November 15, 2019

What’s happened with Dr. Gabriel since August?

Physician career change or chance

We’ve been following two physicians as they figure out their career path in real time. Today we have an update from our family man and urologist, Dr. Gabriel (not his real name) If you missed his posts, you can read the initial one here, and the most recent update here.

Read on to find out how what’s happened in this physician’s career journey since August.

Q: Last summer you left a large group practice and moved out of state to join a small private practice.  How is the change?

Dr. Gabriel: The new job is a mixed bag. To be honest, I’m still learning what things I should ask about prior to accepting an offer. While I did *technically* join a small private practice, we merged with a couple of other practices so, I’m back working for a big corporation.

However, I think this is different. In my last practice, there was no future for me from a business standpoint. This is a doctor-led group and I will have opportunities that were not available to me before.

Q: What do you wish you’d asked more about during negotiations?

Dr. Gabriel: I wish I had discussed more about the equipment I needed as well as all the different ways the upcoming merger would change the practice. Also, how much say I would have on conditions I would or wouldn’t see, and any potential roles I could have outside of seeing patients. Some things I figured would just work themselves out and I didn’t want to drag out the negotiations. Truthfully, things did work out for the most part. It just probably would have been better had I sorted them out up front.

Q: Are the job and work environment what you expected?

Dr. Gabriel: More or less, yes. I would say overall I’m happier- it’s a better work environment. It’s hard to say exactly why. I still have difficult patients, many of whom treat me poorly. I still have battles with hospitals, staff, insurance companies, etc. I think our group gets along better and has more self-determination. Everyone has a better attitude in general and it makes a difference.

Q: What is your work week like?

Dr. Gabriel: I start at 7:30 am if I have surgery, 8:30 am otherwise. I’m usually leaving the office by 5 – 5:30 pm. Most weeks I’d say I’m working an average of 45 hours M – F. Call is one weeknight per week and one weekend every 7 weeks. It’s not been too bad. Down the road, I will have a 4-day work-week.

Q: You had looked into a variety of nonclinical options, how do you feel about your decision to stay in practice?

Dr. Gabriel: I would say that a non-clinical job probably would still be better for me in some ways. Maybe it would have been better in some ways to have tried to do something on my own – be my own boss. Ultimately, I decided this wasn’t a path I wanted to pursue. I can’t say yet how confident I am that I made the best decision – it’s still too early.

Q: Was there a nonclinical job that you were excited about?

Dr. Gabriel: Dr. Gabriel: I did interview with the FDA. I thought the interview went well and I actually had some experience in medical devices so I thought I was a good candidate. They seemed very uncomfortable with my relatively young age. I don’t think they believed I wanted to leave clinical practice and seemed concerned I wouldn’t be satisfied with the job. I actually thought the position overall seemed great in terms of lifestyle and the work. Admittedly, the pay cut would have been hard.

Q: What do you like most about your current work situation?

Dr. Gabriel: I’ve got more freedom about what type of patients and diseases I see and there isn’t a penalty depending on what I choose. I’m more of a generalist and less of a subspecialist. This might actually be why I’m a little happier. The 99% subspecialty mode I was in was more stressful and lonely. I also think variety is better for me. My days feel like a little less of a grind

Q: What is the most challenging part about your current work situation?

Dr. Gabriel: Being the low man on the totem pole again. You want to be a good soldier and make a good impression in your first year but there’s a fine line between that and getting dumped on.

Q: Is there still some feeling of uncertainty around your career?

Dr. Gabriel: Absolutely. It only takes one unreasonable patient, conflict with hospital staff, etc. to ruin my day. Then all the things I hate about clinical practice come rushing back. I just try to take a deep breath and focus on something positive.

Q: What are some of the biggest differences in how you feel about your life and yourself now?

There’s a factor I haven’t discussed here yet but one that I think is important. I’m now in the same place as my sister and one of my closest friends. Having family and social support is making a big difference. I also felt like I had no future with my last company. There were no opportunities to do more than just be a worker bee. Here I have a voice even though I’ve only been here for 5 months.

Q: How do you feel in retrospect about leaving your job with a Plan B?

Dr. Gabriel: Other than the lack of income for 6 months, I don’t think I have any regrets. The environment at my last job was so toxic I think it was necessary to leave when I did. The old partners have said I was wise to leave when I did and nearly all the remaining partners have turned in their resignation since I left.

Q: What have you learned about your self in this process?

Dr. Gabriel: Hmmm.. that I am super risk averse. Sometimes I think I’d be better off doing my own enterprise. Other times I think I work much better on a team. I still don’t know what is true. One question is, will I ever venture out on my own and find out? My best guess is I don’t have the stomach for it.

