November 13, 2019

What changed for me at the SEAK Nonclinical Careers Conference?

This was my 10th year at the SEAK Nonclinical Career conference in Chicago.

I attend SEAK every October to mentor and sometimes speak.

This year there were close to 400 physicians looking for options besides patient care.

What has changed in 10 years?

Most things are still the same. It’s a fantastic conference and always delivers.

There are still burned out doctors who want to leave practice.

There are still doctors who want to make clinical practice work.

There are still doctors who have creative and entrepreneurial ideas they want to try out.

The core topics covered are fairly similar over the years. This year’s lineup of nonclinical careers included:

Strategies for Career TransitionLinkedIn
Public Speaking
Life Insurance
Consulting
Health Insurance/Utilization Review
Start-ups
Teaching
Pharma
Locum Tenens
Medical Science Liaison
Telemedicine
Medical Communications and Advertising
Administration
Coaching
Hospice Medicine
Principal Investigator
Informatics and Healthcare IT
FDA
Medical Writing
Contract Research Organizations (CRO)
Disability Reviews
Physician Advising
Investing

I grabbed my syllabus from 2010, dusted it off, and compared the topics.

The offerings were similar, with a notable difference this year of the inclusion of talks on coaching, telemedicine, and Start-ups.

In 2010 there was a talk, “Selling Your Practice.”  How many private practices are there left to sell at this point?

The food was similar – white bagels and cream cheese with fruit and cereal for breakfast.

Lunch was a buffet with salads, various iterations of fish and chicken in red or white sauces, veggies, soup, and a choice of desserts.

The random comments from attendees I’d hear about the conference were similar –

“This is like drinking from a fire hydrant.”

 “I’m really glad I came. I didn’t know there were all these options.”

 “I’m feeling overwhelmed.”

 “I have no idea what I want to do.”

 But there is one thing that has changed.

It happened at my mentoring table – more than several times.

It happened when I’d see tears welling up in the eyes of a physician mom who has no time for herself and little time for her family because of caring for patients.  She always feels exhausted and thinks she’s never doing a good enough job at work or home.

It happened when I’d see the pain on the face of a physician who’s been working for years without joy in a career that’s the wrong fit in order to provide for his family.

The tears and pain are not new. They have been there every year, and they often bring tears to my eyes too.

I feel the pain of what so many doctors have to endure to just do their job and take care of their families. When do they ever get to really enjoy their lives? It has always made me upset and angry.

But this year it felt different. Sharper.

The words in my head as I looked upon these faces were,

“This is so, so wrong.”

No one should have to work so hard to get into a profession, train like a marathoner to learn a craft, and then suffer on a daily basis to provide care for others.

Being a plow horse sounds like a dream job next to the reality of being a physician these days. Fresh air. Exercise. Accomplishment.

I know this is nothing new. It is and has been this way for a while. And I’ve always felt it was wrong.

But I’m feeling it’s time to do something more about the plight of our own.

The rallying cry, “Physicians owing it!” comes to mind as a slogan to capture our self-empowerment to effect change.

Physicians owning it can mean a lot of different things, but an overriding theme is for us to be honest about whatever we are experiencing (not hiding) and taking action to regain more autonomy and respect.

The individual actions may seem small and insignificant, but many small things over time can have an impact. They also help us feel like our contribution matters.

These are some different ways I’m seeing physicians “owning it” more:

Acknowledging to themselves and others how they honestly feel.

Being more willing to have their true identity published on blogs about their transition story.

 Letting administrators know they’re experiencing burnout rather than hiding this fact and soldiering on or quitting.

 Talking and writing publicly about their burnout, depression, malpractice suits, and colleagues who’ve committed suicide.

 Negotiating to work fewer hours or have a different schedule, even if the party line is “No.”

 Getting involved with the development of wellness programs within their institutions – and being paid for it.

 Helping each other out with resources and support in Facebook groups and other communities.

 Creating podcasts and on-line courses to help each other with nonclinical options and side-gigs.

 Refusing to let guilt and shame keep them stuck in the wrong job or career.

The problem is so big and complex – it can feel like trying to stack grains of sand to effect any change – futile.

But grains of sand put together can make a path. And that path can start leading somewhere.

We can all be contributing our own grains of sand to the path forward, in our unique way.

Does anyone want to start a “Physicians Owning It!” movement?

I’d love to hear what you’re doing to “own it” and reclaim the autonomy and respect that you earned and so deserve!

We can all help each other. We can each make a difference. We can create the path.

Be back soon,
Heather

PS – If you want to read my post about the SEAK conference in 2015, click here.

Comments

  1. “but grains of sand put together can make a path…”

    Yes!

    “Owning it” is essential to maintaining the respect and dignity for our profession which we deserve and have earned.

