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My parents don’t think I’m smart enough for family medicine: One medical student's story

My parents don’t think I’m smart enough for family medicine: One medical student's story

I’m not sure why my parents were surprised when I told them that I was applying to go into family medicine. It seemed like a logical transition after spending six years working in public health and primary care before medical school, but from the perspective of Taiwanese immigrant parents, I couldn’t have made a more absurd career choice. I was confronted with comments such as, “Most people choose careers to make money – why aren’t you?” Even more jolting was when they asked, “Why are you throwing away years of hard work and accomplishments?” I was flabbergasted by the line of questioning, but they’re my parents, so I had to answer the fundamental question – why family medicine?

For me, the answer is simple: I went into medicine to improve the health of my community and our society, and when I think about the most pressing health issues facing our nation, it’s preventable lifestyle disease. According to the Centers for Disease Control and Prevention, more than 75 percent of our health-care costs and 7/10 of deaths stem from chronic diseases that are largely preventable.

The potential for primary care to fix our society’s biggest health-care problem and to have a real impact on overall population health is why I’m choosing to go into this field

As a medical profession, we’ve largely been unsuccessful at getting people to engage in healthy behaviors. Luckily that’s where family medicine doctors are uniquely positioned to succeed. For one, the family physician has the breadth of training to serve everyone in a community, and in doing so, can influence community behavior as a whole. This approach is vitally important since lifestyle choices are never made in the clinic; they’re made in communities based on social norms set by families and peers.

Second, as I’ve learned through my own journey of overcoming obesity by losing 40 pounds in the past year, so much of one’s ability to implement healthy lifestyles hinges on one’s sense of self-efficacy. Again, that’s where the family physician comes in. A family physician has the benefit of deep interpersonal relationships developed through continuity of care to more effectively cheerlead and coach a patient to success. If executed correctly, family medicine has the potential to succeed in promoting healthy lifestyles, improving community health, and actually preventing disease in ways we haven’t been able to before.

The potential for primary care to fix our society’s biggest health-care problem and to have a real impact on overall population health is why I’m choosing to go into this field. Increasingly, policy makers are turning towards primary care to fix a health-care system that’s becoming more expensive than we as a society can afford. As that happens, I want to be at the front lines leading the charge and developing impactful solutions.

When I told my parents this, their response was, “There are already a lot of smart people who trying to fix this problem and unable to find an answer – so what makes you think you can?” In essence, they don’t think I’m smart enough for family medicine. The problem that primary care has been charged to solve is so big that my parents don’t think I can do it.

Maybe my parents are right, but that won’t stop me from trying. Ignoring the issue doesn’t make it any less urgent. To communicate this to my parents, I responded with a Chinese proverb they taught me long ago, “Plugging up your ears so you don’t hear the fire alarm doesn’t mean there isn’t a fire.”

Raymond Tsai is a fourth-year Stanford medical student who is going into family medicine. (He finds out tomorrow, on Match Day, where he will be doing his residency next year.) He chronicles his journey to adopt a healthy lifestyle on his personal blog.

24 Responses to “ My parents don’t think I’m smart enough for family medicine: One medical student's story ”

  1. KT Park Says:

    Nice piece Raymond! Good luck on Match Day tomorrow

  2. My Blue Dots Says:

    Raymond, I applaud you for doing what you want. We need more people like you to step and make a difference. Good luck tomorrow on your Match Day.

    My Blue Dots

  3. ES Says:

    Celebrating getting the wax out of all our ears, and joining together in the creative orchestra poised to make a difference. You are destined to do great things, Raymond. Fabulous piece.

  4. Viviana Martinez-Bianchi Says:

    Wonderful thoughts! I am looking forward to seeing your work from this side of the country. You will be a strong member of the Family Medicine Revolution!

  5. Jenny Says:

    Good luck tomorrow! I’m a third year medical student at UC Davis and will be going into family medicine as well. This blog was posted on my facebook newsfeed by a fellow medical student AND an Asian American sociology professor at CSULB. Totally unrelated people. That makes you kinds famous.

  6. Erika Says:

    This is wonderful Raymond! Saludos desde Guatemala! We miss you guys!

  7. California Academy of Family Physicians Says:

    Wonderful article to complement what is sure to be a GREAT Match Day for family medicine!

    We’re thrilled to have you as a family physician Raymond!

    Best of luck to everyone matching today.

    Callie Langton
    Director of Workforce Policy
    California Academy of Family Physicians

  8. Patrick Dowling MD Says:

    We are most pleased that we learned this morning that Raymond, as well as another Stanford classmate, will be joining us at UCLA in July. We have huge problems with respect to the provision of high quality affordable health care in LA and we welcome people willing to think outside the box like Raymond !