Q: Anything else you have learned?

Dr. Gabriel: I learned how much I was neglecting the rest of my life when I was in a job dominating my time and causing so much stress. It was great spending so much time with my kids when I was in-between jobs. Some days I wish I could go back to more of that.

I am truly grateful to Dr. Gabriel for sharing his career journey as it is unfolding. 

On May 15th we’ll be checking in with Dr. Gigi. Stay tuned to discover her career direction and real identity.

I’ll be back in two weeks with my own update on getting unstuck.

‘Til next time,



  1. anonymous says:

    Thank you Drs. Fork and Gabriel for posting. It is very helpful to see such honest dialogue about the journey that he has taken.

    I agree that dealing with difficult patients truly does take the wind out of one’s sails… I have been struggling with how to address these patients with firmness and gentleness at the same time. Letting these patients know that their behavior is not accepted and should be changed when interacting with their doctor… Any tips?

    Thanks again for sharing.

    • Hello! I very much appreciate your taking the time to comment and show your support. I also appreciate Dr. Gabriel’s honesty. We often only hear about the stories where everything is “happy-ever-after” but that is more like Disneyworld than real life. There are always pluses and minus – especially in healthcare right now.
      You ask a great question about handling difficult patients. I found an article that addresses this topic in a lot more depth than I can here. I hope this is helpful. Sometimes doctors have a hard time be assertive and setting boundaries, so if that is the case, doing some reading work in these areas can be helpful too!

  2. Congratulations Dr. Gabriel on taking the necessary steps to move forward in your professional journey! Even though your current position may not be your final “destination”, I sense that you have learned a lot about what works and what doesn’t work for you. Cheering you on!

    Helen Rhodes MD
    (currently wearing “3 hats”: owner of solo Gyn only micropractice, Center Medical Director for plasmapheresis industry, traveling locum tenens doc providing full scope OB/GYN care to women in underserved rural areas of TX & NM)

    • Thanks so much Dr. Rhodes for your kind and supportive words for Dr. Gabriel. It really helps for each of us to know we are not alone in our journey and it’s really helpful when someone like you takes the time to give a shout out to cheer a colleague along. Kudos to you for finding a way to be using your experience and skills in this interesting combination of pursuits! Congrats to you too!

  3. Josette Covington, MD says:

    Thank you for the update on Dr. Gabriel. He mentioned that employers worried that he was too young to sincerely want to transition out of clinical medicine. However, I fear the opposite. Being in my late 40s, I wonder if employers will look at me negatively because I’m not a young whipper-snapper who potentially will hang around for 30 years and help make their companies better.

    • You are most welcome Dr. Covington, and thank you for your comment and question. Being a physician in your late 40’s really is not a disadvantage for most companies. You have a lot of experience under your belt, if you have kids, they are likely getting more independent, and you still have a lot of career years ahead of you. I would not worry about your age.

  4. This is a nice interview Heather, Dr. Gabriel seems he maintained to be a responsible family man despite his busy schedule with his new environment. Being aware of the stress in your life and creating a proactive plan to manage it can help you to transform your experience of stress, particularly if you are a doctor. In other words, focusing on self-care and stress management can help you to relate to the challenges your patients face and learn to overcome them so you can better help your patients to do the same.

    From: Internal Medicine Doctor in Houston

    • Hi Gregory! Great comment. Thank you kindly for taking the time to read Dr. Gabriel’s update and share your thoughtful words. Yes, it definitely is a balancing act between work and family, especially with young kids. I hope that things continue to go well for him. How are you liking your concierge practice?

      • Hi Heather, there are some challenges. Everyday is a new day, figuring out how to simplifying the whole system smoothly. Overall, I am happy with what I am now. I hope to see more of your interviews with other Doctors. It’s a nice approach coming from real peoples experiences.

        • Hi Gregory, I hear you. Any new direction has its ups and downs, pluses and minus. If overall you are happy then the math is working for you. I’m glad you like the “real life” physician stories. I always feel it is most powerful when we get to go to the source and hear the truth. And I also like hearing the story as it unfolds because that is where life is lived anyway. The endpoints are just a dot in time, and then the dashes start again. One reason why not to dash to the endpoint ( unless of course it is a real race!).

  5. Hi Gregory, I hear you. Any new direction has its ups and downs, pluses and minus. If overall you are happy then the math is working for you. I’m glad you like the “real life” physician stories. I always feel it is most powerful when we get to go to the source and hear the truth. And I also like hearing the story as it unfolds because that is where life is lived anyway, in the process of change. The endpoints are just a dot in time. The fullness of life is in the dashes between the goals. So what’s the point of trying to dash to the endpoint or goal – unless it’s a real race? (I have to keep reminding my self that).

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