Editor’s Note: The concepts of “solo” and “solitary” are worth considering as a career path is being chosen.
The solo part:
When I was growing up, I was always a first; first girl to play Little League, first 6th grader to play in the high school band, first woman admitted to my residency program, one of the first women to do a fellowship in my newly recognized subspecialty, the first woman admitted to a prestigious male-dominated subspecialty society and one of the first female presidents of a state orthopaedic society.
When I finished my training, I wrote letters to inquire about job opportunities in the area of my geographic preference. I got no responses so apparently, no one was interested in hiring a woman. So, I chose to establish a solo private practice. In my new practice setting, I was responsible for everything, including the business end of things and hands-on patient care. This style of practice was wonderfully gratifying but also very isolating. I had a family but needed to work most days to sustain my successful practice. As an example, when I had breast cancer, I took only one day off from work for radiation because “it is what you do when you are solo.”
Solitary:
Being in solo practice left me little time for a social life beyond my family and mandatory professional activities. I was not only perfecting my orthopaedic skill set but was also learning the ever-changing landscape of medical business management and financing. Interestingly, Dr. Ruth Jackson, the first board certified female orthopaedic surgeon, also ran her own private practice. It’s a solitary endeavor.
Another solitary piece of my career was attending professional meetings. I was a woman among the overwhelmingly male membership in the early years. I was largely dismissed and gradually became more comfortable with this reality. Later, it moderated as I became better known and more women became part of the membership.
I have a non-traditional family. As a gay woman, I feared being “out” in residency. In the past, my chosen life was poorly understood by my more conservative male colleagues, so it was best to simply “delete that part of myself in the workplace.” When our child was born, I was chief resident. I told my colleagues I had to leave work so I could act as a “labor coach” rather than as a parent participating in our child’s birth. Solitary again.
As I look back on my career, I can truthfully say I did and currently love what I do. When I leave the OR after a challenging case, I mentally say “yes!” This is it; this is what I love. I get an adrenaline rush and remember how grateful I am for my chosen profession.
I also really care for my patients, and they appear to care a great deal about me. I give them part of my heart and can choose the amount of time I spend with them. I have been on call every day for my own patients throughout my years in practice. This is what solo practice requires. It is a solitary responsibility. Thankfully, I can go months without an after-hours call. I believe this is a product of my patients being well educated about their conditions and trusting that I will be there in their times of need so there is no need for panic.
What has my story taught me? Early on in my career, I had a choice of how to practice and I feel I got it right. I have been able to innovate, operate, take extra time with a patient when needed, and discuss aspects of patients’ lives that may affect their treatment outcomes. Through this approach, I have gotten to know my patients and have developed some wonderful long-term relationships.
What can this account teach others? If you choose a solo and solitary style of practice, you must have a plan for maintaining your joy in living. For me, joy comes from doing what I love and the freedom to organize how I do it. In addition, having the support and love of my wife and kids is essential. We all have 2 lives, one professional and one private. Each is necessary for sustenance.
Finally, my advice to others:
-
Don’t work all the time. Build in the opportunity to get away and have some fun.
-
Join your state orthopaedic society no matter what practice type you are involved in. There is way less competition for notoriety or service opportunities there. The society can offer education on how to run a practice or what you can/should ask for as an employed surgeon. It introduces you to colleagues from around your state and can offer an opportunity for leadership when you are ready. Leadership allows you to influence the “culture” you practice in. The society also can be a means of meeting students and residents who may be looking for mentors.
-
Find what you love and control how it’s done.
-
If you can carve out time to develop and nurture friendships, do it.