Out of Patients

A Novel

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Pub Date 16 Aug 2022 | Archive Date 16 Oct 2022

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Description

After practicing medicine for more than thirty years in the sweltering suburbs of Phoenix, Dr. Norah Waters is weighing her options, and early retirement is looking better and better. At age fifty-eight, she questions whether she still needs to deal with midnight calls, cranky patients, and the financial headaches that come with running a small clinic. Fighting burnout and workplace melodrama, Norah gives herself one final year to find the fulfillment and satisfaction she remembers from the early years of her once-cherished career.

As she embarks on her year’s journey, Norah grapples with a medical practice that is experiencing a concerning loss of income. She is supervising two medical students, one whose shyness hampers his development and another whose arrogance and contempt for family medicine creates major friction at the clinic. Norah’s life is further complicated by her elderly mother, a feisty 86-year-old living in Sun City, who once rejoiced at Woodstock and recently partied at Burning Man. Troubled by a shadow in their past, both women find themselves on a quest for self-worth in their shifting worlds. Norah also must cope with the end of an unhappy, long-term relationship with an aspiring, but deadbeat, novelist.

Supported by her steadfast dog, a misfit veterinarian, and a thoughtful radiologist, Norah wrestles through a surprising assortment of obstacles, sometimes amusing and sometimes dreadful, on her way to making a decision about her future.

After practicing medicine for more than thirty years in the sweltering suburbs of Phoenix, Dr. Norah Waters is weighing her options, and early retirement is looking better and better. At age...


Advance Praise

“Readers will enjoy Miller’s sense of humor and her marvelous dialogue. [S]he really understands the world Out of Patients is written about. She did a terrific job.”

—Phyllis Barber, author of The Desert Between Us and Raw Edges: A Memoir

"Out of Patients has a good narrative with enjoyable, full characters and an interesting plot. It is well-paced and Miller provides interesting turns of phrase throughout. This is very good writing and kept my attention.”

—Leslie Greenberg, MD, FAAFP associate professor, family medicine residency assistant program director, University of Nevada, Reno School of Medicine

“Readers will enjoy Miller’s sense of humor and her marvelous dialogue. [S]he really understands the world Out of Patients is written about. She did a terrific job.”

—Phyllis Barber, author of The...


Marketing Plan

• Insider/personal perspective on how doctors think about their patients.

• Interpersonal relationships within the medical field.

• Behind-the-scenes look at medical practies.

• Stressors that drive a doctor to quit practicing / finding meaning meaning in your career.


• Insider/personal perspective on how doctors think about their patients.

• Interpersonal relationships within the medical field.

• Behind-the-scenes look at medical practies.

• Stressors that...


Available Editions

EDITION Other Format
ISBN 9781647790592
PRICE $21.00 (USD)
PAGES 256

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Featured Reviews

This ARC was provided to me via Kindle, from University of Nevada Press and #NetGalley. Thank you for the opportunity to preview and review. Opinions expressed are completely my own.

Ripe with whimsy, the tone is perfect for the time in which its set. Humor sprinkled throughout, characters are written with a thoughtful perspective.

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Story: 4/5 Characters: 5/5 Writing: 4/5 Enjoyment: 5/5

Norah is the tending-toward-cynical but unfailingly caring and dedicated family practice doctor in the Arizona desert. In her 50s, she thinks of retirement almost every day, but can’t get herself to pull the trigger.

With a jaded but humorous and never bitter tone, Miller brings to life the modern family doctor. Forget Marcus Welby, Norah and her colleagues are beset with endless regulations, condescending specialists, arrogant medical students, health insurance battles, and a plethora of patients who don’t always (ie hardly ever) advance their own cause. On top of this, the practice seems to be losing money despite a full waiting room, and someone is leaving nasty-notes on car windshields. Norah had to kick her do-nothing boyfriend of three years out of the house for … continuing to do nothing, and she has nearly daily calls with (possibly my favorite character) her 86-year old mother who has a crush on the elderly, but well-built mailman and gives detailed instructions on what to do if she doesn’t answer the phone (wait several days to make sure she is dead!). While too grumpy to even consider dating, Norah does come across some potential love interests — an even grumpier vet and a shy radiologist who suffers at her side during endless student admissions committee meetings .

