Author Chat: Dr. John M. Maxted on "To Be a Family Doctor...and More Than That!"
Thanks to the author for a gifted copy of the book!
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I was thrilled when Dr. John Maxted, a retired Family Physician from Ontario, reached out to me and asked if I’d read his book. I’ve gotten to know him over the last couple of years as a member of a physician retirement group and I always appreciate his wise words. Hot off the press, To Be a Family Doctor…and More Than That! is clearly a labour of literary love, born from his desire to not only write his memoir in a wholly self-reflective way, but also to showcase the life of a family doctor. I love the generativity that this book imparts: he aims to inspire a new generation of medical students to consider a career in full-service family practice. And as all of us Canadians know, we need young doctors to choose family practice.
I was even more thrilled that Dr. Maxted agreed to answer a few questions about his life in medicine and the process of writing the book.
Trish: Thanks for joining me on Trish Talks Books! I’ve been reading more memoirs lately, and I can truly say that I enjoyed your book very much. It was compelling reading and I found myself welcoming the times during the day when I could sit down and catch up with your medical adventures. You begin the book with your teenaged decision to pursue medicine as a career: it all started from a water-ski accident that landed you in surgery. What was it about medicine that drew you to it as a profession?
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| Dr. John Maxted |
John: Thanks for your interest in my book, Trish, and for the privilege to be interviewed by you. My book touches on your first question when I describe how I felt upon awakening from surgery and witnessing the caring attitude of those around me. This was a completely new world for me and having witnessed it, I wanted to be part of it.
What else attracted me? "The doctors for their authority and certainty. The nurses for their kindness and concern. The orderlies for treating me as just another guy." I chose doctoring over nursing because I wanted to be a surgeon, my first love in healthcare. However, nursing orderlies did not escape my attention either. I was thrilled to become one to help pay for my first four years of medical education.
Trish: It can be such a brief but impactful circumstance that guides our life paths. I love that you worked as an orderly during medical school. I have fond memories of working in the central sterilization department of my local hospital during medical school!
The first parts of the book were fascinating, as you write of medical school and residency, setting up a rural, full service family practice, and growing your practice. I particularly enjoyed your tales of buying and setting up your first standalone medical office after having shared space with a colleague for a few years. You were raring to start, but beginning practice can be intimidating! Did you feel out of your depth sometimes? Do you think this may be a barrier to new doctors setting up a rural practice?
John: I will not deny there were times during my first five years when I felt that I was over my head. This was more frequent when I was caring for patients in the hospital than when caring for them in my own clinic. Yet in hospital, I was blessed with the aid of congenial and understanding medical specialists who wanted me to succeed. Likewise, in my clinic I had the benefit of my wonderful associate, Dr. John Payne. We were both new to this business so could commiserate and consult as necessary.
Nevertheless, the challenges of a new practice were a welcome part of the excitement in learning to become an experienced doctor, in making a diagnosis and guiding my patient through the caring process, and in becoming an important part of their lives and those of their family members. As I describe this now, I am reminded of the privileges that came with this professional identity and the sense of value that brought me so much pleasure for almost 50 years.
Will new doctors feel hesitant to set up a similar rural practice? Absolutely! It comes with the territory. And I can understand their sense of awe and hesitation might be even greater than mine since the level of medical knowledge and bureaucracy associated with starting practice has increased exponentially over the years. Nevertheless, I suggest the same approach as mine will stand them in good stead. View it as a welcome challenge; take a few steps at a time; and ensure the help of trusted colleagues before trying to conquer the next mountain.
Trish: I love your advice, and your beginning-doctor excitement is so inspiring. You mention having trusted colleagues around you. A physician myself, I felt nostalgic for your descriptions of the Doctor’s Lounge where staff physicians could meet informally. It was a part of my early practice at a local hospital, but that culture ebbed over the years. Have you noticed the opportunities for collegiality change over the course of your career? Is there something that has replaced the “doctors lounge”?
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| Flying in the Guatemalan jungle |
John: My book references two venues that I called professionally therapeutic during my career – the doctors’ lounge and the drug company evenings, the latter more ethically challenging as time progressed. These were re-energizing and de-escalating because they supported in-person collegiality in a non-threatening environment.
Where can doctors find these comforting elements now? Continuing medical education conferences are one place. I sometimes found that the further I was from those with the same vested interests as mine, the easier it was to let loose, discuss openly, and get relief. These experiences are still available to physicians.
However, the daily doses are missing and in its place are professional blogs that are not as helpful. Without face-to-face interaction, written dialogue is great for supporting expressions of frustration, especially given the current state of Canadian healthcare, but not as useful in supporting the mutual sharing and laughter that more conducive, collegial settings could provide. In short, I’m not sure that anything has effectively replaced the doctors’ lounge.
