I Am Not Primary Care: A Surgical Intern's Take
It’s higher numbers of primary care doctors in a community — not surgeons — that correlates with milder morbidity and lower rates of overall mortality.
The very first thing you learn in surgical residency — before you learn how to tie a two-handed knot, or how to give subtle side-eye to an ED doc who called for a consult, or how to stay awake for 24+ hours without complaint — is that you are not a primary care physician.
Instead, you're the decider, the intervener, the alpha and the omega. The buck stops with you. You're aggressive, decisive and definitive. You solve problems. You're a surgeon.
All of that sounds great — and works really well on TV. Some of it is probably even true. But is it good for your patients? That's a whole other and more interesting matter.
The second thing you learn in a surgical residency (besides that you're still no good at giving side-eye) is that the job is tough. You're expected to know everything and you have to handle immense amounts of pressure — gracefully.
Also, everyone's a critic. You need the self confidence inherent in seeing yourself as the alpha top dog in order to get through the day — and to get to the point where your skills actually catch up with your ego.
So you can't be faulted for your attitude. But the thing you might never learn in surgical residency is that there are other ways to better patient's lives. Even though you might not be able to see those alternative approaches immediately, in the end they might have more impact.
You see, it's higher numbers of primary care doctors in a community — not surgeons — that correlates with milder morbidity and lower rates of overall mortality caused by heart disease, hypertension and other big killers.
It's easy to see why this is so. Primary care physicians are responsible for getting people to take their medication, to quit smoking, to start exercising and, heaven forbid, to actually go see a doctor. Let's see a surgeon do any of that.
So we get it. You're a surgeon. You swoop in heroically at the critical moment and save the day and everyone applauds. You're not ordinary, everyday primary care. But when it comes down to it, who actually saves more lives?