I coached several physicians in the last month who are drowning in shitty jobs. There were more similarities than differences. What can I do instead of medicine? I need to get out but don’t know the next best step. I want to start a business but it’s overwhelming. I’ve been dreaming of having my own DPC practice but that feels impossible. But what almost every single one of them needed was rest. They either felt unworthy of rest or it didn’t occur to them to address their exhaustion. It’s scary as hell to take time off to “just rest” but our lives depend on it. Suicidal ideation and attempt increases when an exhausted human is unable to envision a future in which there are less mental/emotional demands. That is medicine for most of us. Talking with other physicians helps. Getting permission (that you don’t really need) from a supportive peer helps too. There’s free coaching available inside the Rebel Physician community, along with dozens of other resources. Join at www.RebelPhysician.com
Respectively, most physicians are employed and don’t have jurisdiction over an “inner circle team.” The whole team is under the auspices of administrators who themselves have directives from finance people (yes healthcare is a business). As long as metrics like RVUs dictate salaries and bonuses, more rest isn’t the answer. 2 days after a vacation one feels it was just a distant memory. Peer discussions over burnout is wasted energy and preaching to the choir, often creating more PTSD. The best remedy is either leaving medicine, changing work hours (pt time, no call, etc) or expanding your horizons beyond medicine.
Sujin Lee
3mo
I think what helps these physicians is to normalize what they are experiencing. It’s not just them, there are many physicians going through similar experience. And it’s not their fault. They are not broken. We, physicians, are not broken Then, ask a deep question - what you want your ideal day look like. Many physicians don’t even know what they want anymore mainly because they are so burned out. Anyone in this position really need is to take time off from the toxic environment. Leaving “medicine” is not the right answer. Leaving “toxic healthcare system” is the right answer. It’s not “medicine” what is toxic. It’s the “healthcare system” especially the private payers. Most of doctors who don’t work with the third party payers feel much more fulfilled and satisfied with their model of practicing medicine. I find answers in DPC and DSC to current toxic healthcare system. That’s why I strongly support physicians who want to start and grow their DPC/DSCs.
Kristin Yates DO this is a real problem and there is no clear path for struggling physicians who want/need to leave clinical practice. The search for non-clinical jobs is challenging at best and a deterrent at worst. Job applications are sent into the ethos and often followed by generic “sorry we didn’t pick you auto-generated” emails. Most physicians do not even know how to write a resume since we are used to crafting CVs. For all of these reasons I have offered to help physicians lockdown jobs in Utilization Management. It seems like you are working for the Dark Side but sadly it is better than clinical practice for most.
Physicians, review your toxic (or good) employers anonymously at RYHE.org. That way your colleagues can find good jobs and avoid bad ones.
Kristin Yates DO I recognize that feeling of not deserving to rest, eat, enjoy with family, support my loved ones, or even have an opinion. What was more painful was to see “friends” in the same place acting with selective blindness in front of the same situations that I was trying to fix. Why? Because their fear was too big, the stability was too comfortable, and in some cases because their values were not clear or strong enough. Doctors, we are smart people. We don't need to be victims. We can say no. But when there is just one rebel physician against the system, it is hard to keep hope.
The best advice I have received is to continue to live like a med student or a resident. Resist the urge to buy a home, plant your roots and take on a car loan or any loan when you have student loans to pay. Work on financial freedom then no one can touch you. Avoid the golden handcuffs!
Thank you for making rest seem normal!
Totally agree that you cannot see your way out of the toxic environment without a break to rest. Your brain needs it. I also think many physicians who say they want to leave clinical medicine don’t actually want to give up seeing patients- they want autonomy to practice how they want and how the patients deserve, with adequate time, energy, and resources.
The real problem is that medicine and healthcare has changed dramatically in recent years. Traditionally, physicians owned their own practices and had more autonomy. They could chose how to practice and how to take care of their patients and themselves. Now, most physicians are employees of large corporations and hospitals and have litte autonomy. Their "quality care" is measured in RVU and google reviews. Also, a career in medicine is long and expensive. Many physicians have high debt and few choices when it comes to employment. Corporations and hospitals know this. Very few careers end up with so much debt, so litte autonomy and a job that literally has the life of others in their hands. Physicians are leaving medicine not because they lost a love for medicine but because the demands far exceed what any person should be asked to do. No one should have to rush from patient to patient, spend hours on prior authorizations, work through lunch or stay up late at night charting. It is not good for patients or physicians. The focus has shifted from patient care to strategic charting for the best reimburesment from insurance companies. I hope that more resources will become available for medical students and residents- it starts there.
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3moIf you're in a situation that's toxic - and you can't figure out a way to change it into a more supportive environment - the only defense is to limit your exposure. For an employee physician, typically that involves cutting back to part-time or leaving medicine altogether - which is often quite difficult unless you were already on that pathway to begin with. Most of the time you can make small changes that make a big difference in your inner circle team in your practice - but the tactics to do so we're never taught in the medical education system. My heart breaks when the business of medicine drives out lightworkers that still enjoy and do a good job of seeing patients. The world's a smaller, darker place when that happens IMHO. ROCK ON REBEL Kristin Yates DO