I loved the tone, loved the characters, and appreciated the peek into a real doctor’s life by someone who a) has lived through it themselves and b) translates her knowledge into a highly self-aware and comical story. Some very interesting medical tidbits and asides as well…

Some good quotes:
“To give your life more purpose, for what that’s worth. I’m not sure anyone has ever convincingly proved that human life actually has a purpose. Evolution just does its thing. Sunrise, sunset.”

“I guess when your spirit pales to a washed-out shadow, you grow tentative.”

“Once upon a time we became physicians, but now we also must perform as secretaries and transcriptionists and file clerks and coding authorities and billing experts ad regulations enforcers.”

“And I wondered how anyone can eat baloney, that mash of pig snouts and ears and genitals. You can feel gritty little bits of bone.”

“That made me sad, but why should it? Why should I impose my arduous overdrive, my endless quests, on a quietly contented person?”

“No, apparently my ego needed to analyze and try to fix them. Make a difference in their lives. Maybe I worried that my failure with Grace, a previous student, might repeat itself. I may have mentioned how doctors often obsess about doing things right.”

“Nobody listens. Sometimes I feel like a tiny squeaky voice in a wind tunnel, about to be blown away.”

“And even before I say this next sentence, I’m aware it isn’t fair, because I know tons of great physician men, smart and intuitive, generous and wise. But between Jeremy Newell and Carter Billings, I’d drink my fill of medical males that day.”

“A long afternoon, but mostly rewarding. Nothing easy, nothing cut and dried. Everyone needed to talk. Mostly good patients, all with real problems. No one surly or defiant, no one acting like I owed them good health because they demanded it, no matter how unwilling they might be to earn it. Every now and then those petulant people stayed home and I felt in my element, listening, sorting, treating. Come on, Norah, I told myself, settling in with my charts after everyone had gone.”

“What would fix me would be better healthcare systems, not spending hours grappling with a convoluted computer program. Where I got more than ten minutes with an addict. Consistent medical billing and affordable insulin. Free insulin, Where medical students didn’t lose their glittering idealism in a few short years, while a handful of ego-besotted attending physicians badgered them into despondency. Until some students lost themselves under the crushing demise of their dream. The statistics on physician suicide are dreadful — every day, at least one physician or medical student is lost forever. What an unforgivable waste.”

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Out of Patients by Sandra Cavallo Miller is about Dr. Norah Waters, who, after practicing medicine for more than thirty years in the sweltering suburbs of Phoenix, is weighing her options. She wrestles through a surprising assortment of obstacles, sometimes amusing and sometimes dreadful, on her way to making a final decision about her future.

The story involves depression and how depression affects the characters. I enjoyed reading about everyday life in medicine. However, the story started off very slow and read slowly in parts.

I loved the Arizona setting, and the dogs were a great addition to the story. The telephone calls with Norah and her mother were extremely realistic and added a great touch to the storyline.

This was the first book I read by this author. I enjoyed this story and would recommend it. I may check out other books by this author.

#OutofPatients #NetGalley @UNVPress

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Have you ever wondered what it's like to be a family practice physician in this day and age? If so, this is not to be missed!

Dr. Norah Waters, at age 58, is wondering about her life choices. Working as a partner in a local clinic in Phoenix, she is fed up with everything. A bit bitter and a lot overwhelmed with all of the job responsibilities, she wonders if it is time for her to retire. Trying to juggle the staff, mentor two medical students, see her patients, attend a volunteer medical school admissions committee, and wonder why her accounts billable seem to be tanking are taking her to the edge. Is she burnt out and crispy done or does she still want to continue. All she knows is that something has to change.

Told in the first person, I fell in love with Norah. Her narrative voice, the humor, and her acerbic comments on just about everything really rang true. I loved all the medical and clinical details and enjoyed her interactions with the other characters in this novel. As a registered nurse, I could really appreciate the situations Norah found herself in and could relate to so much of how things have really changed in the practice of medicine over the last couple of decades. This book has a lot of heart and the reader understands that only an author such as Sandra Cavallo Miller has the credentials and experience to write it with such authenticity.

I've read and loved all of this author's previous books and eagerly await the next one. Thank you to NetGalley and University of Nevada Press for this e-book ARC to read, review, and recommend.

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I requested to read “Out of Patients” by Sandra Cavallo Miller. We meet Norah Waters, a committed doctor in her late fifties. Like many hard workers, she’s exhausted and approaching burnout and as a result, is contemplating retirement. Hence, the reader joins Norah on her journey to figure out what she wants to do with the next chapter of her life.