Trish: I admire your courage in shaking things up mid-career and getting your MBA. This led to a different focus as you became immersed in the world of medical administration, and you discuss some of the rewards and challenges of the work. What’s your advice for young doctors who might want to explore administrative medicine?
John: Thousands of doctors have taken management and administrative routes as part of their practices, some pushed into it and others because it’s what they really wanted to do. But most of them did not obtain an MBA. I did this because I believed it would improve my credentials and because it was a time in my career when I needed an outlet to generate alternative interests. I would encourage others to do this for the same reasons.
It’s easier nowadays for hospital-based doctors in other specialties to become administratively involved than family doctors because so many have left the hospital environment. But they still have outlets available to them, such as becoming engaged with community, university, or professional organizations. It takes resolve, calculated intent, and courage to get involved. Once in the door, more opportunities become available. Personal success also takes continuing commitment, the ability to build good relations, and an open mind to innovative ways of doing business. If doctors embrace these characteristics in administration, they are more likely to find opportunities that not only satisfy their curiosity but also their search for the kind of variation that I enjoyed in my career.
Trish: Yes, and I know that you pursued teaching too. A university affiliation can be really rewarding.
Changing subjects, I’d love to ask you about your writing process. What spurred you to start? Did you have a regular writing schedule or take any writing classes?
John: I started writing my story because I like to write and wanted to leave a legacy of the joys and challenges that I had in being a family doctor. I did not want to leave with the regret that I just walked away as if it never existed.
I began after I retired from teaching, practice, and my leadership roles in 2021, though I did one more year of part-time practice. Having written a tremendous amount during my career, especially with the College of Family Physicians of Canada, I was able to apply some of what I had learned in those experiences. However, I discovered that I had a lot more to learn in writing a memoir and spent many hours on the internet searching for additional advice.
I won’t go through the details of what I learned but will add that working with a beta-reader and editor helped me to become a better writer.
Trish: The idea about writing being a way to leave a legacy and honour your career is very compelling, and I totally understand that! Indeed, I suspect writing a memoir does indeed come with a lot of learning. Another thing that I valued was your transparency; not only with patient cases, but also your openness to sharing about your personality and your self-evaluation as the book progressed. How did you make choices about what to reveal and what to keep off the page?
John: This is a probing question that may not be easy to answer. I used my writing to reveal what I thought would help readers to understand the inner compulsions and choices that drove my career. I also wanted them to identify that there are inter-related and multi-factorial but sometimes unrecognized impulses that make each of us the professionals we become.
I shared some of my values and personality in my book for cathartic relief, a form of release. As an introvert, I am not inclined to talk about myself and what makes me the kind of person some people discover. Writing about my career gave me the opportunity to open up and reveal more of the real me.
Trish: Right, we often think of how a book affects the reader, but I think that the process of writing must inevitably change the writer as well.
At the end of the book, you are clearly optimistic about the future of family medicine, at least for those determined to adapt to a changing medical landscape. Your book is not only a memoir of medical practice but also an invitation to young people to enter family medicine. What gives you hope for future family doctors?
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| "Holding one of my treasures..." |
John: We cannot live without hope. As I witness the despair of family doctors around me, I struggle with the stance I ought to take as a leader, one that has “put in his time.” I decided I must look beyond the current turmoil to a better future. Only supporting how awful it is does not help young and existing family doctors who are emerging in the ranks.
I truly believe family doctors will reach a state of more contentment, happiness, and professional satisfaction. Without repeating what I wrote in my book, this will come with give-and-take on the part of family doctors as well as the bureaucracy that has made their life so difficult. Even though it will not be exactly the same as what I enjoyed, the lessons I learned in being a happy family doctor are still applicable to those who want to be part of this different world.
Trish: And finally, do you see yourself continuing to write? Might there be another book in your future?
John: Besides the above, I also wrote this book because I am activity-driven. Writing has been a tremendous help in filling my time during retirement and supporting my continuing desire to be an engaged learner.
Will I write another book? I can’t answer this question right now. There are many uncertainties that impact me in retirement. If I was to transition to a mindset that I would produce another book, I would need a very compelling topic, the inner drive to take it on, and a foreseeable future that would allow me to be successful. If I accept such a task, it’s not in my genes to give up!
Trish: Thanks so much for your time and for sharing your knowledge and wisdom with me! I wish you every success on the launch of your book. Where can folks get a copy?
John: And thank you again for this opportunity, Trish! I would be pleased to help anyone who is interested in a copy of my book. They can contact me at john.maxted@outlook.com.
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What a wonderful opportunity to talk with Dr. John Maxted today. Stay tuned for another post in my Author Chat series soon!
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