Dr. Joe Bardinelli shares his journey from cop to doc [Show summary]
Not everyone follows a traditional path to a career in medicine. Today’s guest, emergency physician Dr. Joe Bardinelli, was a police officer for six years before deciding to enter medical school. In this episode, he shares how and why he went from being a cop to being a doc.
A physician’s nontraditional path to med school [Show notes]
Dr. Joe Bardinelli earned his bachelor’s in Criminal Justice at age 22 and for six years worked as a police officer. At 28, he started osteopathic medical school at Lincoln Memorial University and then pursued his residency in emergency medicine at Conemaugh Health System. Today, he’s an ER doctor in Florida.
Can you tell us about your background outside of medicine? [1:48]
I grew up in the South. I was born in Georgia. My dad moved around to several jobs while we were growing up. He changed careers a couple of times. That took us to the Carolinas and subsequently Tennessee, so I was there from high school on and went to East Tennessee State University for my bachelor’s degree there, and that’s where I ended up going into law enforcement in Kingsport. I stayed there more or less up until I started medical school, which was over in Harrogate. That’s about an hour north of Knoxville, probably an hour and a half from where I went to high school.
Now we’re married. We started with one child, going into medical school, and then we had our fourth about two months into residency. We’ve got eight, six, five, and three now. We like to be outside; that’s why we moved down to Florida. We wanted to be near the water. We have no ties to the area down here. We just wanted to try something different, and we figured that if we were going to do it and make a big change that we might as well do it while the kids are young.
Do you think your father’s ability to change careers influenced you? [3:08]
It had a role in it, because he was a police officer as well. My grandfather was, and I think, ultimately, that’s probably why I ended up going into it because I felt like I needed to try it. He ended up getting out of law enforcement and went back to a school for neuro-diagnostics to do EEGs and other neurologic testing on the brain. While he was in that, it was right around middle school or high school, so that gave me the opportunity to go into the local hospital and volunteer.
He worked closely with one of the local neurosurgeons there. At that time, it was much easier than it is now. I was able to go in and shadow surgeries and got to be around medicine more, so that’s kind of what sparked my interest. I knew in high school that I had an interest in it, but I still pursued law enforcement going into college just because I felt like I needed to. But I certainly don’t regret the decision. I had a lot of great experiences and learned a lot about life that I otherwise would’ve never seen had I not gone into that. I made some lifelong friends as well and still miss certain parts of it. But it’s definitely been a good change overall.
When did you start thinking you wanted to be a doc and not a cop? [4:22]
Probably two or three years into working at the police department, I started re-evaluating and trying to decide if this was something that I could really do for 30 years. In Tennessee, their retirement system is set up to where you have to work 30 years, and you have to be a certain age before you can retire. We just started thinking about the totality of the circumstances where we were at.
Obviously, nobody goes into law enforcement for money. It’s usually not a driver for people to go into it. It’s more of a feeling like you’re doing something good for the community. But unfortunately, the administrative folks in a lot of the departments can beat that pride out of you because you only hear about when you do bad things, never anything about the good that you do. Obviously, you’re held to a higher standard, and I think you should be. But unfortunately, there was a lot of growing anti-police sentiment at that time, which I think has gotten a little bit better since. But I finally just took a step back and I thought, “I don’t know. I’m still really interested in medicine. Am I too far into this? I could go back and make a change.”
Around that time we were pregnant with my first. I guess I really just changed my perspective about things. My wife, I think, was pretty instrumental in me ultimately deciding to go back and make the change, because it was me spinning my own wheels trying to go back and forth, making the decision of whether or not I could actually do it, or if I was stuck where I was at.
What was the hardest part of the decision to change careers? [5:59]
The hardest part was finally making the decision to do it, and I did it to myself because whenever I was considering going back, medicine was always what I wanted to do. But you start thinking about it from a time perspective and thinking, “This is a really long road ahead of me. Do I really want to commit myself to doing this?” I considered other options like dental school, optometry school, nursing school, PA school. I looked into all of them, and depending on the day that you asked me, it was “I’m going to be a dentist,” and then the next day I was like, “Well, I don’t know, maybe I’ll do PA school.” I shadowed a lot of different folks just to try to make a better informed decision.
But ultimately, I think I knew in the back of my mind that I wanted to go to medical school, and all these other ones were just kind of shorter options. I think what finally did it is when we went on our last vacation without children. My wife was probably about nine months pregnant. We went to the beach and had some time to reflect, and she finally just said, “Take the time out of the equation, and just do what you want to do, and I’ll support you and we’ll make it through.” Once I did that, it was so much easier. Once I was able to just eliminate all these other possibilities and focus on what the route was and how we were going to get there.
