Birthday reflections: envisioning my third act

I'm celebrating my 43rd birthday today, and nearly a decade of blogging at Common Sense Family Doctor. Although 2018 was the first year in which I wrote fewer than one post per week (46 total), I haven't slowed my writing output overall, authoring or co-authoring ten journal articles or textbook chapters last year and kicking off 2019 with a new study in the Journal of the American Board of Family Medicine on conversations on Twitter about women and Black men in medicine. I am grateful to my longtime colleague Dr. Ranit Mishori (@ranitmd) for coming up with this novel research idea and inviting me to join the team.

The changing of the calendar prompts me to reflect more on my career arc as a family physician, researcher, educator, and author. I have been thinking of my career thus far as an ongoing series of "acts," each lasting for several years. The first act began in 2004 with a year-long editing and faculty development fellowship at Georgetown, continued through my time as a medical officer at AHRQ, followed by a year working in urgent care, and concluded with my re-joining the family medicine department as a full-time faculty member and associate deputy editor of American Family Physician and earning my Master of Public Health degree from Johns Hopkins.

In the second act, beginning around 2012-2013, I gradually built my outpatient primary care practice in northwest DC (a handful of patients found me first through my blog); developed and enhanced medical school courses and a fellowship program involving population health, health policy and advocacy; and was promoted to professor of family medicine and deputy editor of AFP. To be sure, there have been setbacks along the way, including, recently, the disappointment of not advancing to the interview stage in my application for the open editor position at the Annals of Family Medicine.

2019 feels to me like the start of Act 3, although I can't fully articulate why. Maybe it's because in my 15th year of practice I have clearly entered mid-career. My patients are getting older, and more of them now struggle with chronic diseases and chronic pain and are spending time in various local hospitals. With my paths to editorial leadership of prominent family medicine journals closed off for at least the next decade (barring the unexpected), I have turned my energies toward developing new features such as AFP's Lown Right Care department and, together with collaborators at Lown, Georgetown, and in Louisiana, am working on a systematic review for the first time in years. My public speaking continues to focus on overuse, particularly of screening tests whose benefits are overvalued and harms are underappreciated. My four kids (ages 4 through 12) keep growing, my wife's house calls practice and nonprofit are thriving, and our family has no plans to leave the DC area anytime soon - again, barring the completely unexpected.

Act 3. The curtain rises. What does this next act have in store for me?