Physicians receive no training on how to leave a practice professionally. The expectation is that you will be there forever and ever, amen. But this is just not realistic. So let me give you my top 10 tips on how to leave your practice well should you make this decision.
Welcome to another day of burnout recovery week! It sounds like we're going to AA or something. But really I'm talking about recovery from burnout in your professional life. I truly believe that you can have a job that you love to go to. It can be sustainable for your life and you can stop taking vacations just to get away from the office.
Today, we're going to talk about feeling stuck. For me, there is no worse feeling then when I feel like that I am stuck. I HATE NOT being able to move from a situation or figure out how to make it better. I get frustrated and grouchy when I feel like I'm pinned in the corner. I'm like a caged animal that just wants to come after your jugular and fight my way out of it.
But guess what I've learned. It's not about fighting your way out of a situation. It's about shifting your mindset to realize you aren't really stuck. Instead of thinking you're locked in a box, maybe you just need to turn the handle and step out!
Here are my suggestions on how to remind yourself that you are really never stuck:
“You are not a flower, move your ass.”
Have you seen the social media square that says "Bloom where you are planted"?
Well I'm going to be honest with you, I hate that graphic.
To me, it's like saying, "Well...your situation sucks but just stay there and do your best."
Yes, we have to make our situation the best that we can. However, when we give up trying to change our situation...that's accepting defeat.
That's accepting that you are stuck in a situation and limiting the possibilities that it can change.
So, I say pull up the damn roots and move out of that garden!
Maybe it's in your practice? Maybe it's time to change locations where you live? Maybe it's time to prune out some relationships in your life that are not healthy?
No matter what it is, stop “just dealing with it” and commit to making a change!
“Your job does not define you”
As a mother of three young children, we have a lot of Moana in our lives. But that’s ok because I think it is a WONDERFUL movie. I catch myself singing “this does not define you...This is not who you are...You know who you are.”
If you don’t know, Moana is a girl who will lead her people after her father.
"I can lead with pride
I can make us strong
I'll be satisfied if I play along
But the voice inside sings a different song
What is wrong with me"
She's loves her island but had a deep yearning for the sea, “it calls me.”
Like Moana, we all have things we are committed to and that we do love (our island, our people) but we have the one little part deep down inside of us that we can't get off our minds, it calls to us.
We see others doing or experiencing that thing we secretly desire. Don’t get caught in the mindset that you are stuck where you are. Because that yearning, it means something. It is hard to step out on it. Just like it was scary for Moana to jump in a boat and sail the ocean having never been off her island. But the payoff…..it’s priceless.
Listen to Moana’s Gramma Tala:
You are your father's daughter
Stubbornness and pride
Mind what he says but remember
You may hear a voice inside
And if the voice starts to whisper
To follow the farthest star
Moana, that voice inside is
Who you are
I've heard all the reason why you can't make changes. Hell, I've even spoken most of them myself. Let me tell them to you and why it's just not true…
“I’m stuck in this position because I am participating in a loan repayment program.”
Yes, those agreements have some penalties for not completing them: immediate or full repayment, increase in interest rates, an added penalty. So what!
Take the hit and get out. Why stay miserable for a 16% interest rate or 10k? Isn't feeling better WORTH it!
Get creative on how to pay the penalties or additional interest and GET OUT FROM UNDER THIS ENSLAVING CONTRACT!
Ask help from someone who has been in a similar situation to you and see how they handled the potential penalties. (ahh-hhmm...been there...maybe I can help!)
Ask to be released from the contract. (You never get what you don't ask for.)
Find a position that is willing to take on these burdens as part of your signing bonus. Or ask your new company/group to take this on as part of your compensation model.
Think: Are these penalties really that bad or am I making them bigger than what they really are?
No matter, do not let these burdens keep you in a place of darkness, feeling trapped or indebted.
“I can't leave my job because I really love some of my patients.”
Best advice I ever got on this topic was… ‘There's always one more patient. You have to learn to walk away.’
