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'It's Very Rewarding:' A Q&A with Dr. Meadows About the Primary Care Experience

Decades into practicing Family Medicine, Kadlec chief medical officer shares why he'd do it all over again.

With the growing shortage of physicians and high levels of burnout in healthcare, clinicians may wonder: Is a career in Primary Care worth it?

PS&D sat down for a conversation with Dr. Rich Meadows, a Family Medicine physician and Chief Medical Officer with decades of experience, to better understand the benefits and challenges of being a Primary Care physician in today's rapidly evolving healthcare landscape.

In a full-circle moment, PS&D recruited Dr. Meadows for a role at Kadlec Medical Group in 2014. Within a year, he was promoted to Chief Quality Officer. Now Chief Medical Officer, he works with PS&D to hire clinicians for Kadlec, the leading health system in Tri-Cities, Washington.

He says he has truly loved his career so far as a Primary Care physician.

"I think Primary Care is such a unique opportunity for someone who enjoys science, enjoys being around people and being a social person and wants to be able to walk away at the end of every single day and feel like you did something good," Dr. Meadows says. "You helped somebody, and you can be proud of what you did. There aren't a lot of jobs that give you the opportunity to combine all those things into a single role every single day and be paid well for it."

Learn why he feels those considering or working in Primary Care will continue to build rich and satisfying careers, well into the future.

PS&D: What makes a good Primary Care doctor? What attributes are you looking for when you interview candidates?

Dr. Meadows: The desire to have that long-lasting personal relationship with your patients. Healthcare has this propensity to become transactional, which makes it kind of a job, but most anyone who goes into healthcare doesn't do it for the job. They do it because it's their calling and they're passionate about it.

You need to be really committed to wanting that relationship, and candidates should be offering that up in interviews. It's not a question I ask, but if they don't offer it up, that's a bit of a red flag and makes me wonder, "Is this going to be somebody who really fits here?"

Ironically, because Primary Care providers (PCPs) are usually so committed to their patients, sometimes that actually keeps them from making their lives easier and more efficient. There are always going to be things that someone else could do, but when you've cultivated a relationship and feel a deep responsibility for your patient, it can be hard to delegate the little things.

That is absolutely contributing to physician burnout, especially in Primary Care. On top of the responsibility PCPs feel to be the person who answers every MyChart question or takes every call, there is just too much volume for that to be sustainable. The pandemic changed how people interacted with their healthcare providers, and many patients now expect direct access. It's a patient satisfaction thing now. I think the key is for PCPs to lean into help where it's offered and be open to learning new systems, like the AI we are seeing more of now, which can alleviate some of that administrative burden.

One other big thing is you need to have a certain degree of comfort with not knowing everything because you're not a specialist. You're not going to go as deep into things, and so you need to be comfortable with knowing a fair amount but not everything, and you also need to know your limits and when you need to refer and when you can handle it on your own.

Lastly, you have to be comfortable with psychosocial issues and care because a lot of that need is met by PCPs. Primary Care recognizes that people's habits, what's going on at home and other social barriers can get in the way of them complying with a treatment program, and so having a partnership to address those things is a big part of the role. A lot of specialists see their job as a technical knowledge – telling people what to do, prescribing the right things, doing the right procedures – but the psychosocial aspects are often up to the PCP.

Have you enjoyed your career as a Family Medicine physician?

Unequivocally, yes. I have enjoyed my career, and if I thought there wasn't a need for my presence in this leadership role, I would be perfectly happy going back to 100% patient care because I do really enjoy the role.

What I enjoy most is the long-term relationships with the patients; figuring stuff out together and getting to share in the successes when patients have them. You get to live vicariously through their wins, just like teachers get to enjoy the success of their students.

I have also learned so much about so many different careers from my patients. After you know them for a while, you end up learning the things they have to do in their jobs, or the things they get to do in their jobs, depending on their perspective on it. And I just find that absolutely fascinating.

Are Primary Care doctors happy?

I think the majority of Primary Care doctors are happy. It's important to acknowledge that everybody has bad days in every specialty and every profession, and there will always be some people who are unhappy in the roles they've taken. But I think by and large, Primary Care providers are happy, and I think people can be happy and still have some aspects of burnout. People will have pieces they don't love, but they can still be happy with their career choice, and they would still choose to do Primary Care if given the choice again. I know I would. It's been very rewarding.

And one thing I think that's been helping is there's so much work being done on how we can work together to take some of the burden off our physicians, whether it's adding social workers, pharmacists, care management nurses, direct care nurses, behavioral health specialists or others to care teams. And most of that effort is focused on supporting Primary Care providers.

What are some of the benefits of being a Primary Care physician? Why go into Primary Care?

Something that is important in Primary Care, and this is probably one of the big reasons why people seek it, is that Primary Care physicians want to have their nights and weekends for family time. They may still end up taking work home, but at least they're home with their families, whereas a lot of other specialties have hospital calls and other aspects of the job that take you away from your family and off-site.