The novel is told through Norah’s perspective. Her narration has plenty of wit (and a hefty dose of self-depreciation). We also get to meet a colorful cast of characters including her spirited mother and the medical students she supervises. Of course, a protagonist who owns a dog always makes me smile. There are places where the plot thins out and it becomes more of a commentary of female primary care physicians, but overall, it was a good read.

Three and as half stars.

My thanks to the author, the publisher, and NetGalley for the privilege of reviewing this book.

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I enjoyed this behind the curtain look at a late-career physician's life.
This book was funny and educational. Well-written and full of emotion. Plus dogs.

This ARC was provided to me from Net Galley in exchange for an unbiased review.

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Dr. Norah Waters has been practicing medicine for more than thirty years. Norah is tired of the disgruntled patients, the paperwork, the work habits of her peers, and is questioning her next choices in life. What will she do if she retires? As she ponders these questions, she is tasked with supervision of 2 medical students. One, a shy doctor learning how to communicate with patients and how to portray confidence. The other student, a self-assured, condescending jerk who tries to put everyone down, including patients. The story was interesting, especially the narrative about the patients and their conditions. Thank you to NetGalley and the publisher for the advance review copy in exchange for my honest review.

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Maybe 3.5 stars. I think if you know very little about medicine, especially family practice medicine, this book will be interesting. But I am a retired nurse that spent most of my 30+ years in a family practice clinic. I absolutely loved it. I felt like we got to see a little of everything. This book is mostly about Dr. Norah Waters. She is a +/- middle aged family practice physician. She borders on burnout and loving her job. The extraneous things that happen in Dr. Waters life- both professional and personal- make this book closer to 3.5 stars. I would read another book from this author and I will recommend it, probably to some of my nurse friends. Thank you to NetGalley and the publisher for allowing me to read an advance copy for my honest review.

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Out of Patients by Sandra Cavallo Miller is a pleasant and even a bit of an eye-opening read, looking at both life in general and a behind-the-scenes glimpse at private medical practice in America.

In some ways this was just the book I needed right now. The characters are interesting, there are major life questions but not a lot of dark or dangerous stress, humor that makes you appreciate even the characters you wouldn't want to spend the day with. Like any good novel it is still a journey, but an almost leisurely one where the different possible avenues all seem likely at one point or another.

I enjoyed my time with Dr Walters, as well as most of the others. It was fun to get inside her head and see so many things from a different perspective than I normally would (not being a medical doctor and all). I would recommend this to readers who like stories that are far more within the realm of possible or even probable than the super twisty novels that throw obstacle after obstacle in front of the protagonist. Don't get me wrong, those are exciting, but a story like this one in some ways grounds me a little, makes me appreciate the people I see every day a little bit more. I would, however, caution any reader who really just wants or needs action to stay engaged. This might not have enough for you. Then again, the characters are wonderful so you might get caught up, as I did, in the day-to-day with occasional blips.

Reviewed from a copy made available by the publisher via NetGalley.

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This is the second book of Sandra Cavallo Miller's that I have read. I enjoyed the first one greatly so I was pleased to be able to read this new one. It was every bit as good as I expected. I love her writing style and love how she has adeptly introduced us to the life of a doctor with all the challenges that modern-day medicine brings. Anyone considering going into medicine should read this! The setting in Arizona lends itself well to the poetic descriptions of days and nights and the dogs are a great touch. I'm going to be recommending this to everyone I know. It's just a total winner of a book!

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It is not easy being a family practice doctor in this day and age. Norah Waters is seriously ready to retire after 30 years in practice. Her stress is at an all time high between work, love, mentoring, volunteering and being trolled on-line. At times humorous, this book is also real. I can relate to the phone calls with her mother (in her 80's) and found lots of truth in the health care part of the book. I, too, have been in health care for 30 years in different capacities This is my first book by Sandra Cavallo Miller and I look forward to reading some of the stuff she has written in the past. Thank you to NetGalley and Nevada Press Publishing for the DRC in exchange for an honest review.

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Love the cover and title of this book, and wanted to give this first-time author a chance. It was a good read in that it revealed the ins and outs of a job in medicine. I think the book would benefit from a bit more narrative drive, meaning something to compel the reader to keep going forward. However, if you are looking for a light, pleasant read, and curious about life in the medical field, this is your book! Thanks to NetGalley for the ARC.

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This is fun, with some humor along the way. I liked the characters and relationships, and the interesting plot. The ending was a bit weak, but a good read overall. I'll check out her earlier books.

