This post was originally published on 2/28/2012

“When it comes to the future, there are three kinds of people: those who let it happen, those who make it happen, and those who wonder what happened.” John M. Richardson

I’ve been thinking about how I started my career in medicine. In grammar school, I had vague ideas of wanting to somehow work in the field of science. In early high school, it became using science to help people in some way, and in later high school and college, I realized that medicine would be the path I could pursue.

What helped me succeed was to envision what my future would be like. That way I could endure the work, missed parties, and “fun” that other people had, while I buried my nose in books to get accepted to medical school and then become a physician. Through the first two years of medical school, I endured endless classes, knowing that I would eventually get to see patients and help in their care. The second two years, I endured the pimping and cramming because eventually I would be a resident, and fully participate in the care of patients. And in residency, the call and work was a path to the shiny future of the attendings, who took care of patients without supervision.

And now we attendings are faced with the reality of current practice, struggling to keep up with daily practice finances, external rules, unfunded mandates, insurer oversight, and the thousand slings and arrows of daily practice. The John M. Richardson quote reminds me. Early in my career, I made it happen by working hard to get to a point in my life: to be an attending physician, taking care of patients.

Somewhere along the way, however, we physicians just started working and stopped dreaming. By being passive and just practicing medicine, without an eye to the future, we have put ourselves in the current state of medicine. And we wonder what happened?

It is time to pick up our heads and dream again of a shiny but attainable future. What does your ideal practice look like? What do you want your work day to look like in five to ten years?

You can figure that out. Certainly the forces that exist today will not magically go away. There will be physician shortages and limited resources to meet the needs of a growing population. But you will also have the continued rapid growth in technology and an increasingly connected world as tools to help you cope.

Given these and other variables, what does your practice look like? Get that picture in your mind and then work with the Pennsylvania Medical Society to set a path to go there. Let’s make the future happen. We did it before in our careers, and we can make the short-term sacrifices again to get to that shiny future we now envision.