Did you choose DO over MD, or was it a matter of where you got in? [7:27]
Well, when I first started looking, I really didn’t even know that osteopathic medicine existed, and it just so happened that the school that I went to was about an hour and a half from where we were living. I went down and took a tour there trying to educate myself about osteopathic medicine. We had a local allopathic MD school at East Tennessee State University, but a couple of things played into it. I wasn’t really well-connected in terms of any kind of a premed community or anything like that. Being a little bit older and having already graduated with a bachelor’s degree in a totally unrelated discipline, I went back because I was paying out of pocket at this point and did my prerequisite classes at the local community college. I wasn’t even present on campus at ETSU to get any kind of guidance from them.
The other thing that kind of played into it is the way that the admission’s role between allopathic and osteopathic schools is a little bit different. I can come back and take the prerequisite classes. I was still basically finishing up physics and organic chemistry while I took the MCAT, and at ETSU, I was not even eligible to apply for the year before I got in because I would have had to wait an extra year to have all of that completed with the way the application cycle ran. I feel like it all just worked out the way it was supposed to.
I came to find out that osteopathic schools tend to have a soft spot for nontraditional students, more so than MD schools. Now I don’t think that’s the same across the board, but I think you’re probably better off as a nontraditional student looking at an osteopathic school because the way that you approach patient care should and does follow the way that they do admissions processes. They consider your whole application as opposed to just what you look like on paper.
What medical school did you attend, and what do you like best about it? [9:34]
I went to Lincoln Memorial University. It’s a private school in Harrogate, Tennessee, which is about maybe an hour or so above Knoxville. It’s right at the junction of Tennessee, Kentucky and Virginia. It’s called DeBusk College of Osteopathic Medicine. Pete DeBusk is a local businessman there that owns DeRoyal Industries and has a lot of patents on medical equipment. He’s really a champion for that area and for that university.
It was a great place to go to school. It’s kind of in the middle of nowhere, so there’s not a lot of distractions, and they were really flexible about learning styles. We actually did not have an attendance policy, and they recorded all of our lectures and uploaded them to a page called Mediasite, and they were easily available that same day. I found that I stopped actually going to class. I would still be present on campus, but I would be up in one of the study rooms and while the live lectures were going on downstairs, I would be reviewing the stuff from yesterday. And then once the lectures posted for the afternoon, I would spend the afternoon into the evening reviewing that stuff for the day because I found that I was more distracted when I was sitting in class. If they covered a concept that I didn’t get right away, I would get stuck on that and be going out of the way looking at things for clarification, and I was just lost by the time I got back. But the nice thing about Mediasite is you could pause, rewind, watch it at double speed, and our school was totally fine with that. I mean there were only a few classes that required attendance like labs and things like that. I really appreciated them having the recognition that people learn differently.
What could be improved at Lincoln Memorial University? [11:17]
The only thing that was a woe for us is that they increased the class size the year that I went. They basically doubled the class size, and I think that there were a lot of hiccups getting through the growing pains of that. I think that they have since then opened a second campus in Knoxville, which seems to be a growing trend, with a lot of schools opening at multiple satellite campuses. I see why they do it, but I kind of wished that they would focus some more effort on graduate medical education. They have a couple of residencies that they sponsor. I believe that as of a couple of years ago they had family medicine and an orthopedic surgery program, but I feel like one of the bottlenecks is that all of these medical schools are opening, but we have not really kept up to speed with all of the residency slots. A lot of the folks that are graduating from a medical school aren’t going to have a residency slot because they just keep on increasing the number of graduates that are coming out.
One other thing: I wish that all medical schools, not just mine, would implement a little bit of education about personal finance because historically physicians do some pretty dumb things with their money. It’s a big shock whenever you go from basically borrowing to live and then getting into residency, and then subsequently, when you start your first job as an attending, you get relatively large pay increases. I think that people put off and put off for so long that they get themselves into trouble because they feel like, “Well I’ve delayed gratification for so long,” but usually you come out with a hefty amount of student loan debt, and people don’t really get prepared with a plan on how to tackle this. I wish that they would at least do some introductory things. A lot of it’s going to be on you for you to learn for yourself, but there’s really hardly any mention of it whatsoever.
