I received an email update from one of my clients who’s an Emergency Medicine physician. After almost a decade of working in the ER, burnout and dissatisfaction with medicine prompted her to find a non-clinical job.
She was just hired for a remote utilization review position with a well-known company.
In her email, she mentioned to me that this career change feels “weak.”
This is not an uncommon feeling among those of you who are considering leaving medicine or titrating back. Today I want to share what she wrote and dive into this topic. Here’s what she wrote: (shared with her permission)
I’ll be honest in saying that I’m still not sure about this new opportunity but I’m liking all the people so far and I think this job has good potential. I think my doubts are really more from “the doctor” side. It’s been ingrained in us to work beyond our basic needs. Anything less is unacceptable. So doing something like this feels “weak.”
What is weakness in the context of being a physician?
An OB/Gyn physician is tired of being woken up in the middle of the night and dealing with the risk of obstetrics. She wants to do Gyn only. Is she being weak?
An internist just had her third child. She wants to work remotely for a health insurance company to be more available for her family. Is she being weak?
An ophthalmologist is having significant anxiety doing cataract surgery. He is considering giving up surgery and only doing medical ophthalmology. Is he being weak?
Some definitions of weak from Merriam-Webster are:
- Deficient in physical vigor, debilitated
- Not able to sustain pressure or strain
- Not able to withstand temptation or persuasion
- Not factually grounded or logically present
A place we readily go is to tell ourselves if we can’t take the pressure or strain of medicine – in its current dysfunctional state, we must be weak.
Are we supposed to be like the Bionic Man or Wonder Woman? Maybe the Energizer Bunny on steroids?
This is a sticky trap because this reasoning is part of what has enabled the system to keep you working hours that are not healthy and have a very skewed perspective on what is normal.
We also cloud the picture when we get into judgments about what or who is weak or strong.
We all have our weak areas.
We all have our unique strengths.
Cataract surgery would definitely make me weak at the knees. Changing careers, not scary to me.
We are wired differently.
Some physicians have more energy, need less sleep, love working a gadzillion hours. Have more nerve.
Some physicians are OK if a patient dies or if they miss a diagnosis. Others are devastated and can’t get over it.
Some physicians want to be using different skill sets and have a lot of variety. Others prefer stability and a predictable routine.
You can’t compare yourself to anyone else because they are not you.
Using the example of the ophthalmologist who is having anxiety during cataract surgery. He may be having difficulty withstanding the pressure and stress of this surgery. He may be able to work through this, but if he cannot, it doesn’t mean he is a weak person.
It means that this type of surgical setting does not play to his strengths.
You could call it a weak area for him. But it does not mean he is weak. He might have a gift for dealing with angry patients or delivery a tough diagnosis.
It’s not weak if he decides to change the nature of his work, either by not doing surgery or even by leaving ophthalmology.
He is figuring out what is most sustainable for him and will optimize his strengths.
He will end up contributing more if he is in a setting where he’s thriving and not struggling to get by.
Let’s look at some steps for going in the direction of strength
- Choose a situation – it could be your job, your career direction, or a relationship.
- Ask yourself, “Is this working for me? Is it sustainable? Is it strengthening or weakening me?
- Do everything you can to improve your situation before making big changes. You won’t be running away out of weakness.
- Get objective feedback from people who don’t have an agenda for you.
- Be honest about what your true needs are. Strength comes from honoring what you need and what works best for you, not denying it or feeling guilty.
It can be hard to know exactly what you need or want, or what changes will be best for you. You often have to try things out.
This is what the Emergency Medicine physician is doing.
She will get to determine what ultimately works best for her.
Her decision to do something about her burnout is a strong decision.
It’s a self-respecting decision.
There is no weakness is saying, “Let me try to find something better for myself.”
Anyone who tells you that it’s weak to take charge of your own life isn’t someone to listen to.
Make sure you aren’t saying this to yourself.
Be back soon!
Heather
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The reason I managed to sustain a career in medicine for 41 years is because I began to “shed” my “don’t likes” from my practice. In Anesthesiology, your career can be inclusive or specific. I did everything from NICU babies to open heart surgeries. I did it to gain experience, but when I finally got up the gumption, I began to say “no”. Did I feel “weak”, maybe a little, but my rationalization was that the patient needed an experienced clinician who was dedicated to the practice. I didn’t want to be a “jack of all trades; master of none”, so I gradually divested myself of certain subspecialties in Anesthesia. By the time I was 60, I no longer did sick kids, obstetrics, vascular, thoracic and hearts! I still enjoyed outpatient surgeries, but mostly ENT, GYN and Ortho. However just before retiring this year, I worked exclusively at a GI outpatient facility. It was wonderful ending my career still feeling the joy of providing a great anesthetic. But as Ole Blue Eyes would say “I did it MY way!”(For you young people, his name is Frank Sinatra)
We need to stop “guilt-tripping” over our medical careers! If it ain’t workin’, it ain’t workin’! Find your joy IN medicine or NOT! Be happy. You have only one life to live. Make it count for YOU.
Love your comments Dr. Charity! You give excellent examples of how you changed what you were doing in anesthesia to stay comfortable with the risk and keep active in your career. This is great sustainabiliy. You had an impressive run and likely due to fact that you listened to yourself and “did it your way.” We can always look at others and think we need to be like them or we should be like them, but that do us any good and often takes us in the wrong direction if we let it. Congratulations on a very long and successful, custom-tailored career.
Another wonderful helpful post. Another colleague and I went down to .8 FTE. He’s enjoying his young children and I’m more or less keeping my sanity taking care of my 89 year old mom with a lot of help. I’m sending this post to our doctor in charge of wellness in our health system.
Thank you Jane! I’m really glad that you have made some changes to accommodate the fact that you are not only working hard seeing patients, but you have a lot on your plate with caring for your mom. This is true of so many physicians. You work hard and come home and are not eating bon-bons and lying on the couch. The responsibilities can often be overwhelming. Keep on taking steps to care for yourself. You are precious and deserve to the life that works for you.
Thank you
The stress of hospital politics, toxic group dynamics and the worry over difficult cases was taking its toll on me as a pathologist. My cardiologist husband was feeling the effects of 20 years of night call. Both of our groups were unwilling to agree to part-time. My elderly parents passed away within 18 months of each other. Our dog died. So we did it – we both resigned in our mid 50s and took a sharp left turn – we joined the Peace Corps! We spent two years in the post-Communist country of Albania where we used our skills to teach other docs in our specialties. It was life changing. We are now going to different countries on medical adventures at least twice a year. It’s a new chapter in our lives and we are loving it. Don’t stay in traditional practice if it’s making you uber stressed and unhappy. There’s always something else out there! Don’t give yourself a hard time and don’t give up.
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Thank you very much! Glad it is helpful.