Physicians are privileged to see patients at their most vulnerable, to reshape lives and continually revitalize the nation’s health system. In a challenging practice environment, physicians remain driven by the power of healing and the indelible connections they form with patients and families.

The AMA Wire® “When I Knew Medicine Was My Calling” series profiles a wide variety of doctors, offering a glimpse into the lives of the busy women and men navigating new courses in their careers and in American medicine. No matter their age, their specialty or their career stage, they were born to do this and they tell us why.

Share a moment with: David O. Barbe, MD, MHA, a family physician from Mountain Grove, Missouri, and the AMA’s 172nd president.

The moment I knew medicine was my calling: My life just flows, so it’s hard for me to pick out monumental moments in my career that changed my course. I felt the calling to be a physician early in college. The opportunity to help people understand their own health and how to take care of themselves is what turned me to medicine. The AMA’s initiatives around reducing the burden of chronic diseases such as diabetes and high blood pressure are a great resource for both my patients and me.

My source of inspiration: There is more required of us now than just being great clinicians. Physicians must now be knowledgeable in topics such as team based care, population health, value based care, health information technology, and health system economics.  I’m eager to use the AMA’s resources around “health system science” to help students, residents and physicians gain this knowledge.

Hope for the future of medicine: I want to see us restore the joy to practice. Medicine is an amazing profession and the fact that the luster has been lost for so many physicians is a real tragedy. We have to get that back. I am eager to advocate for improvements in EHRs, reduction of regulatory burdens and the mountains of paperwork that divert us from direct care of our patients and lead to high levels of dissatisfaction.  The AMA’s work to create a better practice environment is one part of the antidote for burnout.

The hardest moments in medicine and how I get past them: The hardest days for me—and for most physicians—is when a patient dies under our care. We always question ourselves and wonder if there was something else we could have done. A young man died of pneumonia under my care and that was the single worst day of my career. I had the support of my physician colleagues who understood how I felt and how it had impacted me. They affirmed my decisions and my care. Professional support and collegiality is essential.

The most challenging aspect of life in medicine: Burnout is causing a breakdown of collegiality and vice versa. The physicians’ lounge at the hospital and the clinic breakroom were touchpoints for doctors. We have to find new ways to interact with our colleagues. We need to rebuild this collegiality. Especially for small and rural practices, isolation is an issue. We know from our statistics that a lot of doctors are still in small groups. We have to leverage technology to keep the profession connected.

The AMA is already working on ways to do that. The most obvious first step is drawing attention to the need and being there to help suggest ways that doctors can stay connected. That goes all the way from the local societies to every level of the Federation of Medicine. Those local and state societies are the grassroots of physician organizations, but they can’t do for doctors all they need to without the resources and support of the AMA.

A quick insight I would give students who are considering medicine: Whenever I speak to young people, I first tell them how wonderful it is to be a physician and how great an impact they can have on their patients and society. Then I talk to them about how to get involved and become a leader.  

First, “show up.” As Woody Allen said, “Eighty percent of success is showing up.” Go to the meetings. Find the action. Second, “step up.” Take some responsibilities. Volunteer. Being a good servant is a prerequisite to being a good leader. You serve your organization through participation in committees, workgroups and so on. If you do that well and faithfully, others will identify your qualities as those they want to lift up. You don’t have to pursue leadership; it pursues you. If you are a servant leader, you will get more responsibility from your peers.

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