Welcome back to another episode of the Career Transition Posse! Today I’m following up with Dr. Kay, our PM&R/Pain Management physician who’s kindly sharing her career transition as it unfolds in real-time. If you missed her initial interview, you can find it here. 

Read on to see how she’s trying different things out and as well as some words of advice she has for you if you’re on the journey.

Are you feeling any different about clinical practice than when we last checked in with you?

No.  I really don’t enjoy patient care anymore.  To echo the words of Dr. Rachel*, “people can really suck.”  I would add that living in the midst of a crisis like one we have never seen before does not always bring out the best in people—patients and colleagues alike, sadly.  

Several months after my initial request to do so, I have reduced my hours at work.  Less time at the office has not made me like it any better, unfortunately.

(*Rachel’s interview was brilliant. I cried when I read it. Dr. Kay)

Has COVID affected how you feel about your role as a physician in any way?

First of all, in these times, I feel as though I am supposed to be grateful to have a job and job security. Sometimes I am. 

There was a brief period of time, at the start of the outbreak, when I was worried that I might be asked to work in the ER or in the hospital to help out during the “surge.” I felt guilty about not wanting to help in this way. But, I would be useless, and terrified, working in an ER or inpatient setting because I am an outpatient physiatrist. 

I have also discovered that I do not like telemedicine at home any more than I like going to the office. It is hard to practice at home, maintain confidentiality, home-school, etc.  That said, my hospital’s administration is talking about sending us back into the office to do telemedicine.  All I can say about that is I really don’t want to go. I’ve looked at my schedule for the coming weeks and I am dreading seeing all of the new patients.  It’s visceral.  

I have been hoping to be furloughed or laid off and I am disappointed that it isn’t happening. I wonder if people with careers outside of medicine who don’t like their jobs feel this way. Basically, I do not miss being at the office and I think that is more proof that I need to stop doing this, right?

What have you been looking into career-wise since your initial post?

I’m on a few “panels” to do on-line chart review. I have been doing some peer review.  That was very busy at first, but it has slowed down significantly during the pandemic and decline in non-essential medical care and testing. I am also doing disability claims review on a monthly basis.  

I did have an actual job interview for the disability position and that was a really good thing to do. The last time I had an interview for a non-clinical job was a disaster.  It was really helpful to prepare using Heather’s interview checklist and some of the resources she referred me to, particularly the youtube videos.  I also had an interview for a full-time job.  I didn’t have as much time to prepare for that interview, and it was a phone conference with multiple people which was a stressful, strange, but worthwhile, experience.

I am also looking into becoming a physician Life Care Planner.

How do you like doing the chart review? 

I like doing the chart review.  I can do it during my free time for the most part. I’m using my brain to think more objectively without a patient sitting in front of me. However, I don’t like having to call other physicians to do “peer to peer” discussions.  Most doctors won’t call you back anyway, but it’s kind of a hassle. Plus, I know how it feels to be on the other end of the call.  The other drawback can be the reimbursement. You may only get paid for the “review” time, not the time you take to call the physician or the time it takes to complete the report. I’m doing this for the experience so I’m not as concerned about the money right now.  

How about the disability review work you’re doing?

I really enjoy this.  This particular work is very detailed. I am given massive amounts of records to review in some cases. Decisions are based in medical guidelines and facts. Part of this work involves meeting with a team of physicians from other specialties to discuss opinions and finalize a report. It has been a great way to work collaboratively with other doctors.  Also, I am using my brain and my expertise in an entirely different way than I do in the office. It’s objective. I’m learning a ton. Also, I really like that this very detailed process ensures that things are fair. As a physiatrist, and a sometimes advocate for my disabled patients, this is really important to me.

Can you tell us a bit about what a Life Care Plan is?

This is the official definition, which really sums it up:  “The life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs.” (International Conference on Life Care Planning and the International Academy of Life Care Planners. Adopted 1998, April.) It is a way to plan for the lifetime needs of an individual with a disability. The life care plan is typically used in litigation.

What interests you about doing Life Care Planning?

I became a physiatrist because I am interested in helping people have lives that are as independent and fulfilling as they can be.  When a person has been through a catastrophic injury, their ability to do this is altered greatly.  There are treatments, tools, and modifications to one’s environment that are essential in maximizing a person’s quality of life. A life care plan can be a means to making those things happen for a person.

What have you found out so far about Life Care Planning?

There is training and certification to become a Life Care Planner. I am planning to enroll in a course to do this. I am going to be speaking with some graduates of the course.  

How are you handling the uncertainty of your career direction?

I do feel like I am narrowing things down a bit.  

Previously you said that putting your family’s financial security at risk was your biggest fear in this change process. Has that changed?

It continues to be a big concern for me, particularly in light of what is happening in the world right now. That said, my husband and I had a chance to meet with our financial advisor late last year. He basically said that I should not continue on in a career that I don’t enjoy and that he would help us figure out how to make it work during the transition. My husband would occasionally tell me that I should “just quit” now. Perhaps I should have done that already. Now, we both agree, may not be the best time for me to do that. (But, as I said, being laid off or furloughed would not be the worst thing to happen.)

What are you learning in this process of career change?

I kind of thought that something may just fall out of the sky, into my lap, with a big bow tied around it. After a life of going to school, and through training, and being immediately employable, I had forgotten that all of that was really hard work. Changing the trajectory is hard work too.       

Is there any advice you’d like to give others about making a transition?

Be kind to yourself.  You have the right to feel the way you do about your career. Making a transition isn’t a vanity project or an escape from reality.  You want to make a change for good reasons. If you’re having a hard time with that, it may help to write those reasons down, talk them through with someone else who is not going to judge you for them, be clear with yourself.  

It’s hard to make this process of change the priority it needs to be if you are judging yourself and not honoring how you feel. There will always be other things like your job, family, kids, random pandemics, and who knows what else, that can take your attention away from what you want and need.

It definitely takes time, and nothing has happened overnight for me, but if you just make a commitment to something better for yourself and keep at it, the changes will come.

A heart-felt “Thank you!” to Dr. Kay for her in-depth interview. Please feel free to leave comments for her. Your support and encouragement make a huge difference for the Posse members.