    I am fortunate to be experiencing a “career renaissance” through running my own solo Gynecology micropractice and doing full scope OB/Gyn locum tenens in underserved areas of rural NM, TX and KS.

    I also have other side gigs…

    Unfortunately, the traditional fee-for-service reimbursement model does not adequately pay physicians for providing quality care in an unhurried, relaxed and caring environment. Hence the financial necessity for “side gigs”.

    Despite this financial reality, I have chosen to continue my Gynecology micropractice because I still love what I do, have passion for helping my patients and feel this practice model must remain viable in today’s healthcare environment.

    I also want to be a role model and mentor to other physicians–especially those early in their careers.

    Thank you Heather for all that you have done and continue to do to help physicians maintain their autonomy!

    Helen

    • You’re so welcome Helen! Thank you for being a loyal reader and often sharing your valuable thoughts and perspective. You obviously are very connected to your values in creating a practice to care for women in a way that works for you and them. It takes a lot of strength to buck the trends and do what is important to you. How lovely that you are willing to be a role model and mentor to other physicians. You have so much to offer! Love your spirit and generosity. You are on the path! THank you.

  2. Harry Reahl, MD says:

    Thanks for the neat peak at SEAK.

    I had a thought; part of owning it, is naming “it”. We need to name “it” correctly.

    As physicians, we know the power of a correct diagnosis leading to targeted therapy vs. empiric therapy directed at symptoms. We have learned the tragedy of blaming the patient/victim in historically failed treatment models of addictions, depression, epilepsy, HIV, homosexuality, incest, leprosy, obesity, poverty, rape, schizophrenia, sequelae of toxic exposures, STDs and I am sure many other conditions. “Burn-out” should join this list.

    Burn-out is a description of a response the physician has to years of abuse. Burn-out is a physician in crisis, in moral distress (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912298/)”, knowing the right thing to do, but being unable to do it. Burn-out is not the problem. Abuse is the problem.

    Burn-out blames the physician. A psychologist with all the facts would not say a teenager is surely, has poor school performance, has no interest in extracurriculars, dreads school, dreads home, just needs to practice mindfulness and effective time management if dad were hitting him, mom molesting him, and kids at school bullying him! The psychologists, knowing all the facts, would call out (and report) all the abuse; why not with physicians?

    Burn-out is just one response to abuse. It might be interesting to create a whole “Out” symptomatology, recognizing them all as responses (some of which are extremely maladaptive/illegal/deadly) to the abuse doctors suffer. Off the top of my head:
    Cop-out: the physician caving in to patient’s and institutions unreasonable / ill advised / illegal demands.
    Sell-out: the physician initiating illegal activities (fraud & abuse, illegal prescription writing, boundary issues)
    Check-out: physician suicide
    Shoot-out: physician homicide (not sure this ever happens, but there was a case in LI, NY in which a cardiologist was involved in an arson/ murder plot against another cardiologist. A stockpile of weapons & explosives were recovered from his home)
    Punch-out: physician involved in physical altercations not in self defense
    Time-out: physician who take extended time off, away from practice.
    Zone-out: physician who goes through the motions of practice, provide adequate patient care, without joy or enthusiasm.

    Naming these responses is not to sanction but to identify; the physician still needs to be helped, society needs to be protected, just as a patient needs to be treated, and their contacts need to be protected. However, treatment has to be comprehensive, directed at the cause, which includes an abusive system not valuing the personhood of physicians.

    In my own thinking, I’m changing “There is a burned-out physician” to “There is an abuse-survivor physician”. Feel the difference?

    The “it” is “abuse”. We have been abused. We need to own it before our abusers every will. No matter where our transitions take us, we need to work towards a world in which abuse of physicians is unacceptable.

    • Thank you Harry for your very thoughtful and description response. I do agree whole-heartedly that a lot of what is happening to physicians is abusive. There are some eerie parallels with the workers in the sweatshops back in the tenement era. Long hours, little choice over schedule, no real breaks, and that feeling of being trapped in a system that just wants to use you. I think the “it” can mean many different things, and abuse can certainly be one of them. When I initially thought of the phrase, the “it” to me is the truth of who we are and what we are experiencing. Abuse may be part of the “it.” And the “it” can also be a feeling of empowerment. A desire to make positive changes. Owning it can simply be owning one’s path and refusing to not be a victim, to not be abused. Thanks so much for taking the time to share your wisdom and perspective.

  3. This is a wonderful post. I first encountered SEAK in 2016, at the recommendation of Dr. Pam Pappas (www.drpampappas.com), when I was at a crossroads in my career, unsure about what the “next step” for me was. I then heard your keynote in 2016. The whole SEAK experience was eye-opening because from 2009 to 2016, I thought I was “the only one”, but was surprised to see so many different options and possibilities, and to see this huge community of like-minded individuals, and as they say, “the rest is history”.

    Thank you so much for your contributions to this community!