I don't think there will ever be a time when a Primary Care provider is going to be paid like a surgeon or medical subspecialist who does a lot of procedures. Those people are working holidays and nights and spending more time away from their families. I do think efforts are being made, particularly in the government, to create a more level playing field when it comes to physician compensation in Primary Care versus specialties. They've started working on those things, but there is still work to be done.

Another benefit is Primary Care is not just transactional work. You know these people, and they know you. And some of the stuff you're going to talk about in visits isn't even going to be about medicine, it's going to be what's going on in their life that they want to share with you. When I see patients, many of them ask me about my kids or my wife. There's part of it that's just social and fun and doesn't have to be focused on the medicine, which feels like a relationship as opposed to a service.

There's also value in not being the last stop on the train for patients. You don't need to know how to handle every single thing. You can try to figure it out, and if you can't, you can always refer patients to specialists, and then it's their challenge to figure it out.

Lastly, if you go into Primary Care, you get to live anywhere you want, rural or urban. Primary Care is needed in the entire country, and it doesn't matter if it's a teeny little town or a huge city, unlike specialists who need a big enough area to justify their role.

What is a current day in the life of a Primary Care physician like, and do you feel like it's changed over the years?

It's pretty busy. You're going to see somewhere between 15 and 30 patients a day. Some of those people are going to be new and you don't know them, and you may need more time with them. Some of them are going to be people you've known forever, and it's pretty quick as long as they don't have big, bad things going on.

You'll probably spend 50% of your day seeing patients, and the other 50% of your day is going to be filled with administrative work, things like finishing documentation for the patients you did see, doing refills, answering MyChart questions, answering phone calls, looking at specialist notes, helping your staff with filling out paperwork and all the other things insurance companies throw at you.

Since the beginning of my career, things have definitely changed. There are so many more government and insurance regulations and requirements. It's just what healthcare in the United States is now. There are so many other things that have been thrown onto the plates of providers, all with good intentions behind patient safety and saving money, but they are contributing to the widespread burnout we see.

We've seen a shift in Primary Care over the years from physicians to NPs and PAs. Have you noticed the same at Kadlec?

We've all known the physician shortage is real, and COVID really sped that up. We had more people who dropped out of the workforce or direct patient care. The supply and demand curves have finally hit a point where if you're going to provide care and there's going to be enough clinicians to take care of patients, a big percentage of that is going to come from nurse practitioners, physician assistants, midwives and others to help address that demand.

If you could go back in time and talk to your younger self, just launching your career in Primary Care, what would you tell yourself?

The first thing I would tell my younger self is when you are in medical school and residency, just eat up every single learning experience you have and don't ever be afraid to do something because you think you might fail. Because you never know when you're going to get those learning opportunities again.

I'd also say that however busy you decide to make yourself at the beginning of your career, that is likely going to stick. Those decisions you make around work-life balance are probably going to stay with you. So set good boundaries and develop good habits early on!

Finally, ask for feedback from other clinicians, nurses, medical assistants, front office staff, your manager or whoever. You will get much better advice and so much more honest advice that will help you in your career if you ask for feedback instead of waiting for somebody else to give it.

We hear you were hired by PS&D, by Tracie Klander, in 2014! Can you tell us that story, just briefly?

Prior to starting at Kadlec, my wife, who is a nurse practitioner, and I lived and worked in Port Townsend, Washington. We knew we wanted to both remain employed in healthcare and were looking to relocate, but we didn't know exactly where we wanted to go when we left. We had some things on our list we wanted to make sure were there, both in the community and in the job.

One of my med school buddies was here in the Tri-Cities and that got us interested in being here, too. We reached out and applied to a couple open roles at Kadlec and connected with Tracie. From that point on, she was our contact and took care of everything. Tracie helped both my wife and me find the right roles within the same health system. She really got to know us and advocated for us, and she walked us through every step in the process. She made us feel cared for the whole time, which is something she still does for Kadlec candidates today.

Can you talk about the value that PS&D brings you now, as Chief Medical Officer, to hire the providers you need?

I got into a leadership position less than a year after starting here, and so my relationship with Tracie quickly transitioned, and now I work with her to get other people hired here. I've pretty much been in touch with Tracie every single week for most of my time here.

One of the things that Tracie does, she puts people together. She could be recruiting for one specialty and have an applicant and because of their story, she already knows who that candidate would get along with that she recruited years ago. Even if they're not in the same specialty, she makes connections for those people and makes it feel like they're going to come and have a community right off the bat, which is huge.

How PS&D Can Help You in Your Primary Care Career

At Provider Solutions & Development, we specialize in Primary Care roles, hiring Family Medicine and Internal Medicine physicians as well as nurse practitioners and physician assistants into jobs across the country.

Founded and owned by Providence, we recruit for hundreds of jobs within its seven-state footprint, in addition to Primary Care and Urgent Care roles for more than 40 other partners. We've helped thousands of providers find their next Primary Care opportunity.

Are you looking for your next Primary Care job opportunity? We can help you find the right fit the first time, at every stage of your career. Reach out today to get started.

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