If a person is admitted to the hospital for any reason other than surgery (or illness requiring critical care) then they likely end up on a medicine hospital ward. General medicine wards are run by internal medicine physicians. Since internal medicine is my residency path, I’ve spent close to 50% of my time in residency on general medicine wards.

Recently, I finished my last shift on the medicine wards…possibly forever. As a primary care physician, I won’t work in the hospital. There are things I’ll miss about inpatient medicine – like the fast pace and the medical surprises. But, mostly, I’m glad to be done.

On the medicine wards I enjoyed investigating acute illnesses and how to help people feel better. I liked the pressure of trying to solve medical problems and overcome challenges efficiently. I enjoyed the variety of pathology. On the wards I’ve seen my share of rare and unusual cases. Moreover, after years on the wards, I’m comfortable managing the common medical conditions that bring patients to the hospital from infections to heart failure exacerbations and abdominal pain to new confusion. Being comfortable makes me confident that it’s time for the next phase of my career.

The art of preventing medical conditions in the first place (preventative medicine) and managing conditions before they require hospitalization is different than the art of treating acute illness requiring hospitalization. I look forward to shifting to 100% preventative medicine and management of chronic health challenges. I can’t wait to get to know my patients over years in my clinic rather than only briefly during a terrible time of their life (like when they’re admitted to the hospital).

I felt a pang of sadness as the medicine ward doors closed behind me after my last shift there. But the sadness was brief. Hospitals will be there if my career takes an unexpected turn and takes me back inpatient. Until then, I’m thrilled for clinic life.

Goodbye medicine wards – to the excitement and the headache. To the physicians who remain on the medicine wards, I know you’ll take good care of my patients when they’re admitted. Please send them back to me in clinic without too many changes to their outpatient blood pressure medications. Leave the chronic medication tinkering to me.