Thanks very much for the free ARC for review!!

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This is my first exposure to this author and I enjoyed the experience. With touches of romance and humor, this novel chronicles the challenges and frustrations in creating life/work balance while navigating the demands of today’s health care system.

The protagonist, Dr. Norah Waters, is a dedicated primary care physician in a small group practice. Teetering on the edge of burnout, she is seriously considering early retirement due to long hours, the mountain of paperwork, patients who cannot or will not accept her help in managing their health issues, and a mysteriously dwindling income despite her hard work. Add to this mix a strained relationship with her quirky mother, mentoring responsibilities for fledgling medical students and the end of an unsatisfactory relationship with a deadbeat boyfriend. It is little wonder that Norah is depressed, cynical and bitter. The one saving grace is her dog, Emcee, whose insights and commentary add a bit of levity.

The story is a first person narrative from the viewpoint of Norah, which is well-developed, believable and relatable. There is a wealth of other characters – some more developed than others – that populate her world and added color and dimension to Norah’s rather contracted worldview. My one criticism is that the ending felt a bit abrupt. It was gratifying to see the resolution of the issues and the beginning of new possibilities for Norah. However, after accompanying her on this lengthy exploration of her dissatisfaction with her life circumstances, the ending seemed superficial, lacking any real emotional depth. Because of this, I deducted 1 star.

My thanks to the author, the publisher, and NetGalley for the privilege of reviewing this book. The opinions expressed in this review are completely my own.

This review is being posted immediately to my GoodReads account and will be posted on Amazon upon publication.

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Norah is a family medicine physician who is, well, burned out. She has a full time practice, volunteers, and mentors medical students (some of who can be a real pain). She has recently broken up with her boyfriend and her mom constantly encourages her to give him another chance. She has a few other physicians in her office with her and they begin being harassed, and they have to figure out who would harass everyone in the practice. She also begins spending time with both the veterinarian in town and a fellow colleague (radiologist).

What I liked: I’m a female in medicine so I enjoyed the day to day medical life aspect. It was a little disheartening to see someone so obviously sick of her job, though this did improve by the end somewhat.

What I didn’t like: It was a little slow to get going. I also wish there was a little less of the “harasser” and a little more of the love interest. The harassment didn’t really seem to add anything to the book from my standpoint.

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It's a compelling and interesting novel, humorous and poignant. I appreciated the tone of the narrator, never complaining and always adding a pinch of humour. The aged mother was my favorite characters.
It's a not a fast paced novel but it kept me hooked and turning pages.
Recommended.
Many thanks to the publisher and Netgalley for this ARC, all opinions are mine

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I really enjoyed this book. Dr. Norah Waters is a family medicine doctor in a small clinic in Phoenix. In her late fifties, she is disillusioned with medicine, especially all the time spent doing records. The stress of mentoring a caustic medical student and dealing with mysteries like missing income and disturbing notes being left on her car are burning Norah out and making her consider early retirement. Her personal life isn't much better, as she recently broke up with her long-term boyfriend, but going home to her dog every night is a bright spot in her life. As she deals with the struggles life sends her way, Norah learns there are people she can lean on, and that change may be intimidating but it can also be positive. The characters are interesting and relatable. I like the author's writing style: the book flows smoothly, and the story caught my interest from the start and held it to the end. The story has a bit of everything: humor, drama, romance, mystery.

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Norah Waters is tired. She's 58 and tired of being a physician, tired of dealing with her partners, and so on. Her dog Emcee seems to be her best friend. This novel is an intriguing look at the day to day life of a family practice where the patients don't always needs drugs or supplements but someone to listen to them. Norah's also mentoring two medical students- one of whom initially has trouble talking to patients and the other - Jeremy- is hateful, arrogant, and hopefully an unrealistic portrayal. It's Jeremy who introduces the topical issue of social media into the mix. There's also a love interest of sorts in the vet who treats Emcee. And her mother. This is awkwardly written in spots, especially when it veers into romance, but there's interesting insight. Thanks to Netgalley for the ARC. A good read.

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Out of Patients👩🏻‍⚕️🐕
Author: Sandra Cavallo Miller
Genre: Fiction
Rating: 4⭐️
Pub Date: August 16, 2022

Definitely meant to post this on pub day this week, but you all know how life goes!

