Tending the garden: Reflections on family medicine

I recently began to learn about gardening. There was unused space in my yard and bare soil ready to be filled, and the idea of growing a beautiful garden was appealing. What I did not expect was how difficult gardening could be, and how the lessons learned would reflect my work in family medicine.

One of the first lessons gardening teaches is that you cannot rush growth. No amount of watering will make a seed sprout faster, and no amount of attention will make a plant grow before it is ready. In family medicine, we are often asked to take on more patients in our panel, see more patients each day, and do more administrative tasks like completing forms and writing reports. But so much of what we do and what is centrally important is building relationships with patients over time. Managing chronic diseases, supporting mental health, and encouraging healthy lifestyle choices all take time and effort. We are chipping away, one piece at a time, and this cannot be rushed.

Another lesson became clear when many of my plants failed to thrive. The issue was not the plants themselves, but the soil and the environment. Until I improved drainage, added nutrients, and allowed areas to recover, the garden struggled. The same applies to medicine. The system we work in determines our ability to provide effective care. In British Columbia, ongoing challenges such as limited access to primary care, long wait times, and inequitable health care delivery all directly impact patient care. Asking physicians to thrive without first addressing these issues is like blaming a plant for struggling in depleted soil. With the introduction of the Longitudinal Family Physician Payment Model, which has been a system-wide change in family medicine, both physicians and patients have benefited greatly.

Gardening has also taught me the importance of restraint. Too much intervention can be harmful. Overwatering kills more plants than neglect does. In family medicine, we see this lesson often. Overinvestigation and overprescribing can create unintended harm and put unnecessary strain on our system. Doing more does not necessarily equate to providing better care. Early in my training, I often felt pressure to act—to order tests or to offer treatments—because patients are often looking for immediate answers. But in family medicine, we are in a unique position to practise longitudinal care and develop an understanding of patients over time. With experience, I have learned when observation and monitoring can be appropriate and effective. Knowing when to step back is also an important skill.

Finally, the quiet, hard work of tending to a garden may feel isolating at times, like in family medicine, where fatigue and burnout can also feel isolating. Family medicine is not about dramatic lifesaving moments; rather, it is about showing up, season after season, caring for our patients in small, meaningful ways, but making a lasting impact. This is the true power of family medicine.

Gardening has reinforced several truths about family medicine: growth cannot be rushed, strong support systems are essential, and restraint is often necessary. As spring approaches, I encourage colleagues to take time to slow down and admire the nature and beauty our home of British Columbia has to offer. Maybe even take up gardening. You may find, as I did, that it has as much to teach us about medicine as it does about plants.
—Yvonne Sin, MD

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