    Below is my website and my contact information

    -Amazon Author Central – https://amzn.to/2PaQn4p
    -LinkedIn – http://bit.ly/2SrQcOY

    –Chris

    • Hi Chris! It’s great to hear from you and I enjoyed getting to meet you at SEAk in 2016. I”m glad it was a pivotal experience for you. You have made a great career for yourself with your real estate ventures and books. I hope you are doing great and having fun with your entrepreneurial pursuits. Thanks so much for reading the blog and commenting. It always makes my day to receive comments.

  4. Dana Chambers MD says:

    This “survivor” is squeaking by financially doing telemedicine, which is sometimes very demeaning work where patients eat, put on makeup, shop the aisles at Wal-mart, lay in bed, blame you for their bad internet service and act like you are a nuisance they have to endure. Then I get “reviewed” like I’m a server at the local chain restaurant. Does the fact I’m “sweet” or “Southern” have anything to do with my clinical expertise, my 20+ years of experience??

    It’s a paycheck, not a passion. But I’m a damn good actress! I cannot go back to the insanity of office practice either. For a career I’ve wanted since I childhood, it has been heartbreaking to see it end but also a relief. I’m going to dig deep to find that new path, those grains of sand. Heather’s blogs are a lifeline to that!

    I don’t need a pedestal but we’ve fallen so far off the ledge, I can’t see up anymore. I am already saving to be at SEAK next year!!!
    Thanks, Heather!!

    • Hi Dana! I had no idea patients were doing all these different things on telemedicine calls, but I guess it doesn’t surprise me. Oh dear. Very funny about being a “damn good actress.” It’s too bad you’re not being paid for your high level acting skills. I am sure you could rival Julia Roberts in these challenging moments when you have to bite your tongue.

      I’m exicted to hear that you will be at SEAK next year! I will look forwrad to meeting you. Make sure to check with me prior to the confernce so I can give your some insider tips on making the most of the conference.

      Find your support on that ledge and know that there are steps leading back up again.
      Thanks for your lively comments and being a loyal reader of the blog. Much appreciated.

    • trusandra taylor says:

      Dear Dana,

      I was very moved by your post and wanted to respond immediately but was hesitant because I didn’t want to offend you by being forthright in my response. Subsequently, I recognized that we must all reach out to each other and must not hold back in an effort to help.

      First, I want to say that I hear you about the insanity of office practice. I have practiced for > thirty years and know the toll that it can take on your well-being. Yes, I have experienced recognized rewards but on the other hand office practice and direct patient care can lead to unwelcome enervation.

      Yes, you deserve better than what you are experiencing in your telemedicine practice. However, I must ask would you accept the described demeaning patient behavior in an office practice? I certainly would not and require that patients do not eat or drink, talk on the cell phone or engage in any other distracting behavior during their office visits with me. It is not fair to you and them and does not allow you to provide the very best care that you are obligated to provide. I further recognize that you may feel you are not in control of this in a telemedicine practice and feel pressured to allow this behavior because you will be “rated” by the patients. Even outside of telemedicine, we are rated by patients and frequently the ratings are unfair and not truthful. This is the state of healthcare today. I could go on and on about this. Enough is enough and you should have ability to provide feedback to the telemedicine organization without feeling that you are “complaining”. After all this behavior impedes your ability to demonstrate your expertise and provide excellence in patient care.

      Regardless, Dana, and the bottom line of my message to you is that I recognize you are not doing what you love to do. As you begin your journey and prepare to attend SEAK next year, focus up “what you love to do”. That is the key, no matter what. This has worked for me as I am enjoying my journey.

      Peace and Blessings!
      Trusandra Taylor, MD

  5. Trusandra Taylor says:

    Yes, it is time to start a “Physicians Owning It!” movement and I am on board!

    First, I am letting go of the guilt and shame for feeling that I seek alternatives for practicing medicine and want to leave direct patient care; that I feel burnout from this experience and most importantly that I am not doing what I truly love to do.

    To reclaim my autonomy and respect, I am practicing “self-fullness”. Please read Heather’s previous blog on the difference between selfish vs. self-full. Practicing “self-fullness” is working for me to create the path leading to my journey to freedom.

    Don’t wait, begin now! Nameste!

    Trusandra Taylor, MD

    • I am excited to have you on board Trusandra. You are setting a great example of Physicians Owning it and taking action to reclaim your respect and autonomy. I see how you are doing this in your personal life for yourself and being a support for other physicians. You are so right to let go of any shame or guilt from finding what works for you professionally. I do believe we give the most to the world when we are doing something that we enjoy and fulfills us. We benefit, those around us benefit, the word benefits. Nothing to feel guilty about. We can go into medicine with the full intention
      and desire to practice, and there is no way we can see in a crystal ball and predict how we will feel or how circumstances may change. Thank you Trussandra for sharing your path forward.

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