Synopsis: At 58, Dr. Norah Waters has been practicing medicine for over 30 years. She questions herself every day if she is ready for an early retirement. Feeling the burnout constantly, along with workplace drama, Norah gives herself until the end of the year to decide on retirement. On top of this, she is mentoring two medical students who couldn’t be more complete opposites of each other. Working through past struggles as well, Norah starts on a quest for self worth. Support from new friends along the way and her beloved dog, help her make the final decision.

What I Liked: As someone who isn’t into character driven stories, I actually enjoyed this one. It could be because I also relate more to Norah since I also work in the healthcare field and have felt some of the same burnout feelings she has. The writing style is humorous and clever. I also really like how the main character was always the main focus, any side characters were simply just on the side. The ending of the story is heartfelt and wraps the whole book up nicely.

Favorite Quotes:
- “Certain people simply make lousy patients, demanding and rude, regardless of whether they ride the bus [to see me] or drive a new Tesla.”
- “Those who don’t know the joy of returning home to a waiting dog simply haven’t lived a full life.”


Read If:
* You love character driven stories
* You work or have worked in the healthcare field
* You like a little humor in your books

Shoutout to all healthcare professionals for doing what you do! ❤️

Also, thank you NetGalley, the author, and publisher for an advanced copy!

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Dr. Waters works in a teaching hospital. Her students are generally very receptive and eager to learn. Jeremy is the exception. He comes from a long line of doctors and is convinced he knows it all and is horrible to his physicians’ tutor. He has no bedside manner, poor interviewing skills, and worse charting habits. Dr. Waters considers him a danger to his patients and the medical profession.

This book exploits the inner workings of a teaching hospital and the terrific job these teaching doctors do for the medical profession. I highly recommend it as a valuable insight into the grooming of our medical profession. 4.5 stars – CE Williams

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I very much enjoyed this book, especially the dogs. While I am not a physician, I completely understood Norah's disgust and disillusionment with the healthcare system in this country. I did feel the book was a bit too long and there were a few parts I didn't like (no spoilers but some people should reap what they sow). However, I found myself laughing out loud during a few parts. A charming read, something I might even consider reading again.

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Having previously read, appreciated, and enjoyed Where No One Should Live by Sandra Cavallo Miller, I was eager to read her new book, Out of Patients. I was not disappointed in the book whose protagonist is a family practice doctor, Norah, 58 years old and a bit tired of trying to keep all the balls in the air at a Phoenix clinic that has five doctors, two medical students who need supervision, and some clearly quixotic patients. Miller does a great job of educating the reader about various medical conundrums and solutions. She also has a sly sense of humor which shows that being a doctor and diagnosing various illnesses is mostly a challenge. Miller does a great job of creating characters and intertwining their often impractical and unrealistic hopes for improving their health. And yet she is empathetic, understanding, and knowledgeable about their concerns.

One of the medical students is a problematic and Narcissistic future doctor whereas the other, who seems unlikely to flourish as a physician, turns out to be just the opposite. He makes improvement; has good, practical ideas about how to encourage well-being in patients; and is clearly set to be a successful doctor. Norah's 86-year-old mother is comedic, deciding she wants to spend more time with a much younger mailman. In the meantime, the plot, as they say, thickens. Some nefarious person is regularly writing nasty notes and sticking them under the windshield wipers on the cars of the clinic employees. At the same time, money is being siphoned from the clinic coffers, and no one is able to identify the thief or why he or she is stealing clinic funds.

Norah has rather recently broken up with her boyfriend, a laconic, would-be writer who seems to lack both ability and realistic goals for himself. At the same time, she meets a veterinarian and then a radiologist, both of whom are interested in her. We also become acquainted with her dog and then later on, another dog from the vet clinic that needs to be adopted.

To wit: this book really has everything needed to make it a great read: a cast of characters, both grumpy and supportive that balance each other; humor; a realistic portrayal of clinic employees; and a plot that thickens and is imaginative but realistic.I highly recommend it and am looking forward to Miller's next book.

Thanks to the University of Nevada Press and Net Galley for the opportunity to read and appreciate Out of Patients.

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Dr. Norah Waters is thinking of retiring, she decides to go to a teaching hospital and supervise two medical students for a year, before she makes a decision. very interesting read.

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Thanks to Netgalley and the publisher for an e ARC of this book.
What a great book. Entertaining and witty, the book accurately describes life as a female family practice doctor. Highly recommended.

