I wish to affirm the Premise put forward by Drs Bell and Sloan that both patients and physicians benefit from increased access to primary care [BCMJ 2024;66:14-15] [10].

I have been in family practice for 40 years. I have been on call for most of that time. Earlier in my career, I was generally available 24/7, as I was mostly doing locums in remote solo practices, often in the Arctic. For the past 28 years, I have “limited” my availability to about 14 hours/day, 7 days/week, year-round. This includes most days that I am away on holiday, which averages 13 weeks/year. Wherever I am, I turn off my phone at 8 p.m., guaranteeing a good night’s sleep. About half of my 2500 patients have my personal contact information. They know not to call me, but they may text or email anytime, in English, French, or Spanish.

What is the consequence of this engagement? Happy patients and a happy, healthy doctor. So far, I have accumulated 4 days of disability—1 day for a bad flu in 1986 (no flu vaccine back then), 1 day to recover from esophageal surgery for a Zenker diverticulum, and 2 days off work after a total hip replacement (I cycled to the office on day 8 post-op). I have never experienced fatigue or burnout. On the contrary, I consider my life essentially stress-free. I continue to indulge in many other pursuits, including cycling a minimum of 10 000 km/year for the past 21 years, all over the world. At age 64, I enjoy practising medicine as much as ever and hope to continue to serve my patients for many years to come.
—Thomas DeMarco, MD
Whistler
 

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