We do become really attached to our people. I have wept with patients, for patients and because of patients. At the end of the day, you cannot do this because of other people. Live your life and work your work for YOURSELF. You can't be fulfilled if you living your life for other people who aren't even in your family!?!
Your fulfillment must come from inside of you and your passions.
You will continue to touch lives no matter where you go and what you do.
Sure, you will miss these current relationships. But you will also make new relationship.
You may be missing out on helping and curing patients you may never have interacted with if you stay where you are now. That's a food for thought!!!
“If I quit, then I'm a failure at medicine." -or- "If I quit then I'm just not cut out for this."
Did you get through medical school?
Did you get through residency?
Did you pass your boards?
Where in the hell do you see any failure in that?
Just because a job doesn't work out, it doesn't mean that you are inadequate or incapable of being a wonderful physician.
In no way are you an absolute failure because you recognize that where you're working is not aligning with who you are as a person!
This is where I get clear about the difference between a job, profession and career. Your job is where you go, who you work for and what you do on a daily basis. Your profession is the occupation or trade that you received trading/education in. Your career is your life's work. It's the combination of all jobs, occupations, skills, knowledge and experience. It's the journey.
My career is to help others. My profession is physician and life coach. My job is currently an EM physician at a small Indiana hospital.
You can change jobs. You can change professions. Your career is lifelong and about walking your journey. Job changes are just part of the path! It's not FAILURE, it's just adaption.
My definition of true failure: "You only truly fail if you give up all hope and never take another step forward, never try again or give another chance."
“I don't know what else I could be besides a doctor.”
Physicians are some of the most intelligent and creative individuals that this Earth has.
Whatever we trap ourselves in the box of thinking that there is nothing else that we can do besides practice medicine in the exact same way that we are doing now then we lock our creativity and intellectual power out.
There is not only the decision to stay or go. There are literally thousands of different opportunities that you can pursue by just being you.
Do you like writing? Write content within medicine, blogs for patient education, blogs for companies, write something totally out of the healthcare realm, like a fictional novel or children's book.
There are no limits when you discover what the desires of your heart and start dreaming how to pursue them.
I hear, "I just want to help other people." Well, you can help others WHILE not practicing medicine. You can help people and practice medicine in a totally different way. You can help people and practice traditional medicine but do it the way that is sustainable and invigorating for you.
The key here is you must stop putting yourself in a box with limitations and start opening your mind up to the infinite possibilities of what you can do with your skills, your creativity, your intelligence, your passions, and your desire.
I hope this was helpful to shift your mind frame from "oh that can't happen" to "HELL YES." Let's make it happen. I want to be your coach. CLICK HERE to schedule.
If you want more information about how I change my practice or what I'm doing to help other positions change their practice, hang out with me on social media!
Check out my program DOCTOR ME FIRST on how you can live a life that goes from just surviving to thriving.
I specifically remember that morning. I got up from bed, looked at my husband and said, “Today really is a new day!” I felt free.
Within my first months of practice, I was desperately searching for help. I can remember sitting in my office after hours scrolling through my phone thinking, “There’s got to be a solution for how I’m feeling.”
I had been reading the KevinMD blog with other physicians feeling similar to how I did but their solutions of DPC (direct patient care), training in fillers and botox or leaving their practice then traveling the world just didn’t fit me.
I came across a blog post about being an entrepreneur physician and it directed me to a site called The Entrepreneurial MD. After reading through, I signed up for the freebie. I enjoyed it so much that later I bought the self paced “Physician Odyssey” program. I learned so much about myself in the first chapter but I craved to talk to another physician. I need an non-biased colleague to talk about how I was feeling and what I should do next that I signed up with Philippia Keannely MD to be my coach.
It was a slow start but through our coaching relationship, I was able to have huge discoveries.
I describe my “being coached” experience as THE CAVE.
I felt like I had gotten lost in a cave deep, down in the ground with a broken flashlight. When I got a coach, it felt as if someone joined me, replaced the batteries in my flashlight (empower me) and say, “Hey, I’m here with you. Let’s walk and explore.”