There’s a lot of people that masquerade as financial advisors that are really insurance salesmen, and physicians make easy targets. A lot of this is talked about by Jim Dahle, the White Coat Investor. Physicians are easy targets because we have this inherent trust that anybody that we come across on a professional level, we think they’ll behave the same as if I was going to call a physician to consult on a patient of mine out of the emergency department. But it’s not like that in the financial industry. Not everybody has your best interest in mind.
Were you ever concerned about the match because you were coming from a DO school, and emergency medicine is fairly competitive? [14:27]
I wasn’t so much concerned because whenever I went through, it was still pretty separate. There was a DO match that occurred in February, and then there was the MD match, or you could also call that the AOA and the NRMP. I focused all of my attention on the osteopathic match because there were still plenty of emergency medicine programs that were in that match, and as long as you were willing to apply broadly, there were plenty of options for great quality programs to get trained. It ended up working out great because once the ACGME and the AOA decided that they were going to the single accreditation system, all of the osteopathic programs or formerly osteopathic programs had to apply for accreditation. My program at Conemaugh was one of the first ones to get an initial accreditation through ACGME.
About a month after I matched there, we found out that we got our accreditation, and we also changed from a four-year program. All of the osteopathic emergency medicine formats were two- or three-year, which is what traditionally is done in the ACGME world. We had a nice surprise. You only ended up having to do two years instead of four. I did not apply for the other match because it wasn’t a great setup. I’m actually glad the match has unified. If there had been a program that I was interested in the ACGME match in March, I would have had to have basically completely foregone the DO match in February. With that one, you’re pulled and your application is done. You have a binding contract. But if you wanted to gamble and completely forgo the DO match and take your chances in the MD, and then you’re running the risk of not matching.
But I did not take the USMLE and that was for a couple of reasons. It’s quite expensive as a student to pump out the hundreds of dollars for these licensing exams. Really, it was more of a principle thing for me because the USMLE is a licensing exam for something that I will never obtain. I will never be in an MD. I guess I had a little bit of stubbornness in me; I refused to take a licensing exam just to appease potential program directors that I felt didn’t want to take the time to interpret a COMLEX score and compare one to the other.
Now the single match is there. I hope eventually that they address the standardized testing because I do think that there may still be some inherent bias that’s region- or specialty-specific, like neurosurgery or orthopedic surgery. Some of these programs traditionally will not take that many DO applicants, even if they’re 100% just as qualified as an MD counterpart. It’s just one of those things. You still see it occasionally. It’s going away, but there are still some institutions that either don’t know enough or people don’t apply there for them to know enough, but I think you still see that. In emergency medicine, that’s pretty much gone away.
I do think that they should do something about the standardized testing because you are still seeing a fair number of osteopathic students that feel like they have to take the USMLE in order to feel competitive. Some people may be tied to a particular geographic area, or if they really want to go into a particular specialty, they’re going to feel like they have to take the USMLE just because that’s going to theoretically put them on a level playing field with the MD applicants. But now that USMLE is going to pass/fail, I think that kind of throws a wrench in things as well, so we’ll have to see how that plays out.
Was there ever a time in medicine, either because of some tragedy or the sheer workload, where you questioned whether you were making the right choice? [18:58]
Not for those reasons, but still daily, I question myself. I ended up learning about impostor syndrome after all of this, and that fits me to a T. I still feel like a cop pretending to be a doctor a lot of days. I look back and feel like I have everybody fooled. I take things hard if I have a tough case at work or if there’s a procedure that I didn’t get. It really bums me out because I feel like I’m supposed to be the expert in these particular things, but everybody has good days and bad days.
I have never thought about leaving medicine because of any of the workload or the burnout things. Fortunately, because I have the second perspective as law enforcement, I realized that burnout is not just in medicine. Probably every professional field has some level of it: pilots, police officers, teachers. I feel like the flavor of it changes. I am thankful that I did something else, so I know that it’s not just medicine. I do think that a lot of the business of medicine interferes with patient care a lot of times, but there’s red tape everywhere you go. At the end of the day, I just try to be happy to be there and just to take care of people and put all of that aside as much as I can.
How has your experience as a police officer been a benefit to, or perhaps influenced, your practice as a physician? [20:35]
There’s nothing directly related to patient care that was applicable from what I used to do. We used to joke and say that our ABCs in law enforcement were “ambulance be coming.” We knew nothing about medicine. A lot of times we would show up on a scene before our EMS partners would get there. It really has been beneficial, though, because a lot of times it’s a similar situation in that you’re dealing with people at their worst. You have to be able to establish rapport quickly with any walk of life that comes through and earn their trust so you can figure out what’s going on with them. Honestly, there’s so many parallels between medicine and police work. It’s still solving a puzzle. It’s just trying to figure out what’s wrong with somebody instead of what’s wrong with the situation. I think that it helps you keep a decent temperament in the emergency department, and I don’t really get worked up about too many things anymore and try to stay calm, and I think that probably was directly beneficial.
