From Residency to Retirement

Book excerpt: From Residency to Retirement tells the stories of twenty American doctors over the last half century, which saw a period of continuous, turbulent, and transformative changes to the U.S. health care system. The cohort’s experiences are reflective of the generation of physicians who came of age as presidents Carter and Reagan began to focus on costs and benefits of health services. Mizrahi observed and interviewed these physicians in six timeframes ending in 2016. Beginning with medical school in the mid-1970s, these physicians reveal the myriad fluctuations and uncertainties in their professional practice, working conditions, collegial relationships, and patient interactions. In their own words, they provide a “view from the front lines” both in academic and community settings. They disclose the satisfactions and strains in coping with macro policies enacted by government and insurance companies over their career trajectory. They describe their residency in internal medicine in a large southern urban medical center as a “siege mentality” which lessened as they began their careers, in Getting Rid of Patients, the title of Mizrahi’s first book (1986). As these doctors moved on in their professional lives more of their experiences were discussed in terms of dissatisfaction with financial remuneration, emotional gratification, and intellectual fulfillment. Such moments of career frustration, however, were also interspersed with moments of satisfaction at different stages of their medical careers. Particularly revealing was whether they were optimistic about the future at each stage of their career and whether they would recommend a medical career to their children. Mizrahi's subjects also divulge their private feelings of disillusionment and fear of failure given the malpractice epidemic and lawsuits threatened or actually brought against so many doctors. Mizrahi’s work, covering almost fifty years, provides rarely viewed insights into the lives of physicians over a professional life span.