This black cave lit up with this new ray of light (hope). Instead of being a creepy dark place, it was now a beautiful cavern with rock formations and sparkling jewels embedded in the walls (to any Snow White fans, you know what I’m talking about). I felt like during our coaching calls, we would go on these exploration walks where she would let me lead and ask insightful questions that made me go, “Hmmm, IDK?!” We had many deep conversation along the way while just exploring and not trying to solve all my solutions.
Eventually, I got to a place that I felt confident enough to go out on myself. We had worked on my plan together. I then was able to walk out of that dark place by myself on my own terms because of her help.
Being so changed by this manner of openness and authenticity, I knew that I had to become a coach as well for other physicians but also because it fulfills a burning desire to help other in me.
Coaching is not about me giving you answers. It’s not about me pulling you along and jumping your ass when things get tough or off course. It truly is about exploring YOU, giving you support and just taking one step forward. The goal is that eventually the steps get easier, you learn how to walk your path and I get to be your biggest cheerleader!
I hope that you truly consider coaching with me because I know how much my first coach changed my life. I would love to do the same for you!
How Burnout Affects Home Life and More
Wouldn't it be nice if life was organized and managed by the clothes we wore. The office or hospital, I put on my white doctor coat and therefore become Dr. Weisman. I changed to my yoga pants and comfy LLR tee and now, BOOM, I'm Mommy. If only these outfits defined which role I was currently in and nothing else competed with it, right?!?
But how many times have I pulled my cell from my front pocket of my white coat to see a text about my children or friend? Or been at home in my favorite black yoga pants and answered pages or completed charts?
No matter how hard I have tried, life can't be compartmentalize. All areas of my life overlap one another often. Why?
Because LIFE IS MESSY!
The following are issues I want to speak to that complicate the beautiful mess of life even more:
- Mom Guilt
- Doctor Boundaries
- Spouse Problems
This is self-shame revolving around the false beliefs like "I'm not enough for my family" or "Someone else is raising my children when it should be me" or "If I was enough, I could handle this."
These thoughts are deeply rooted in identity, worthiness, self-value, unresolved fear and/or our perception of what motherhood and doctoring "should" look like.
I ask you to explore your own thoughts:
- How do you define what qualifies as “good enough” for you?
- Can you really define what will make you “enough”?
- Are there any double standards you are setting up for yourself?
My point is that ENOUGH is undefinable. It is an unreachable point on the horizon. Its definition can be shifting from moment to moment and is absolutely unattainable because in our heads, we change "what is enough" by the second.
So know this....you are enough right where you sit! The only person who gets to define your enough is you!
I remind myself of this when I start to get all flustered about not appearing "good enough." I tell myself MESSY HAIR, DON'T CARE as a cue to say, "I'm here. I'm showing up. I'm being me and that's enough."
You get to make your own definition of enough so own that!
You block off the end of the day because you promised a special little someone you would pick them up on-time. Then a call comes in just prior to the phones being rolled over to the call center. Now, you are conflicted between seeing this person or sending them to the ER.
If you are like me, I hate turning people away but how can you WIN?
Stay, squeeze the person in and leave your child to be the last one picked up yet again or leave, get your kiddo but then think "did I do the right thing by sending them to the ED?"
This is where the programming of ‘patient first’ comes into play hard. It starts in medical training that we are taught to place the needs of others before our own. But were was the teaching on how and when do you put yourself, your own health, or your family first? Where was the lectures about healthy boundaries?
This climate of "accessibility" for patients is chipping away at our personal boundaries and family time. Patients want us opening our doors earlier and staying later, they want to text us and get immediate answers. But no one is talking about this is uncompensated, inappropriate interruptions of our personal time.
No wonder we have trouble with boundaries and feel guilt about turning patients away. There is little help maintaining our personal space (like leaving 30 minutes early one time to get your kid), the unrealistic expectations that we are always doctor first and that we don't need private time.
Burnout can break a marriage to the core. You're already feeling disengaged, exhausted and experiencing compassion fatigue. Then if your support system at home doesn't understand, your marriage could hinder or derail any positive efforts you are making to get better from professional burnout.
