After thirty years in medicine, there's a lot I wish I had known from the start. One of the biggest lessons is understanding the difference between full-time and part-time work.
When my wife, Sara, and I moved to Sacramento in 1998, our son was just six weeks old. With Sara starting as a family medicine intern, I chose to work part-time. Back then, it was unusual, and I was fortunate to have that option. I've kept my clinic part-time ever since because I've found that personal time is the biggest challenge in a medical career.
A "full-time" primary care physician does much more than the typical full-time job description suggests. Beyond seeing patients, there's a mountain of emails, labs, imaging results, notes, and other tasks that pile up. If you can manage it financially, consider working part-time. Those long hours can take a serious toll on your personal life and health, and it's not sustainable over the length of a career for many people.
Another thing I wish I knew is the importance of staying connected to who you were before medicine — and who you want to be outside of it. Maintaining balance through community service, exercise, and spirituality has been key for me. When I practice these things, I'm a happier, more sustainable clinician. For instance, I love going to elementary schools like Ethel Phillips to teach sixth graders about health. It recharges me. I also find peace in rowing on the Delta, where I can disconnect from work entirely. Whether it's swimming, hiking, yoga, or trail running, it's about taking a mental break and restoring yourself. Even though I'm far removed from competitive athletics, physical activity still brings me a profound sense of peace.
Spirituality and mindfulness are also essential. I start and end each day with meditation. It clears my mind, allowing me to approach the day without expectations. I don't expect everything to go perfectly or for all my patients to thrive. I just empty my mind and start again. Finding that inner peace and quietness can be a struggle, but it's worth the effort. Let your spiritual experiences guide you, lean on mentors, and read spiritual authors who speak to you.
Over time, you'll learn to meditate effectively. It might take years to decades, but you'll have those magical moments. When they happen, take note of your surroundings — was it morning or evening? Have you exercised? Were you sober or had you had a drink? Understanding these factors can help you recreate those conditions. It won't work every time, and that's OK; it's part of the spiritual journey. Let your experiences guide your path to successful meditation.
Mentorship is another key component. I find great value in the written word and have connected deeply with certain authors. Their insights have become part of my own thought process. Each person resonates with different voices, so explore until you find those that speak to you.
Finally, staying in a religious lane is deeply personal for me. During church services, I spend 95% of the time in a serene, meditative state. There's something comforting about a predictable service with thousands of years of tradition behind it. For me, it's Franciscan Catholicism, but this sense of belonging and guidance is present in all faiths. Being part of something larger than yourself can be a powerful anchor for your psychological and spiritual well-being.
A few more things I wish I knew: finances will work out. It's easy to stress about student loans, mortgages, and family expenses, but as long as you're practicing medicine, the financial side truly does take care of itself. This is a very economically rewarding career.
Remember, helping patients and their families isn't just about curing them. You won't cure every patient, but you can help every patient. Whether it's getting them into hospice early, helping them through denial, or guiding them to learn the messages their body is sharing, there's more to being a doctor than curing illness.
Lastly, never underestimate the power of your voice, especially in health care leadership and decision-making. Physicians have a unique perspective that can be invaluable to financial decision-makers, senior leadership and policymakers. Even if you don't get the desired result in a particular decision, your input can plant the seeds for future changes. Always use your voice.
Email Andrew Hudnut, MD