Seeing that other part of society that I probably never would have realized existed had I not done that kind of work, so I’m really thankful for what I used to do. It does help out day to day.
It played a big role in why I ended up in emergency medicine. I did try to keep an open mind when I was going through clinical rotations, and I really enjoyed something from all of my rotations. I think that I was already used to shift work, and I really enjoy having random days off through the week, and I enjoy not being on call. I like, whenever I leave work, that I leave it at work. And the camaraderie. The closest thing to the camaraderie that I found in law enforcement is right there in the emergency department because we’re a team environment. You have to leave your ego at the door. There’s not so much of a hierarchy like there is in other fields of medicine. We’re all there with the same goal in mind, and we have, I think, a better working relationship than some other environments in medicine, like outpatient medicine or hospital medicine.
I still think that we kind of sit outside the traditional house of medicine because a lot of our specialists that we consult, I feel like, sometimes don’t even feel like we’re real doctors. And that’s totally fine. We have some great consultants, and you’re going to have some that are not so nice. Whenever you have to wake somebody up at 3:00 in the morning, I’m sure that everybody’s a little bit grumpy at times.
How do you see your career evolving now that your residency and your formal training are finished? [23:45]
Well, I feel like I’m trying to get comfortable in my own skin. I purposely went to a community emergency department setting to begin with. It did not appeal to me to stay at my residency, as much as I loved the folks that I trained with. I always thought it would be weird to be a resident on a Sunday and then be an attending in the same department on a Monday. I feel like there’s something to be said for just going somewhere totally different in the country and bringing what you’ve learned, and learning a different way of doing things as well. I really do love to teach, and I’m hoping to start taking medical students here, but I felt like I needed to grow personally. I feel like I needed to get just comfortable working on my own.
What I’m hoping for eventually is to aggressively pay off my student loans. And after that, my wife and I have talked about us trying to do full-time locums because we school our kids at home and we like to take random trips. If we could get to the point where I could do full-time locums’ work, I think that that’s really what we were looking for ultimately for us and for our kids. There’s a lot of departments that always have needs for good docs, whether because it’s a hard location to keep somebody out there temporarily or somebody has left and they need work. A lot of the physicians are making a career out of doing that work, and the work involves moving around. You may work a couple of months at one place or longer. There may be a facility that needs a doc for a few weeks. You get random emails. I always get them now just to keep an idea of what’s out there. There’s a facility in the Virgin Islands that needs somebody for the next three weeks. Last-minute kind of things. Then there’s other ones in different parts of the country. Some people make a whole career out of traveling around to different places and working.
I’m not quite ready to do that yet because, like I said, I’m trying to pay off my loans aggressively and I feel like I need something more stable at a single facility, so that’s what I’m focusing in on now is trying to perfect my skills as much as I can. I learn something new every day. I think that’s the one big difference between what I do now and what I used to do: I felt like I needed to know pretty much everything I needed to learn within the first two to three years of doing law enforcement. But you have to be a lifelong learner if you decide to go to medical school because things have changed so much. I see something every day and every shift that I’ve never seen before. Always learning.
What would you have liked me to ask you? [28:02]
I get a lot of the students asking and see a lot of chatter about if medical school is still worth it because you see a large number of PA schools and nurse practitioner schools and a lot of online schools and things like that. I think we have a great place for our counterparts that are PAs and nurse practitioners, but I would still say that medical school is absolutely worth it if you are to be the best that you can be in your field. I would go back to the caveat that there are no online medical schools, and I think that there’s something to that. You have to accept upfront that you’re going to have to deal with the business of medicine that interferes with patient care, but you can’t let that deter you. There’s always going to be a need for good doctors that have a desire to want to take care of people.
I would say to do a lot of shadowing before you make the ultimate decision because you may find that another career is what you’re looking for. Some people don’t want to go to medical school, but they still want to take care of people, and that’s perfectly fine too. You just have to align what you want to do with how long you are willing to put up with it. It is a long road, but looking back on it, it really flies by once you get on the tail end of things. Looking back on it now, it just seems like a blur.
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