Summer 2018
Vol 116.1

As a physician, as much as we know the importance of taking care of oneself, we often neglect to take our own advice on this topic.  We all know the saying, “Doctors make the worst patients.”  When I was previously working at a more traditional fee-for-service primary care practice, I would struggle as I would attempt to coach patients on things I never had the time to do myself. I would feel hypocritical reminding women to stay up to date with their Pap smear and I was overdue for mine.  Let alone understand the trials and tribulations of an elimination challenge diet, or truly practicing mindfulness.


Why? Because I was burnt out from running from room to room, rarely feeling like that I was able to give everything that patient needed to heal or succeed.  And on top of that, I then had to complete mounds of forms, EMR check boxes, and hours of documentation.  I didn’t have time to spend with my family, let alone the time for my own self-care. There had to be a better way.

“Working in Direct Care has allowed me to heal from burn out and be fully present and compassionate with each patient encounter.”

Julia Snyder, MD, of R-Health Cherry Hill, NJ, is Board Certified in Family Medicine and Integrative & Holistic Medicine.

R-Health is an AROC 2018 Exhibitor and Silver Sponsor. Learn more at


How Direct Care Allowed Me to
Focus on

This all changed when I began practicing in the Direct Care model. Now, I have fewer patients, giving me more time to spend with each one. With the ability to really form relationships, and dig deeper into diagnosis, behavior patterns, family dynamics and other important lifestyle factors, I really feel like I can make a difference in people’s lives. There are no more “meaningless use” clicks in the EMR.  Did I mention no insurance billing codes? I now have a much better work-life balance, which gives me the time needed to take care of myself. Just as importantly for me as a physician, more time to “practice what I preach” to be a good role model and coach.


Now when I recommend a new nutrition program for my patients, I have already done it and can speak personally to the experience of what they should expect and give pointers. If I find a new workout routine, I can tell my patients what I am doing and what they too could try. Next on my list is Gyrotonics. I am practicing yoga and guided meditation with mindfulness. And I am finally caught up on my own doctor’s appointments.

Another area that used to add to my stress level was being on call. Covering for a large practice, the messages never stopped and I rarely knew the patients. In my Direct Care practice, my patients can message me 24/7 via our secure mobile app, but when I’m off, I choose a few times a day when I look at the app and respond to patient questions.  No longer does dinner have to be interrupted for the “emergent” refill or sinus infection. In real medical urgencies, my patients can call me on my cell phone; however, emergency calls are very infrequent because of the small number of patients and the nature of the respectful relationship we are able to develop.


Working in Direct Care has allowed me to heal from burn out and be fully present and compassionate with each patient encounter. I have time for patients, time for my family, and time for me. I am fully able to practice the type of medicine I am passionate about and that patients deserve.


© 2018 New Jersey Association of Osteopathic Physicians and Surgeons

The Journal is the official magazine of the New Jersey Association of Osteopathic Physicians and Surgeons (NJAOPS). NJAOPS is the sixth largest state affiliate of the American Osteopathic Association. NJAOPS represents the interests of more than 4,700 active osteopathic physicians, residents, interns and medical students. Founded in 1901, NJAOPS is one of the most active medical associations in New Jersey with 12 county societies.