As I reflect on my life and career as a private practice general internist in rural Georgia and now President of the American College of Physicians, I'd like to share some valuable lessons I've learned along the way.
You must be headed somewhere to see where you're going
Becoming a doctor was “my plan” starting from age seven. I was deciding among the three career choices I thought I had in 1967: teacher, flight attendant, or nurse. Since my father was a physician, I wanted to be “Daddy's nurse.” My Momma, who loved to challenge the status quo, queried that choice: “Well, why don't you be a doctor and be Daddy's partner?” Fourteen years later, I started medical school with a plan to become an internist. My first six-week internal medicine rotation as a junior medical student at a community hospital, led by an energetic, clinically astute older male chairman and two bright early-career female internists, successfully balancing work and family, provided inspirational role models early on, confirming my career choice.
Find the right partner
Along the way, I met him. You know, “the one.” I spotted him during the first month of medical school. Jamie was the affable country boy, always with a laugh and quick wit, who seemed to know everyone in the class. I was the city girl from Atlanta, who had gone to college out of state and was looking for a friendly face. He was planning to return to his small hometown to practice with his general practitioner father. I had turned down Georgia's “country doctor scholarship” for fear of being stuck in some nowhere town. I chased that country boy ’til he caught me. God laughs while we make plans.
We married during our second year of residency and planned our move to Thomson, population 7,000. And so began my evolution to a “country doc,” the first woman doctor in town, joining my husband, his father, and his brother in practice. They joked that they were going to call the practice “Lemley & Sons Body Shop” until I came along. My mother-in-law was the office manager and had been hoping for an accountant in the family. Oh well. We became the best of friends and hired an accountant.
Marrying the right person is a critical life decision. In a 2018 article in “Harvard Business Review” on work-life balance, Avivah Wittenberg-Cox noted that your spouse can be your most important career asset. A true partnership makes a successful family and a successful career. No question, I found the right partner in life and practice, and it has made all the difference.
Life happens while you're making plans
Our only child, Laura, came along three years after we started practice. But a year later, my dream life seemed to be coming to a catastrophic end. I was diagnosed with a life-threatening advanced breast cancer. All my dreams of becoming a doctor, wife, and mother had just come true but were now going to end in a nightmare, or so it would appear.
In a small town, bad news travels fast. Within a week, there were over 40 flower arrangements in my living room and my refrigerator was overflowing with meals. In the South, we comfort one another with casseroles, sweet tea, flowers from the garden, beautiful cards, and your name on every church prayer list. My new hometown embraced me with overwhelming love and care. My patients were now calling me, wanting to know how I was doing and letting me know they were praying for me. Instead of doling out medical advice, I was on the other end, with my own precious patients ministering to me. The hand of prayer and the hand of medicine came together in a powerful way for me. During this year of surgery, chemotherapy, radiation, and intense intercessory prayer on my behalf, I truly fell in love with the people of Thomson.
Bloom where you're planted
In Thomson, I quickly learned the three A's of private practice, especially in a small town: availability, affability, and ability, in that order. In the beginning, my husband and I did every-other-night call for the practice and were on ED call every fourth night. We didn't take a vacation for two years. We joined a church, civic clubs, and the Chamber of Commerce and attended high school football games on Friday nights. I taught Sunday school, gave numerous community talks, and became the medical advisor for the local chapter of the American Heart Association. I taught Freedom from Smoking classes for the American Lung Association, ran a cancer support group, and started the local Relay for Life for the American Cancer Society. With only a handful of physicians in town, we were the local health care leaders. I was a big fish (with a big mouth) in a small pond. I could make a difference and watch the ripple of results. I quickly became invested in generations of families. I have grown to really know them, and they know me, warts and all. We have journeyed through tears of joy and tears of sorrow, together, for 33 years now.
