I had the pleasure of interviewing Dr. Bruce Olmschield, a District Medical Director at One Medical, where he specializes in men’s health issues and LGBT care. He offers over 20 years of experience in the study, treatment and prevention of HIV. He earned his MD at the University of Minnesota where he completed his residency in Family Medicine and later went on to direct the HIV education and training program at St. Vincent’s Hospital in New York. In addition to his clinical experience, Dr. Olmscheid spent eight years as the director of Medical Affairs at Gilead Sciences, helping bring the first one-pill-once-a-day HIV regimen to market. He is board-certified in Family Medicine and is recognized as an HIV Specialist by the American Academy of HIV Medicine. He currently resides in Los Angeles.
Can you tell us a story about what brought you to this specific career path as a doctor or healer?
Growing up in rural Minnesota, the reality of becoming a doctor didn’t seem possible at the time. I didn’t know of anyone who grew up in my community and went to medical school. I think I saw it as a challenge. That sentiment was further spurred on by my mother’s death — she passed away from Hodgkin’s disease when I was 12. I remember that, during the time of her diagnosis and illness, the doctors would often leave me in the dark, telling me I was too young to worry or ask questions about the disease. It seemed like all this medical stuff was a private club that I wasn’t invited into, and I wanted to break in and get answers for myself.
I chose to focus on family medicine because I grew up with primary care — back in the 60s and 70s in small town Minnesota, you only had your family doctor. You saw a specialist only when your doctor sent you to one. As I entered medical school, I almost went into psychiatry, but I had mentors who pointed out that I would have plenty of opportunities to use those same skills in primary care.
But the year I started medical school was the year the AIDS epidemic began. After I finished my residency in Family Medicine, I knew that I needed to take care of my community, who was still dying from this horror 10 years later. I moved to Manhattan and joined the staff at Saint Vincent’s Hospital, where I cared for patients, was actively involved in clinical trials and got my feet wet in leadership as the Director of AIDS Education and Training. After several years as an AIDS doctor, I and many others burned out doing such extensive, around-the-clock care — we were constantly on call, continued to do hospital and outpatient work and tended to the wards. It never stopped.
That’s what ultimately led me to pharmaceuticals at Gilead — I could still do my part to combat AIDS, but I could get a full night’s sleep while doing so. After 10 years at Gilead, I took some time off and learned how to be a human being, not a human doing. One Medical turned out to be the perfect place for me to practice, as I am able to make a difference for my patients, while finding work-life balance and peace of mind — and not sleeping with a pager next to my bed.
How have your personal challenges informed your career path?
The extreme burnout I felt after being on call during AIDS care informed the rest of my career trajectory. Following my residency, I opted to avoid a traditional Family Practice setting — after three years on call, I chose to practice emergency medicine so I could avoid the dread of being available for 36 hours at a time. I have learned that I need time for myself; being on call does not work for me. I am grateful to be in a practice like One Medical that has a team of providers who care for patients around the clock.
Can you share your “5 Things I Wish Someone Told Me Before I Became a Doctor”?
1. Primary care is challenging. Sometimes, as a doctor, you don’t have all the answers — and that can be hard to sit with. I have learned over the years that if you can’t handle uncertainty, you may not be the best suited for primary care. You have to help patients understand that time is a factor that must be taken into account when making a diagnosis.
2. Self care is important — and no one will do it for you. At the start of my career, self care wasn’t common and AIDS care was non-stop. Residency training was around-the-clock, with little to no focus on rest. I wasn’t able to disconnect and I needed to. Sometimes, we as professionals don’t access the right resources until we hit rock bottom. As a doctor, you’re going to have to learn to take care of yourself. People need to learn what works for them; self-care is different for everyone. For me, it was giving myself permission to say, “I’ll take care of that tomorrow.”
3. Some people don’t get better, whether they have a life threatening illness or are living in pain from a chronic condition or have depression or anxiety. I have had to learn to celebrate small wins along the way.
4. Learn to set your own expectations and be happy with them. There are a lot of cases of burnout that stem from the expectation that you’ll save every person that comes to see you. One small step in the right direction may be all you get that day and that’s ok. It’s important to look for the wins in each encounter every day. I’ve had greater job satisfaction, success and patient satisfaction in those settings.
5. Sometimes all you can do and need to do is listen. You don’t have to have the answers immediately; sometimes things need to unfold over time and that takes listening. I had a patient come in recently who had abdominal pain and a few complicated issues. He had been to three or four doctors; they’d interrupted him and immediately ordered testing. Not only was there no answer or diagnosis, but he didn’t feel listened to. I took the time to really hear him out and although we didn’t solve the problem on the spot, he valued feeling heard and my assurance that we were moving in the right direction.
Social media and reality TV create a venue for people to share their personal stories. Do you think more transparency about your personal story can help or harm your field of work? Can you explain?
I wouldn’t be sharing my story with you if I didn’t think it would help others. To me, my story may seem like just a story — why would anyone care? But I have learned so much and am so grateful for all that I have learned from mentors, colleagues, coaches and therapists, and I feel that I owe it to others to share my story, to pass it along. There’s just so much burnout and difficulty that comes with being a provider; I hope sharing my story helps people know they’re not alone in that struggle.
Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant to your life?
I have two that are relevant to my life. First “It really is the journey, not the outcome.” This speaks to my entire career — I shifted from practicing to pharmaceuticals and back again, and wouldn’t have the care experience and relationship to medicine that I have now otherwise. One Medical was a saving grace for me, and one of the only reasons I could return to practicing, but I wouldn’t have known that until I was burnt out from being on call. The second life lesson quote would be, “Don’t believe every thought you have (especially at 3am).” I think that one speaks for itself.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
Bring respect and kindness to at least one relationship every day. You get back what you put out.
How can our readers follow you on social media?
I am not on social media. That is another discussion.