Written by Carol Christen
Sunday, 11 July 2010 13:49

-2  Serena's profile as a family practice resident was included in the first  edition of ...Parachute for Teens.  She's now a fully licenced medical doctor working in Butte, Montana.  

   Name:  Serena Brewer      Age:  33      Job title:  Family Practice physician

   Employer:  Butte Community Health Center   Cost of training: $240,000                   

 Dr. Brewer, as she appeared to her patients last St. Patrick's Day.


 Dr. Serena Brewer, Family Practice Physician

  Degree: Doctor of osteopathic medicine

  Training: Four years of medical school plus three years of residency

  Salary ranges: Residency  $36,000 - $50,000     Post residency, starting salaries $95,000 - $125,000

What do you do?  I’m a family physician who cares for patients and families with little or no insurance in Southwest Montana.

I spend  40-60 hours a work working in an outpatient clinic setting caring for patients with varying degrees of health and income.  In a typical day I counsel a diabetic on managing their blood sugars, see several children for well child check-ups, manage nursing home patients, help women choose a form of family planning and round on newborn infants in the hospital.

What do you like about your job?  I love that every day brings multiple new challenges to my skills and learning thus far, as well as opportunities to teach people about both how their bodies function and how to take care of them.

What don’t you like about your job?  To have a successful medical practice requires business skills and training, which you don’t get in medical school. I don’t like that I spend almost as much time each day wading through paperwork and negotiating with insurance companies as I do helping patients. I hope this will be changing . . . someday. With the new health care legislation, there is a possibility of some reform.  Sadly, it falls far short of is needed, and the shots still being called by the private insurance industry.

I also don’t like that the demand for a primary care is so great that there is less and less time to spend with patients.

There has been a recent push to re-vamp health care, however any potential benefits from this push are likely years away, meaning that paperwork, insurance companies and business skills are still necessary evils.

How long have you been in this job?  I’ve been in my current position for two years.  I have a two more to go as part of my service commitment to the National Health Service Corps (who paid for most of my medical education).

What is your ultimate career goal?  To own my own small family practice in the Pacific Northwest that can provide health care to the insured and uninsured alike.

What do you see happening in this field in the next five to ten years?  There continues to be a shortage of both primary care and specialty providers (especially those willing to care for the under or uninsured).  In the next 5 -10 years the politics of health care the importance of primary care in reforming American Healthcare will be in the spotlight, but not likely to change the shortage of providers.

Unless the current insurance laws are reformed, fewer and fewer physicians will be able to afford the costs of maintaining a medical practice. Those physicians who choose to brave it out will find themselves with increasing patient burdens and increasing financial obligations that will likely be passed on to the patient as higher and higher costs of care.

On the plus the side, the shortage will widen the recruiting pool for future physicians.

Have you used social networking sites in a job search?  I have not used social networking sites in a job search.  But I do use social networking sites to keep in contact with colleagues from residency and medical school – we find ourselves constantly comparing working hours, patient panels, salaried etc.  So it’s a way for me to keep up on the current “norms” in my field.

Serena’s additional comments:  My career path started in high school with a notion that I wanted to help people, particularly with physical activities. I looked initially at physical therapy; however, I quickly realized it was the physician who sent someone to physical therapy who ultimately had the most control over a patient’s recovery.

So down the path I went, exploring medical school and physical and rehabilitative medicine. In college, I grew increasingly aware that the traditional medical school approach wasn’t for me. By graduation, I hadn’t made up my mind, so I took a few years off to work in the “real world.” On the side, I kept up my interests in the human body and healing by training in massage therapy.

Through massage therapy contacts, I was introduced to osteopathic medicine, which believes in treating the whole person rather than just a specific issue or injury. I knew instantly this was the approach to medicine and healing that best fit me. (In retrospect, most of my MD colleagues have an almost identical approach to those of us who are DOs, but at the time, when I had to choose where to train, I felt most at home in osteopathic programs.)

At the same time, my interest in rehabilitative medicine gradually gave way to an interest in teaching people how to care for their bodies and stay healthy, especially people with limited income. So once again my goals shifted--from rehabilitative medicine to family medicine. In medical school, there were very few specialties that I didn’t enjoy, but time and time again, what I loved most was working in the family practice clinics and the wider variety of health issues I encountered there every day.

If you think you’re at all interested in a career in health care, find someone who does what you’re interested in and spend the day with them. Ask them how they got to where they are. Most of us in health care would love to share our stories and make it easier for those who come after us. And definitely spend some time volunteering--it gives you exposure and experience, and it lets programs know that you’re serious about your career goal.