Monday, November 21, 2011

The end of an era for me

 As 2011 draws to a close so will ten years in private practice.  As of January 1, 2012 I will no longer be with BridgeSpan Medicine in White Plains.  And I will no longer be practicing primary care for teens and young adults in Westchester.

I will be working as one of the doctors on the multi-disciplinary team of clinicians in the student health center at Barnard College in New York City.  I will be available to undergraduates for primary care, consultation and referral.  I will work side-by-side with nurse practitioners and mental health providers.  And I look forward to participating in mentoring and working with  Adolescent Medicine fellows in training.

My current patients have many options.  They can continue their primary care at BridgeSpan Medicine with Dr Brooke Balchan and her associates from Westchester Park Pediatrics, Drs. Avvocato, Ross, Wurzel and Eisenberg.  And they will be able to access specialty care via a network of fine practitioners throughout the metropolitan area.

In many ways this job is a natural progression for me from being a general pediatrician over 25 years ago when I grew somewhat expert at infants and pre-schoolers as I raised my own tots.   As they grew I was lucky enough to immerse myself in the issues of elementary school, special needs children and parenting.   Over the past fifteen years, my focus has shifted to adolescents and the concern of raising responsible, content people in our culture and how pursuing those goals can affect their health-and that of their parents.    Now as my own children are of college age and beyond, I am called to play a role in the health and well-being of  emerging adults. And how thrilling that is.  I have long thought a job in college health would be a dream for me, and now is the time.

Of course no decision like this comes lightly.  I have struggled for the past decade with the compromises I have had to make with our health care system as it has tried to grow up.  But it is a disabled patient with many handicaps and has lost its way.   As the mammoth insurance industry, unregulated and driven by bureaucracy and profit, has become the conductor of this cacaphonous symphony, the players have lost their music, lost the tune, and are struggling to play in harmony.  I am choosing to move to a smaller quartet, where I can still hear the voices of those next to me and play the classical music of healing that I was trained to deliver.

Many of my patients move in a space in my psyche in much the same way my own children do and I will miss them very much.  Parents I have come to know through tears and laughter will also be sorely missed.  And my colleagues, especially those in the mental health and education arenas, who have taught me so much about doctoring and caring, will be missed as I carry their lessons forward with me.

image from sapphirelane.com via Google

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