New Chapter

Brian Braithwaite, M.D. (MED ’11), completed a combined six-year M.D./J.D. program through Mayo Clinic Medical School and Arizona State Law School  in the hope that he could practice clinical medicine, with a greater understanding of physicians’ rights and medical malpractice. After completing an anesthesia residency and a pain fellowship, he moved to the greater Cincinnati area, where he is now a partner in an interventional pain management practice.

Why medicine as a career?

Health care is a part of my family. My father is an OB/GYN physician in Florida, and my mother is a retired nurse. Growing up, I always knew I would somehow end up in medicine. Halfway through my undergraduate studies at the University of Florida (Gainesville), I decided to take a brief detour and pursue some of my other interests. Over the span of a year, my father and I opened up a doughnut/coffee shop and owned/managed a small commercial plaza in South Florida. Although I learned a lot about business and truly enjoyed the opportunity to work hand-in-hand with my father, the draw of medicine and ability to positively affect change in a patient’s life was too strong to pass up. Within months of returning to the University of Florida, I was studying for my MCAT and plotting my path back to medicine, more determined than ever.

How’d you choose Mayo Clinic for medical school?

During my medical school interviews and hospital tours, I realized that there was something special about Mayo Clinic School of Medicine and about the Mayo Clinic system in general. You were not just an extra body to fill a class or an extra student paying tuition. There was genuine interest in you as a person, how you learn individually and collectively, and this almost invisible guiding force that pushed you to want to succeed and become the best possible physician to your patients.

You got a law degree during medical school. Tell us about that.

During the second year of medical school, and coinciding with completion of USMLE step 1 testing, my classmates and I had the opportunity to pursue various joint degree programs through other universities. Hearing firsthand from my father about the legal uncertainties and medical malpractice implications of clinical medicine, I thought that having a solid understanding of medicolegal concepts would be useful in my medical career. I took advantage of the six-year M.D./J.D. joint program between Mayo Clinic School of Medicine and Arizona State University law school. I sandwiched in two years of accelerated law school curriculum between my second and third years of medical school. I took the Florida Bar Exam right before I graduated medical school and prior to starting my anesthesiology residency.

Why did you choose anesthesiology for residency?

I chose anesthesia as a result of doing my third-year OB/GYN rotation and realizing that not only was surgery not for me, but that I was more interested in the patient monitors behind the surgical drapes than the surgical technique being performed. The immediate sense of belonging I experienced during my two anesthesia electives confirmed my interest. I found an intellectual appreciation for perioperative patient management that required constant vigilance and timely action. Additionally, on a more procedural level, I found that I really enjoyed the hands-on, interventional aspect of anesthesiology, which also served to encourage me to pursue an interventional pain management fellowship after my residency.

You’re in private practice pain management now. Why did you choose private practice?

After being in the academic world for most of my life, I decided that I wanted to try something different. Although I maintain a great appreciation for scholastic achievement, research pursuits and the multi-tiered learning approach of residency, the greater autonomy and personalized control of one’s schedule and patient load of private practice was more appealing. At present, I am part of a four-physician practice based in the greater Cincinnati area, specializing in interventional pain management. After living in many different places and constantly having an itch to move the next place,  I was hesitant to settle down and grow roots. However, the combination of getting married, having two dogs and working alongside one of the best pain physicians in the tri-state area, Dr. Kendall Hansen, was too much to pass up.

Do you miss academic medicine?

Absolutely! One of the biggest things I miss about academic medicine is being in an environment where you are constantly challenged to learn more. Whether it is learning on rounds, attending journal club, working with residents or just a passing conversation/curbside consult with a colleague, the academic environment is incredibly inspiring. It fosters an intellectual curiosity and passion for continued improvement that is hard to reproduce in a private-practice setting. Although I love and thoroughly enjoy private practice, especially all the patients that I am fortunate to take care of, I would definitely consider a return to academics in the future.

What’s life like post-training?

No matter how well you prepare, life post-training is still somewhat of a shock. I found that there was a few-month transition phase where my confidence had yet to fully catch up with my level of training. I was very fortunate to spend the first two months of my private-practice career working closely with Dr. Kendall Hansen, who better prepared me for the speed and required procedural skill sets of private practice. After that I hit the ground running and have not looked back since.

What challenges lie ahead?

In terms of professional challenges, the field of pain management continues to move away from simple prescribing to helpful interventions/procedures that seek to minimize narcotic dependence, avoid or delay surgical intervention, and increase overall quality of life. In our practice we seek to prescribe medications as temporizing measures, until the benefits of injection and adjunctive therapies are appreciated. Despite our efforts at responsible prescribing, the ever-changing landscape of pain medicine, especially when viewed through the lens of the current opioid epidemic, is as complicated and complex as one can imagine.

One of my greatest challenges is achieving a harmonious work-life balance. I love what I do and, despite working long hours, gain encouragement from my patients and staff. I have yet to figure out how best to leave work at work and come home with enough energy to pursue a hobby or two. I remain hopeful that one day it will be possible.

What does balance look like?

I truly wish I knew. Right now, I am of the mindset that work-life balance is rather fluid. Starting out as a newly minted attending physician, the balance is likely skewed in favor of work. After some period of adjustment and practice stability, balance should start to normalize to a level which is more sustainable.

A funny story that happened recently was that I was in the middle of a spinal cord implantation trial. The patient, in between doses of anesthesia, asked me what I do for fun. I found myself speechless for a few moments, eventually replying that I watch Netflix. Everyone in the operating room found enjoyment from my answer and starting laughing. I confess, I laughed as well but soon challenged myself to try and find those hobbies/passions that I had prior to starting this medical journey so I can have a better answer the next time I am asked!

What do you do in your spare time?

It depends on the time of the year but some combination of traveling, exercising, exploring the outdoors and, on occasion, watching Netflix.

See past New Chapter stories here.