Mentors will impact your life
Medical practice in a small town is never boring. So many patients of all ages present with many undifferentiated problems. I can always hear the voice of my chair of medicine during residency, Paul Webster, MD, MACP, ringing in my ear, saying, “And what else could it be, Dr. Fincher?” He would exhaust all of us in training regarding differential diagnosis. Like a dog with a bone, he pushed us to diagnostic excellence. In a small town with a medical community made up of internal medicine and family medicine docs and one general surgeon, you're it! You are the acting cardiologist, gastroenterologist, endocrinologist, infectious disease expert, and, as a woman physician, the de facto gynecologist. My excellent clinical training at the Medical College of Georgia helped me to be successful.
I attended my first Georgia ACP Chapter meeting in 1988. My Chapter became a professional lifeline and truly my professional home. It is there where I first met outstanding mentors and colleagues who were or would become state and national leaders within ACP, like Mark Silverman, MD, MACP, Robert Copeland, MD, MACP, Sandra Fryhofer, MD, MACP, and Joseph Stubbs, MD, MACP. Later, I also reconnected with one of my residency attendings, Ruth-Marie Fincher, MD, MACP, who became the first woman Governor for the Georgia Chapter, a national ACP Desforges Award winner, and an American Medical Association Flexner Award winner (the first woman to do so). She and I worked closely together during her Governorship, she on the academic and educational side and me on advocacy and medical practice issues. She was my cheerleader in leadership roles, promoting and amplifying my efforts and nominating me for awards. I eventually became the second woman Governor for the Georgia Chapter.
When you begin your career, you start seeing new opportunities you would have never considered. Keep showing up, moving forward, and crossing paths with incredible people who have an impact on you, and you on them, building a network. Lean into the opportunities that ring true to who you are, what you are personally passionate about, and where you can make a difference. Don't be distracted by extraneous or irrelevant noise. You might make a wrong turn here and there, but most opportunities will yield important lessons or new prospects to explore.
Pass the torch
In 1996, I had the honor of being a torch bearer in the Olympic torch relay that began in Athens, Greece, went throughout the six continents to Athens, Ga., and then continued through my hometown on its way to the Olympic Games in Atlanta. It reminded me of the flame of western medicine, also ignited in ancient Greece by Hippocrates, and the flame of modern internal medicine, ignited by Sir William Osler at the end of the 19th century. We now are the torch bearers for internal medicine. It is what binds us together as the College. Our calling to medicine and the care for our patients lead us to run this race, fostering excellence in all we do, making a difference wherever we are, lighting the path for others to follow, then passing the torch to the next generation of internists.
Like the torch, life moves on. That little princess born into our family 30 years ago has become a pediatrician and married a minister in the middle of the COVID-19 pandemic. Oh, and I became ACP President, helped plan three different weddings for my daughter, had two major surgeries, buried my Momma, maintained my practice, and Zoomed all over the country and the world visiting the members of ACP. Now you know the “rest of the story” of a little girl's dream, with more chapters to come.
I have learned so much over this past year as ACP President, and over the last three decades from my involvement in ACP. The College has provided a foundation, a professional home, and a framework for support, service, growth, and leadership. It has taught me that no matter where you are in your career, you can always make a difference to your patients, to your practice, to your community, to your ACP Chapter, and, most importantly, to the next generation of internal medicine physicians.
As I pass the torch of leadership to your next ACP President, George M. Abraham, MD, MPH, FACP, I also pass on my lessons learned as a general internist to you. Start with a plan. Find the right partner. Challenges will come but will bring focus and make you better; face them head on. None of us are promised tomorrow, so live fully every day. Embrace change and each other. When important opportunities arise, lean in, but don't be distracted by noise. Surround yourself with good people and be open to diverse perspectives. Live with intention and thoughtfulness. Light the way for others to follow. Pass the torch of your experience and wisdom and mentor the next generation.
This little girl's dream was only the beginning of a life I never even thought was possible. Dare to dream big, and your life will overflow with all the many blessings and fantastic opportunities ahead.