    Patrick Dowling MD,MPH
    Professor and Chair
    UCLA Dept of Family Medicine

  9. Bernie Cole Says:

    As a physician recruiter, I appreciate your dedication to healthcare and humanity. All I hear is “the looming physician shortage”!!

  10. Edwin Kwon Says:

    Raymond,

    Love that I’ll get to work with you at UCLA. Congratulations on matching there!

    Edwin

  11. David Voran Says:

    Raymond,

    Carry on. I can tell you as technology continues to advance and reimbursement mechanisms change the tide will turn and primary care is going to be the most rewarding area of medicine to be in.

    Lately we’ve realized that the more technology and touch we can put in the primary care office the more profitable we are (we’re involved in 2 ACO’s). The specialists are the ones who are now realizing they are a cost center, not a revenue center and that’s leaving them with some pretty wide eyes looking into the future.

  12. Laura Eli's de la Torre MD Says:

    Good for you and welcome to the greatest profession in the world!

  13. Wendy Biggs, MD Says:

    Raymond,
    Thank you for your story…you will be our standard bearer! Patients know the value of a personal physician, and your parents will eventually be THRILLED when you can answer ALL their medical questions. I know you will have a rewarding career. Family medicine is lucky to have you.

    Wendy Biggs, MD
    Deputy Director
    American Academy of Family Physicians

  14. Margareta Troein Töllborn Says:

    Welcome to family medicine, a great area for a physician, worldwide!
    Margareta Troein Töllborn
    MD, Professor, Family Medicine
    Lund University, Sweden

  15. Grant Hoekzema Says:

    Raymond, Thank you for being bold and sticking with your convictions. Unfortuntely, it is not your parents that we must convince the most – it is the medical schools and the priorities they set that impede us most. However, we must do our part as a discipline to show the country that we not only need the best and brightest in Family Medicine, but that we will put those minds to good use with a rigorous, scholarly, discipline that also cares for people!
    Your generation will help us to do just that.
    Grant Hoekzema, MD
    President, Assoc of Family Medicine Residency Directors.
    Mercy Hospital – St. Louis, MO

  16. paula krauser Says:

    I am an aging hippie family doc who is thrilled that folks like you are picking up the banner that I am getting too tired to carry any more. I have never been bored a day in this wonderful career. I am appreciated by patients if not by the “powers that be”. See “Escaping Fire” on PBS to continue your metaphor. Very frustrating to see the solutions when no one in power will hear. Be patient, enjoy the work, and good luck…

  17. paula krauser Says:

    Apologies: Escaping Fire was on CNN

  18. Cliff Says:

    Good job Raymond!

  19. Bill Fowkes Says:

    Raymond!
    Glad to see you going against the grain. Your folks don’t think you are smart enough to be a family doc while most of the Stanford faculty have the opposite opinion. It is a wonderful calling and ENJOY!
    “The old guy”

  20. Future of Family Medicine Blog Says:

    Raymond,

    Thank you for spreading the influence and power of Family Medicine to the Stanford community. We hope that you and your primary care colleagues set an example to prove the Dean’s Lie wrong.

    We would love for you to join our crew over at the Future of Family Medicine Blog.

    http://futureoffamilymedicine.blogspot.com

    Welcome to the Family Medicine Revolution. #FMRevolution

  21. Eric Bouwens, MD Says:

    Many years ago when I was as medical student, I started to receive the same reaction, “Who could b smart enough to go into family medicine”. But these were the same residents or faculty who had a condescending attitude towards the “local MD” who had just sent the obviously mismanaged patient to the tertiary care center. I soon began to realize that this comment was actually code for saying, family physicians couldn’t possibly know what they are doing….. and they don’t. 25 years later, I can still say, I would not have chosen any other field.

  22. Richard Ahlfeld Says:

    As an older patient and medical provider I am a bit dismayed to pick up the not-so veiled enmity in some posts re the “war” between specialists and generalists. This should be a smooth and seamless joining of both groups talents and abilities. The Family physician is the front line but they cannot know or manage everything, in my experience it has usually been important for both groups to work closely for the best patient care,however, I have encountered the condescending specialist, they usually aren’t the best, just the biggest ego.
    My family physician still remains the doctor who knows the most…about me.
    Good luck in your practice

  23. CalBear8 Says:

    Wow, I really enjoyed reading this short but sweet article. You conveyed your message across very clearly. I think it’s actually sad that people are going into medicine for the wrong reasons or simply pursuing it because their parents want them to do so. I’m really glad that you have the resilience to promote what healthcare and medicine is really about. Good luck in your future endeavors!

  24. RPhtoMD Says:

    Just came accross this blog…as a second year family medicine resident in Canada, where family physicians are the gatekeepers of health and on the front lines, I to recall the questions of “Why u can do so much more”, and this was from staff from various disciplines during clerkship. But happily I have love my training so far and think of no other place to be.

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