It was the end of my inpatient hospital shift. I’d worked many days in a row and was eager to get home. It was drizzling; I walked with determination as I scurried to my car. I passed a person walking into the hospital but didn’t pay them much attention. Several steps later I heard someone call, “Hey, are you my doctor?”

I paused and turned. “Yes! I’m your primary care doctor,” I said, smiling. I recognized the patient as one I’d seen for several years. The patient was visiting a family member who was admitted. My patient and I chatted briefly before we went our separate ways. Interactions like this are why I settled on primary care as my next career step.

After I finish residency, I’ll work as a primary care physician. That’s not where I thought I’d end up. Yet, after experiencing almost every niche in internal medicine during my residency, primary care was the best fit. I like the longitudinal relationships primary care physicians have with their patients. Over the 3 years I’ve followed my panel of patients in my primary care resident clinic, I’ve learned so much about their lives. My patients and I have achieved goals and faced challenges. I’ve seen some of my patients’ health decline with age or new illness and other patients improve their health immensely. It’s been fun growing and changing together.

In residency, we spend more than half our time working in the hospital with patients who are admitted for illness that can’t be managed at home. One thing I’ve noticed is that many hospitalizations might have been avoided if patients had appropriate access to good primary care. Working in the hospital, I save lives (literally). It’s gratifying. When I work in primary care, I can shape people’s futures in subtle and positive ways. For example, if I can help a patient prevent diabetes and control their high blood pressure, they might not have a heart attack. Maybe they’ll never develop heart failure or kidney dysfunction. Maybe they’ll never need to be admitted to the hospital. The chance to help people avoid potentially threatening, serious disease is rewarding.

There are other reasons I like primary care that are more logistical. I like working only business hours, having holidays off, and having weekends off. In residency, I’ve worked every hour of every day at some point. Obviously, I don’t work 24-7. I do, as a resident, work holidays, weekends, nights, and weekdays throughout the year. I also like that one can do primary care anywhere. It’s exciting to have a job that I could do around the world, in urban or rural communities. I contrast the geographic flexibility of primary care to some medical specialties that are so specialized that physicians in those fields must be near a large academic hospital to provide treatments and interventions that aren’t available at small hospitals and clinics. For example, oncologists (cancer doctors) often must be near larger hospitals to offer many types of chemotherapy.

About a week after my encounter with my primary care patient while walking home, I was admitting a patient to the hospital from the emergency department. The patient I was admitting was in a bed next to other beds with only a curtain between them. As I was leaving that patient’s area after examining them, I heard someone call, “Doctor Jett!” I turned around to see who had called my name. A different one of my primary care clinic patients was in the bed beside the patient I was admitting. I said “hi” and wished them well. I found myself smiling again and hoping my clinic patient would get better soon even though I wasn’t involved in their hospital care.

There’s something incredibly fulfilling about being a positive force in people’s lives. Even if I’m a small force. Even if I’m limited by a broken healthcare system. Even if most of what a primary care doctor does is like saving for retirement – accumulative. The benefits often aren’t seen until years after the effort is made.