What Doctors Do

How doctors spend their time depends on what type of physician they are and where they work. Some doctors work in hospitals, some work in offices, and some work in laboratories. Many work very long hours, from the early morning until well after dark. Others keep regular daytime office hours. In fact, the only thing that all doctors have in common is that no two days are ever exactly the same.

The Children’s Doctor

Dr. Burrows is in her third year of pediatric residency at the University of Michigan (U of M) Health System. She works six days per week, and one or two nights, at the hospital. A typical day at work begins at about 6:30 a.m. First, Dr. Burrows meets with the night shift doctors to find out what happened the night before. During her shift, she typically sees about fifteen to twenty patients per day. She visits with children and teenagers who suffer from such illnesses as asthma, pneumonia, and skin infections as well as a variety of other ailments. She also sees patients with different types of cancer and other life-threatening diseases. Since parents often have concerns about their children, she spends time meeting with them to answer any questions they may have.

In addition to working at the hospital, Dr. Burrows works one or two half-days per week at the U of M pediatric clinic. She explains how this differs from her work at the hospital:

The kids who come into the clinic are there for more routine medical reasons, such as physicals and checkups. For instance, today at the clinic I saw two kids who had coughs, two with eye infections, one who was having a behavioral problem at school, a newborn baby who needed a six-week exam, and a boy who wanted a wart removed. This is very different from the hospital, where the patients I see are more seriously ill.[4]

Helping Patients Relax

Dr. Burrows says that one of the things she enjoys most about working in pediatrics, both in the hospital and the clinic, is the relaxed atmosphere. She explains why this is important:

Children are scared when they come to see a doctor, and it’s our job to help them relax. That’s why doctors who work in pediatrics tend to be more laid back than doctors in other areas. We can’t just start examining these kids without first making them feel comfortable with us. We need to gain their trust, to help them understand that it’s going to be okay, that we’re there to help them, not hurt them. That’s why we rarely wear white coats, and the guys wear ties with cartoon characters on them. We all have goofy animals hanging off our stethoscopes, and we aren’t afraid to get down on the floor and play with the kids. It’s a way of helping them not be afraid. That is so important.[5]

Caring for Families

Like pediatricians, family practice doctors spend their days seeing patients. However, their patients are not just children. Family practice doctors care for people of all different ages. Dr. James Cooke is a family practice doctor who finished his residency in 2000. He works in a medical practice along with several other physicians in Chelsea, Michigan.

Dr. Cooke typically gets to work about 7:00 a.m. each day. The first thing he does is check his e-mail, because patients often send questions to him. He responds to them and then starts seeing patients. Between 8:00 a.m. and 5:00 p.m. he sees an average of twenty-five to thirty patients. People of all ages come to see him for many different reasons. For instance, parents bring their children in for physicals or because they are sick with sinus infections, ear infections, or the flu. Older adults come in with illnesses such as heart disease, diabetes, or high cholesterol. Pregnant women come in for regular prenatal visits and then later bring their babies in for checkups and vaccinations. Dr. Cooke spends time with these patients, examines them, and sometimes prescribes medicine or other treatments. Also, he performs minor surgeries in his office, such as freezing off warts, taking off bad toenails, or removing moles.

Working in Hospitals

In addition to seeing patients in his office, Dr. Cooke also works in the hospital about six weeks out of the year. Plus, if one of his pregnant patients goes into labor, he may be called at any time of the day or night to deliver a baby.

Another aspect of Dr. Cooke’s job is providing supervision to residents. He says he enjoys the teaching part of his job as much as he enjoys working with patients: “There are many reasons why I love being a doctor. I can help a lot of people, and taking care of patients is rewarding. But I also get a lot of satisfaction in helping new residents learn to be better doctors. At the end of each day, I feel good about the work I do.”⁶

Life of a Surgeon

A surgeon’s job is quite different from that of a family practice doctor. Surgeons spend most of their time in hospitals, where they check on patients, meet with families, and perform surgery. Dr. Robert Shack works for a major hospital in New Jersey, and he has been a surgeon for twenty-six years. He is blunt when he describes what surgery is all about: “There is no such thing as a casual or routine surgery. If you think that, and a problem comes along, you are going to wish you were in another specialty very quickly. Every case is unique and different… Surgery involves discipline. It does not matter if you had an argument with your wife or a tough night before, you are obligated to provide a professional product for your patient, and good doctors do.”⁷

On one particular day, Dr. Shack performed operations on three patients. At 7:30 a.m. he performed gallbladder surgery on a female patient. At 10:30 a.m. he performed a mastectomy (breast removal) on a woman with breast cancer. At 12:30 p.m. he performed surgery on a man to repair a hernia. This was a complicated operation that took a long time to complete. In between and after the surgeries he reviewed laboratory reports, talked with patients and their families, and consulted with other physicians.

According to Dr. Shack, being a surgeon can be stressful. Even the best surgeons have a tough time if they run into complications during surgery. If that happens, or if things go wrong, they must be able to learn from the experience. In spite of the difficulties of the profession, Dr. Shack finds being a surgeon to be extremely gratifying.

The Role of the Anesthesiologist

Surgery is one area of medicine that requires different kinds of doctors to work together. During surgery, anesthesiologists play an important role. They provide pain relief and care to patients before, during, and after operations.

Doctors use different types of anesthesia based on what surgery patients are having. In some cases, anesthesiologists give an injection that deadens the nerves in just one area. Other times, patients need to be completely anesthetized—unconscious and unaware of pain. They receive this type of anesthetic either by breathing it through a mask or by an injection. Once a patient is asleep, the anesthesiologist controls the flow of air to the patient’s lungs. For this reason the anesthesiologist must stay close by during surgery. He or she watches the patient’s vital signs including blood pressure, heart rate, breathing, and temperature all through surgery. After surgery the patient is taken to a recovery room. In most cases, anesthesiologists determine when the anesthetic has worn off and patients are able to leave the recovery room.

No two doctors do exactly the same thing. In fact, if five doctors are asked to describe what they do from day to day, they will give five different answers. Yet, no matter how their work and tasks may differ, doctors’ days are often long, and their work is often intense.

⁴ Burrows, interview with author.

⁵ Burrows, interview with author.

⁶ Dr. James Cooke, interview with author, September 26, 2002.

⁷ Quoted in Beth Salamon, “A Day in the Life of a Surgeon,” Family Health. Saint Barnabas Health Care System, Spring/Summer 2001.