At one point, I felt like my husband became my roommate and assistant coach rather than my life partner. We were just trying to manage the chaos and throw people back in bounds. I could see why my colleagues are getting divorced, why put up with chaos at the office then have to come home and fight it too!
Luckily, my husband admitted he didn't know how to help me but that he would do whatever I needed. What I told him, "I just need you to listen. Don't try to fix me or my job or stuff. Just listen." When he stopped trying to give suggestions and I finally started to open up to him about how I was feeling (overwhelmed, exhausted, fearful, despaired, broken), we experienced a HUGE difference in how we interacted with each other. We hit a breaking point or a turning point and I'm so glad we pivoted!!
So no matter where you find yourself, know that you're not the first one to experience any of this. Know that you are not alone!
If you want to talk, CLICK HERE to schedule a time to chat with me!
I say we call BULLSHIT on continuing to function in status quo of healthcare. I believe the first step is we (the doctors) must be as healthy as possible (mentally, emotionally, spiritually, physically) in order to have the energy to oppose detrimental workflows, overbearing policies, aggressive patients, unfair practices, inappropriate expectations, etc.
Once as a collective of healthy leaders, we can do amazing things! But first...healer, heal thyself!
New article I complied for Christian Medical and Dental Association to be published Fall 2016. I'll put the link up to the direct publication when available. -Be Well, My Friend!- Dr Errin
I quit medicine. I was only five months out of residency and I was leaving medicine. I was finally a full-fledged physician with the big paycheck but absolutely no fulfillment. Not only did I leave the office night after night completely frustrated, hopeless and exhausted, I showed up each morning in the same state, if not slightly worse. The personal accomplishment of healing—gone. The enthusiasm of service—gone. The love of humankind—gone.
I was drained and running on empty. I developed physical symptoms of headaches, palpitations and anxiety. But, honestly, the scariest part was I quit caring. It just became about ending the day, finishing one more chart, seeing one more patient now so at least it was one less tomorrow. No amount of incentives was going to bring me back.
I had dedicated my heart, my soul and several years of my life to this honorable profession. I had ever missed my children’s first words because I was at work. It was never supposed to “just be” my job. It was supposed to be my calling, and it had betrayed me.
Does my story sound familiar to you? If you haven’t experienced burnout yourself, chances are pretty high you know a colleague, friend or family member who is going through it right now.
As Christians in healthcare, we feel tremendous responsibility toward fulfilling our God-given calling of healing. We are determined to complete our work, no matter the cost at times. But somewhere in the hustle and bustle, we are letting our servants’ hearts and best of intentions become our greatest downfall. Our self-care is forgotten in the effort to take care of “just one more.” We get busy, tired and stressed, and then we let our love of healing and joy of service become depleted by unending demands. Our cup runs dry. The light of our life literally burns out.
Burnout is a buzzword in the healthcare world because our community is struggling. An increasing number of healthcare professionals are professionally, personally and spiritually trying to survive against daily demands while experiencing chronic fatigue, depression, anxiety, career and life dissatisfaction brought on by prolonged stress mixed with overworking.
Sleepless nights, increased requirements, new stresses, full schedules and practically never-ending 24-hour patient access have left many totally incapacitated and ready to give up. Add on more clinical issues (like larger patient panels, electronic medical records and patient satisfaction scores) along with family responsibilities, financial constraints and other obligations, it’s no wonder burnout is an epidemic sweeping through healthcare.
Meager attempts are being made to “reduce dissatisfaction” or provide “a stress reduction approach.” Institutions and hospital systems are scrambling to find a solution and trying resilience or wellness workshops, employer-provided counseling, stress management training, or financial incentive programs. Again, reducing stress is treating the symptom, like lowering hypertensive emergency to a less critical level. Lower stress takes a situation from terrible to just bad, from critical to manageable. But it’s not cured.
To stop the exit of doctors, money is being thrown about like gauze piled on a gaping wound. However, just as gauze will not return blood back into circulation, I agrue that money will never increase or return fulfillment. Most of us did not enter into this career for the money. No amount of dollar signs can be placed on the art of healing and human life. So treating the burned-out physician with more money, breathing exercises to reduce stress or required attendance at another in-service is missing the mark and degrading our art to a paycheck makes it feel cheap.