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“Practicing medicine is controlled chaos and you have to struggle to keep your head on straight.” So says Dr. Norah, the persevering main character of a marvelous book., “Out of Patients”, by author Sandra Cavallo Miller. This book is now at the top of my “favorites” list and I highly recommend it.

Norah practices family medicine in Phoenix. She lives with her doggie Emcee, who is able to communicate very well. Norah is a bit burnt out, and a bit depressed; also extremely witty and deprecating. Still, she cares about her patients, and her med students and her other professional responsibilities.

I enjoyed reading about her day-to-day life as a doctor. And what really added to the enjoyment of this book, were all the other stories and events that happen to Norah. Mysterious and upsetting messages, unexplained loss of income, difficult medical students, an odd veterinarian, a possible new romance, and a hilarious mother in Sun City all add up to make a meaningful and entertaining book.

5 stars! I plan to read the author’s previous novels. Thanks to Net Galley and the publisher for a review copy. This is my honest review.

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A likable protagonist, humor, and, oh, yes, a dog
Dr. Norah Waters has a lot on her mind. She is 58 years old and is trying to decide if she can continue fulfilling the demands required of a family practitioner. To make it worse, the practice she runs with four other doctors is not deriving the income it used to, and no one knows why. She and her boyfriend broke up over three months ago, but he is not completely out of her life, and meanwhile there are some other interesting men around. Oh, and there is also her dog Emcee (named after Marie Curie).
If you are tired of the current fad for unsympathetic or abused protagonists and characters with whom you can’t identify, breathe a sigh of relief. I liked narrator-protagonist Norah immediately, and she seemed believable as a person. The same was true of the others we meet in the book. Many of them have quirks, but they are believable quirks, like the medical students she supervises, one of whom is overbearing and arrogant, while the other is very shy. Yup, sounds like a lot of medical students I knew back in the day. As a matter of fact, Norah recognizes one of those proclivities in her comment, “Trust me, lawyers do not want a doctor on their jury because we’re way too opinionated, even when we don’t know what we’re talking about.”
While we are getting to know Norah, we also get an unusual and very interesting insight into the life of a family practitioner, which the author knows well, since she is a retired family physician. My respect for my family doc, which was already high, has gone up as a result.
The book is set in the Phoenix area, which I have enjoyed visiting, and it is vivid enough that it makes me want to plan another trip.
With a title like Out of Patients, you might suspect that you will find humor in the book, and you would be right! Norah’s wry observations like the one above keep a book about a doctor who is considering quitting the career she has followed for over thirty years from being a downer.
Out of Patients is categorized as women’s fiction, which may be reasonable, but I could imagine many men enjoying it as well. (In particular, the romance theme is not the main story line.). I will know soon, because I plan to recommend it to a number of friends, not all of them women. I guarantee you will close the book with a smile on your face.
I received an advance review copy of this book from Netgalley and the publisher in exchange for my honest review.

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This was a really good book, no crazy killers, no haunted houses, no views of historical events just a great interesting story about a 60 year old female family doctor. I am in my 60's myself so I enjoyed that the main character was someone I could really understand. So many interesting parts of the book, Norah getting burned out should she retire, income shortages at work to deal with and why is it happening, a recent long term relationship ending, and 2 med students she is coaching. All of these were very interesting storylines and then her conversations with her mom were so entertaining as well. I am a mom of 2 rescue pups so I really enjoyed the chats with her pups too! A very good book!

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This is an interesting story about a female physician who searching for meaning in her life and in her long career. She has to cope with an aging once upon a time hippie mother, two medical students she is trying to mentor/teach, an income from her practice that is dwindling for no apparent reason, and her trusty dog who is her best and perhaps only real friend. The story covers a long year, during which she must decide where to go and what to do. Though the book was somewhat interesting, I found myself struggling to get through it. I think the fact that there was a story, but no real, exciting plot made it more difficult for me. I did find it fascinating to get into the mind of a doctor who had a long and busy career, something I have never done before in all my reading. I got a better understanding and appreciation for the doctors I see all the time, and what heir lives are, for the most part, like. I also liked the fact that this was a female physician, working in a largely male environment. The book just did not grab me. I received this from NetGalley to read and review.

