In his free time, he enjoys mountain biking, rock climbing, skiing, cooking (especially baking bread), playing piano and guitar, and reading. He chose the University of Utah because it is a community-based program with university resources that allow its residents to shape their experience to be perfect for them. Also, it has wonderful faculty and residents, and is located in a beautiful part of the country!

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s