David Wofsy, MD
Past President, American College of Rheumatology
Rheumatologist, Veterans Affairs Medical Center, San Francisco
David Wofsy, MD
Last year, in preparation for giving a lecture on "Careers in Rheumatology," I asked a group of rheumatologists and rheumatologists-to-be why they had chosen this field, whether their expectations had been fulfilled, and what rewards had come as a surprise. Three answers stood out among all others. They crossed generations, and seemed to apply at all stages of a career in rheumatology. First, there was a fascination with the mystery and clinical challenge of the diseases we treat. Second, there was a sense of excitement about the pace of scientific progress in this field and the likelihood that this progress would translate into practical new therapies for people with rheumatic diseases. Third, there was a strong belief that a career in rheumatology - in academic life or in community practice - could be balanced with a full personal life without having to sacrifice one for the other.
Each of these concepts has held true throughout my career in rheumatology. The intellectual challenge is exciting, sustaining and dynamic; the growing number of new therapies, both those currently at our disposal and those on the horizon, adds enormously to the satisfaction of patient care; and this fulfilling career has allowed me to "have a life." I've never been hesitant to admit that I would prefer to limit the number of nights and weekends that emergencies take me from friends and family. I admire colleagues whose career choices place them in the hospital at all hours of day and night, but I do not envy them. In making these frank comments, I do not mean to imply that rheumatologists do not deal in long hours and unexpected emergencies. We do, and like everyone in medicine, we enjoy the special reward that comes from the most serious challenges - but this can be done in a manner that is compatible with a balanced life.
For me, the unexpected surprise of a career in rheumatology has been the enjoyment of caring for people with chronic illness. Frankly, I had expected not to enjoy treating chronic illness as much as treating acute illness. However, the satisfaction of helping people control serious health problems over a long period of time and the reward of developing genuine long-term friendships with patients in the process has been an unanticipated bonus. In the final analysis, this may be the best part of a career in rheumatology.
