Follow a Day in the Life of a Primary Care Physician

This pediatrician's typical work day is nearly 18 hours.

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Thinking about applying to medical school­­—and getting through it—probably encompasses enough brain capacity. But what is it really like to be a practicing doctor?

Heather MacAdam, a graduate of the University of Pennsylvania School of Medicine, is a pediatrician who works at a small community hospital. She was gracious enough to take time out of her busy schedule to give us a glimpse into a typical workday.

[See a typical day for a first year med student and a medical intern.]

Below, in MacAdam's own words, is her typical timeline:

6:00 a.m. — Alarm rings—hit snooze. Today I have nursery rounds, so I slap on some scrubs and head out the door to the hospital. I gave up wearing nice clothes to work after being vomited on one too many times during training.

7:00 a.m. — Newborn nursery rounds. The nurses line the babies up one by one to be seen. Nothing wakes you up like a line of screeching babies waiting for you. After checking their weight and vital signs, I wheel them back to their mothers and offer advice and congratulations.

8:00 a.m. — Head to the practice. Today is fully booked—as I walk in, I notice a waiting room full of playing children and can't help but wonder what germs they might be passing to each other.

8:00 a.m.–12:00 p.m. — Pediatric appointments. The clinic schedules each child for a 15-minute appointment—regardless of the complexity of the problem. As usual, I'm running 30 minutes behind, trying to catch up with the inevitable and unplanned surprises that pop up. The new electronic medical records we are using are nice for some things, but it takes me twice as long to document a visit.

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12:30 p.m. — Lunch, if you can call it that. Today it's shoveling a protein bar in one hand while catching up on notes with the other.

1:00–5:00 p.m. — Afternoon clinic appointments. There are usually more "same day" appointments in the afternoon that are reserved for urgent cases. Today I have a depressed teenager, a 9-year-old who appears to have attention deficit hyperactivity disorder, and a bunch of kids with coughs, colds, and bronchiolitis. I have one sad case toward the end of the day where a mother expresses concern her 9-year-old daughter with Down syndrome is being abused by her biological father. I end the day filing a report with the state.

5:00–7:00 p.m. — Follow-ups. Even though the appointments are done, messages, lab results, X-rays, and prescription refill requests pile up during the day and need to be completed. This is a critical component for a successful primary care practice, but it is not reimbursed.

7:00 p.m. — Leave clinic. I'm on hospital call tonight, so I need to keep my pager on. I watch some favorite TV shows and hope it's a quiet night.

8:15 p.m. — Beeper goes off. It's the labor and delivery floor calling about an urgent Caesarean section on a baby with a depressed heart rate. I get in the car and race to the operating room.

8:30 p.m. — Get to OR. As soon as I'm scrubbed in, the OB [obstetrician] hands me the newborn. The baby required resuscitation, and the next several hours are spent arranging for transfer to the nearest newborn ICU [intensive care unit].

11:45 p.m. — Home. Hope to finish some TV time from my DVR while searching for articles relating to the patients I saw earlier today. Crossing my fingers for a quiet call night—need to rest up to get up at 6:00 a.m. to do it all over again. Pediatrics is a very rewarding career for me, but it can be exhausting.

[Learn whether an M.D. is right for you.]

Whatever specialty you choose in medicine, you will still need to train in, and consider, primary care specialties. Though the reality of these specialties are possibly changing with healthcare reform, many things will remain the same—and it's important to know these things when contemplating a career in medicine.

Ibrahim Busnaina, M.D. is a graduate of the University of Pennsylvania School of Medicine and coauthor of "Examkrackers' How To Get Into Medical School." He has been consulting with prospective medical school applicants, with a special focus on minority and other nontraditional candidates, since 2006.