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Sandra Cavallo Miller paints a picture of the toll practicing Family Medicine can take on doctors. Norah Waters has moved from a rewarding career working at a health clinic for the underprivileged to a more upscale group practice. She spends her days seeing patients, supervising sometimes difficult medical students, and long hours after work finishing documentation and paperwork. Somehow, the practice is losing income and Norah is so very tired of it all. There is also the issues of her feisty 86 year old mother and the end of Norah’s long term relationship with a needy writer. The only constant in her life is her dog Emcee.
I enjoyed taking this journey with Norah. The writing is engaging and the story line enjoyable. I definitely would recommend this to anyone who faces burnout in these times and looks for a chance to remake themselves.

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Out of Patients by Sandra Cavallo Miller

Published: August 16, 2022
University of Nevada Press
Pages: 259
Genre: Medical Fiction
KKECReads Rating: 4/5
I received a copy of this book for free, and I leave my review voluntarily.

Sandra Cavallo Miller is a recently retired family physician in Phoenix who has always been a writer in her secret heart. Very little fiction has been written about women physicians, and she finds it a great challenge to show the struggles and triumphs of day-to-day practice in an entertaining and informative way. To show the human side and, at the same time, create an adventurous story. She likes to call her new genre "science-based medical adventure." When not writing, you might find her on a horse, hiking with a dog, or exploring her latest hobby, volcanology.

“Sometimes small steps feel like long strides.”

Being a physician is hard. Long hours, lots of illness, and constantly being torn between doing what’s right and doing what’s allowed. Norah is feeling burnt out. She is on the brink of just walking away, and she’s dealing with her personal life as an afterthought.

This was an unusual but interesting read. Admittedly, I don’t know much about being a doctor or the inner workings of the medical field.

So that aspect of this book was fascinating. It was interesting to see behind the curtain and learn a bit about what a family physician goes through.

The characters were all well done. I did enjoy the balance between being a medical student through someone on the verge of retirement. The mix was well done, and the balance felt fair.

I enjoyed getting to know Norah, even if she was a pessimistic character. But that seemed to add to the authenticity of the story. Norah represented women in the medical field, constantly torn between career and family.

I loved watching Norah work with George and seeing her passion play through her teaching. It was very cool seeing the character teach each other. It was a neat mix of new and old.

I found the storyline intriguing, and despite nothing crazy happening, the plot moved along at a decent pace. The situations were realistic and unusual but apparently fitting for the life of a doctor in private practice.

I enjoyed how this book showed aspects of the medical friend, both with human doctors and animal, and it felt very authentic. I found the humanity refreshing and honest. It will make you think about how you treat your care provider and perhaps give you a glimmer of appreciation for everything they deal with.

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I found Out Of Patients to be a highly readable, realistic novel about an older family practitioner facing lots of life decisions. Nora is a wonderful character trying to balance her career, the politics of a small clinic, her elderly but energetic mother, a love life, mentoring medical students, and whatever else life throws at her, including a money mystery at the clinic. I really enjoyed this novel and felt the author was really good at pulling everything together in a satisfying read.

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I really like this book! It follows the life/happenings around a 58 y/o female physician in AZ that works at a family practice medical clinic, at work & at home. The author knows about her subject (she's a retired family practice physician) & describes an easily imagined clinic setting, & the co-workers involved there & the rapport between the staff....& a home life. While it isn't in a 'thriller' category, it does seem to captivate you & you find yourself wanting to continue reading right along! The reader follows easily along, this relatable story. I really like the 'common-ness' of the story & characters.....one can easily imagine knowing someone like these people.....& maybe that's what lends this to being read so quickly & enjoyed so much....it's so relatable & believable! There's a bit of a mystery, a bit of romance, some good medical info slipped in nicely, good characters (some 'not so nice' characters!) So there's a little something for everyone, all put together in one read! I look forward to reading more from Sandra Cavallo Miller!
I received an e-ARC from University of Nevada Press via NetGalley in return for reading it & posting my own fair/honest review.

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Thank you to NetGalley and University of Nevada Press in addition to the author for this ARC.
This is my honest review
#NetGalley #SandraCavalloMiller #UniversityofNevadaPress
I just loved this book. This was my first by this author and, as soon as I finish this review, I’m going to go find more. I was immediately captivated by Norah, and not only because that’s my daughter’s name. She was relatable, funny, strong and her story was compelling. Honestly, I chose this book because there was a dog on the cover. I can’t resist a good animal story. This story had everything. The characters were amazing. The story was compelling. The dog was adorable. I have spent most of my life in the veterinary field so the addition of a cranky vet also added some fun and relatability to this story.
There was a lot of humor in this book. It was very character driven. I couldn’t have loved it more.

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