So, some physicians leave. They amputate themselves from the situation, cutting their losses. By removing the gangrenous foot, the rest of the body is spared. However, there is a net overall effect: loss to themselves, their current patients and any future patients.
Others see no end, resorting to suicide. An estimated 400 U.S. doctors kill themselves every year, and the numbers are climbing even among medical students who have yet to start careers. And I understand why. During my “dark days,” an older colleague said, “We would hope to keep you, Dr. Weisman, for the length of your long 30+ year career.” My thoughts, “30 years of this hell? How am I supposed to suffer through!?!” For a brief moment, death seemed like the only way out.
Perhaps it's a time to approach burnout on an individual basis allowing for the healthcare professional battling burnout to take an extremely personal approach to address the exact issues pertaining to them. For me, I did what any good physician would do and started searching for answers because, at my core, I knew my career wasn’t over. I never have nor never will be a quitter. In my searching, I found others just like me and through continued exploration, I discovered help through professional coaching.
Coaching is a partnership that focuses on developing specific, meaningful changes in the life of the person being coached. In essence, coaching is a process that helps individuals get from where they are to where they want to be. Coaches in CMDA’s Life & Leadership Coaching program help healthcare professionals focus on the future, changes they wish to make, goals they want to accomplish and the specific ways to achieve those results. To do this, they use powerful questions like those below to generate solutions.
- Where in my current circumstances am I living out my beliefs or purpose? Where am I not?
- In what ways has my work life slowly encroached into areas I hold sacred?
- How do I know if I am living in the middle of God’s will, dwelling in His power, abiding in His presence? Am I there now? What are some steps I can take to achieve this?
- Where might God be calling me to reclaim my priorities? What boundaries have I let become compromised and slip that need to be reinstated?
- What changes am I willing to make to realign my current life with one that fulfills my purpose?
If you are experiencing something similar, let me share a few truths to encourage and support you.
- Only the Great Physician can be on-call 24 hours every day.
- Get back to the basics. Love, trust and abide in God first, then love others (Matthew 22:37-40).
- Remember that God sometimes gives us exactly what we want just to show us it’s not at all what we need (Philippians 4:11).
- We were never created to live defeated, depressed, condemned, guilty, stressed or unworthy. We were made with a purpose to be victorious through Christ (Romans 8:37; 2 Corinthians 12:10)
- Each of us has a calling, but not all of us have a job that is our calling (Psalms 143:8).
- Don’t get busy making a living and forget to make a life (Proverbs 16:3).
- You can’t effectively serve if you have nothing left to give (Isaiah 41:13).
- Do not lose heart if you are experiencing hopelessness, brokenness, feelings of emptiness or inadequacy. God is with you (Matthew 11:28-30).
- God can use even the smallest amount of faith (Matthew 17:20).
Through coaching, I refocused, redefined and clarified. My life is not perfect now, but it’s certainly a long way from what it was. It’s a daily process to remain balanced and focused on my true purpose. By the grace of God, working with a professional coach and intentionally changing my work life, I’m still practicing medicine, but I’m practicing much differently. I lived through burnout, and I’m better.
If any of this rang true with you, I encourage you to take an introspective look by asking yourself some clarifying questions. Then, determine what you can do to help yourself. Maybe you can seek out help by reconnecting with your local church or CMDA group. Perhaps it’s time you participate in a healthcare mission trip or local service project. Consider taking some days off or changing your current schedule. Maybe just simply turning off your cell for a few silent minutes. Whatever you believe can help, try it.
You do not have to remain stuck; burnout does not have to define you. And remember, you are not alone. Psalm 34:18 says, “The Lord is near to the brokenhearted and saves the crushed in spirit” (ESV). Zephaniah 3:17 tells us God is always in our midst, He is the mighty one who will save us. He is near, ready to strengthen you, help you and hold you up with his righteous right hand (Isaiah 41:10. So don’t give up. Don’t let burnout steal your passion and your joy. Trust in Him, and start taking steps to combat the burnout and rediscover your calling to serve Christ in healthcare.
