As a medical student, do you ever wonder what it’s like to specialize in family medicine? Meet Ashley Erwin, MD, a family physician and a featured doctor in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out her insights to help determine whether a career in family medicine might be a good fit for you.
The AMA Specialty Guide simplifies medical students’ specialty selection process, highlights major specialties, details training information, and provides access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database®.
Learn more with the AMA about the medical specialty of family medicine.
“Shadowing” Dr. Ashley Erwin
Specialty: Family medicine.
Practice setting: Group practice.
Employment type: Employed by Henry Ford Health in Detroit. Henry Ford Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Years in practice: One.
A typical day and week in my practice: My typical day spans from 8 a.m. to 5:30 p.m., with appointment slots ranging from 20 to 40 minutes, depending on the nature of the visit. My schedule is a blend of same-day appointments, chronic condition follow-ups, annual exams and various procedures. To start my day, I usually arrive 30 minutes early, three times a week, to manage my inbox and engage in a short prayer or meditation before the clinic opens.
In an average week, I precept residents in the clinic for one or two half-days. Additionally, I spend one half-day each week precepting residents in our ob-gyn procedure clinic. I also teach a course, “P4: Population, Patient, Physician and Professionalism,” for first-year medical students at Wayne State University School of Medicine, which takes up another half-day each week. Throughout the week, I typically work with a third- or fourth-year medical student once or twice a week.
The remainder of my time is dedicated to my patient panel. Once a month, I work a late-night clinic until 8 p.m. and also work a half-day every second Saturday. In the evenings, I focus on closing out remaining charts, but I make a conscious effort to limit work at home so that I can devote quality time to my family. When I have the energy, I enjoy going for a run or cooking.
Weekends are a time for friends, running, reading, crafting and catching up on charting. Sunday evenings are reserved for preparing for the upcoming week. On average, I work 60–70 hours each week.
The most challenging and rewarding aspects of family medicine: Social determinants of health play a significant role in my patient population, presenting unique challenges that I embrace. Achieving goals such as lowering blood pressure or managing A1c levels becomes even more rewarding, not just for my patients but for me as well. I’ve even kept a scrapbook of inspiring improvements—whether in A1c, blood pressure or kidney function—to help me stay motivated on tough days.
Additionally, watching patients make progress on their weight-loss journeys is a deeply rewarding experience. When they share their lifestyle modifications, how their clothes fit better, or how their health has improved, it’s a shared victory. We celebrate together every time a medication is discontinued or a diagnosis changes to “history of.”
This journey allows me to cultivate meaningful patient-doctor relationships where we share conversations about vacations, celebrate birthdays, congratulate job promotions and mourn the loss of loved ones. I am truly grateful that my patients have entrusted me with their health, and I appreciate how they have shaped me into the physician I am today.
The impact burnout has on family medicine: As the gatekeepers of medicine, family medicine physicians bear a heavy burden, with expectations continually rising. Burnout has led many doctors to reduce work hours, pursue advanced degrees, transition to administrative roles or complete fellowships.
How Henry Ford Health is reducing physician burnout: The support staff at Henry Ford Health is outstanding. My medical assistants, nurses, pharmacists and case managers are invaluable, and I couldn’t function effectively without them.
Additionally, there’s a program or clinic available for nearly every concern. If I have questions about a case, I can easily connect with the doctor’s advice line or submit an e-consult to interact with the appropriate clinic.
How my lifestyle matches, or differs from, what I had envisioned: Looking back to medical school, I had a very narrow view of what my life as a physician would look like. I was focused solely on the practice of medicine and didn’t fully appreciate the accompanying responsibilities—such as managing notes and paperwork, refilling prescriptions, signing death certificates, dealing with prior authorizations and handling peer-to-peer calls. These administrative tasks are an unavoidable part of the job.
Additionally, my husband, who is a hospitalist, works a demanding seven days on, seven days off schedule. In medical school, I didn’t fully grasp how challenging it would be to coordinate our schedules. However, having a partner in medicine has its advantages; we learn from each other, and I’m grateful for his support.
Lastly, I didn’t anticipate the need to rely on family at this stage in my life, but they have been incredibly supportive and are always willing to step in at a moment’s notice.
Skills every physician in training should have for family medicine but won’t be tested for on the board exam: Every physician in training for family medicine should embody empathy, cultural competency and integrity. Patients often share their most personal experiences with us. We should express gratitude for their openness, provide comfort, offer supportive therapy and refer them to the appropriate specialists when needed.
As jacks of all trades, we care for a diverse range of patients, including children, older adult patients, immigrants, LGBTQ+ individuals and people with disabilities. We must provide care for everyone and actively learn about each population, particularly those marginalized by society.
Lastly, it is essential for us—as physicians—to be honest. If we are uncertain about a diagnosis, we should acknowledge this and seek input from the appropriate specialist. This transparency fosters trust and ensures the best care for our patients.
One question physicians in training should ask themselves before pursuing family medicine: Do you value long-term relationships with patients and continuity of care?
Books, podcasts or other resources every medical student interested in family medicine should be reading:
- The American Academy of Family Physicians’ “Inside Family Medicine Podcast.” This excellent 20-minute summary provides an overview of the academy’s bimonthly medical journals.
- “The Curbsiders Podcast.” This long-form content, created by internal medicine physicians, covers topics that are relevant to all physicians.
- Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, by Harriet A. Washington. Every student should read this book, especially those planning to practice in urban areas, to gain a deeper understanding of medical history in the United States.
Additional advice I would give to students who are considering family medicine: If you enjoyed the majority of your rotations and found them equally fulfilling, family medicine may be the perfect specialty for you. It is the only field where you can perform procedures, deliver babies, conduct well-child visits, work in nursing homes, round in hospitals, give Botox injections and manage chronic conditions. Family medicine truly offers a unique and diverse experience.