I quit medicine. I was 5 months out of residency and I was leaving medicine. I had dedicated my heart, soul, several years of my life along with weekends, holidays, special events, and my children’s first words to this honorable profession. Medicine was never supposed to “just be” my job. It was supposed to be my calling and it had betrayed me.
I was finally a full fledged physician and I had the paycheck, the student loans and essentially no fulfillment. Not only did I leave the office night after night completely frustrated, hopeless and exhausted, I showed up each morning in the same state, if not slightly worse. The personal accomplishment of healing was gone. The enthusiasm of service, gone. The love of human kind, gone.
I was drained, sucked dry and running on empty. I had developed physical symptoms: myalgias, headaches, IBS, palpitations, anxiety. But, honestly, the scariest part, I quit caring. It just became about ending the day, finishing one more chart, seeing one more now so at least it was one less tomorrow. No amount of incentives were going to bring me back or cure me.
Burnout is not the disease, it is the symptom of an underlying pathology. Some blame healthcare’s system-wide issues ie: work hours, changing bureaucracy of medicine, overburdenment of clerical work with increased patient care demands, overall increased scrutiny, high acuity of patient care, etc. Others blame the inherit stressful nature of medicine. No matter what the underlying diagnosis is, there is a sweeping plague of premature career deaths of good physicians and other healthcare providers.
Meager attempts have been made to “reduce dissatisfaction” or provide “a stress reduction approach.” Again, reducing stress is treating the symptom like lowering hypertensive emergency to a less critical level. Lower stress takes a situation from terrible to just bad, from critical to manageable. But it’s not cured.
Some physicians leave. They amputate themselves from the situation, cutting their losses. By removing the gangrenous foot, the rest of the body is spared. However, there is a net overall effect: Loss to themselves, to their current patients, to any future patients and to the possible contribution of a career well lived for all of humanity.
To stop this exit, money is thrown at physicians like 4x4 gauze piled on a gaping wound. However, just as 4x4s will not return blood back into circulation, money will never increase or return fulfillment. Most every physician did not enter into this career for the money. No amount of dollar signs can be placed on the art of healing and human life. Degrading our art to a paycheck feels cheap, like being a prostitute to the health system. So, some, like myself, start running away.
Others see no end, leading to the worse ultimatum and resorting to suicide. A silent phenomenon is rippling across the country, physician suicide rates are climbing. I understand why. During my “Dark Days,” an older colleague spoke to me saying, “we would hope to keep you, Dr. Weisman, for the length of your long 30 plus year career.” My thoughts, “Oh @#$%, 30 years of this hell. How I’m suppose to suffer through!?!” For a brief moment, death seemed like the only way out.
So what do we do? How do we change? What should be the treatment plan?
I did what any good physician would do and started searching, hunting, seeking answers because at my core, I knew it wasn’t over. I never have nor never will be a quitter. I’ve always tend to hang more on the “gunner” side. I found (or stumbled upon) others who like me where searching. I found help through professional coaching.
I refocused. (I am more than a moneymaker on the assembly line of medicine.)
I redefined. (I am not the drug dealer providing supply in exchange for good Press-Ganey scores.)
I clarified. (I am and always will be a healer with a servant’s heart and compassionate hands.)
Life’s not perfect now but it’s a long, long way from what it was. I had quit medicine in my heart but love don't pay the bills. So by the grace of God, working with a professional coach and intentionally changing my practice, I'm still practicing but differently now. No, I haven't returned to a bubbleheaded first year med student punch drunk on medical beneficence. But I'm better.
If you or a colleague are experiencing something similar, I encourage you to seek out help. Burnout does not have to define you. My help was in the form of coaching and for that I am eternally grateful.
Not only have I lived burned out, I can help. Want to talk? Follow this link HERE and fill the contact information. You can also email me at email@example.com
Your life, your purpose, your calling matters! You are not alone!