For the last few years since finishing residency, I have been grappling with many things. After my disappointing first job as an academic pediatrician (my "dream job" I thought), and my foray into private practice I realized that the system of medicine many of us practice in, corporate medicine with the primary goal of seeing enough patients in the day, simply didn't fit with the what fuels my heart.
I spent two years during my American Academy of Pediatrics Leadership Innovation Fostering Education Fellowship researching physician wellness and in particular how systems and practices must incorporate wellness and burn out prevention at all levels. It is not enough to tell physicians to meditate if they are being "strongly encouraged" to see more and more patients, have burgeoning administrative tasks (click this meaningful use button), have mountains of debt, or are in jobs that they hate because of loan forgiveness, have less and less control over their schedules, and less time to make meaningful relationships with their patients. A mindfulness seminar won't cut it. Physicians everywhere are saying enough! It's to much! Record numbers of our colleagues are walking away from medicine or are joining the ranks of the hospitalists and specialists. What happens to our system when there are more hospitals, urgent cares, and intensive care units than quality, sustainable primary care practices? What will continue to happen when emergency rooms and surgical suites continue to be more lucrative than wellness centers and small, high quality private practices? Does it mean people will be allowed to get sicker and sicker? Does it mean that large hospital systems will continue to invest less into primary care and more into expanding their Emergency Rooms? Money talks, right?
This year I will be undertaking some exciting new endeavors. To try to get back to what inspired the premedical student who had all of the time in the world to sit with my patients, to commune with them, to build with them. We see it all around us. Patients who can afford it are flocking to naturopaths and integrative medicine doctors. The overwhelming response is that those providers listen. They have the time. So I have to make the time.
I have been hustling and working, but I still felt stuck. Stuck in fear. Stuck in a laundry list of things to do. Stuck in the what ifs. Stuck. So again, I use the tools that I have and start to research solutions. I have been listening to a lot of podcasts about following your dreams and reading books about decluttering and re-envisioning your life (see the list below). I even watched Marie Kondo's Tidying on Netflix. I saw the piles of clothes folks had and thought "yuck! How could things get so bad?" And then I did this while my boys are away:
(clothes stored in my closet, attic, and drawers - don't judge me until you try it! Very eye-opening!)
It's time to get unstuck. The piles and piles of donations, maternity clothes to pass down, and work clothes to pass on won't unseat themselves. No one is coming to save me. I am saving myself. Starting right here. In this moment, again. And I will do it again and again PRN (as needed for those who don't abbreviate on their prescriptions). One day at a time.
Above references mentioned:
Podcasts:
- Dreams in Drive
- Side Hustle Pro
- Therapy for Black Girls
- Marie Kondo's "The Life Changing Magic of Tidying Up"
- Dr. Dike Drummond's "Stop Physician Burnout: what to do when working harder isn't working?"
Netflix shows:
- Tidying Up with Marie Kondo
I read Marie Kondo's book a couple of years ago and redid my closet. It was awesome. (but didn't carry through to the whole house and closet reverted over time to wild state). Just saw the series for the first time and LOVE IT. Letting go of stuff seems like a good first step to becoming unstuck AND doing what brings you joy.
ReplyDeleteYes! Such a good book. I am with you - I wanted to do the whole house but just tackling my items in the attic/closet/drawers was a week-long ordeal. And it's so hard sleeping in a room that is in disarray.
DeleteIsn't the show good? I admit that I fast forwarded a lot of it but I love the tips for each of the rooms. I need to go through Zo's closet next. I know there are old snowpants, old school uniorms, and lots he cannot fit. And Mau is too little for me to keep the items for 6 years! I should pass them on and just get what we need for Mau when he is older.
“It is not enough to tell physicians to meditate...” - this is so on the nose for me right now. I’m finishing up on the interview trail for my first primary care attending job and I am so disheartened by the clinics that brag about their “high producers” then sit with me to go over my optimal RVU schedule... I didn’t go to medical school to be a “high producer”. All I wanted to do was to help people - specifically a reasonable number of people per half day so I don’t lose my mind - and pay off my loans. (I do have a few options I’ve narrowed it down to - all of which I feel like I will have the opportunity to do some good in the world and hopefully allow a semblance of a work life balance :)
ReplyDeleteI realized I feel most “stuck” when I live the same day over and over again and the same routine so I’ve been reaching out more to old friends to get together for baby dates or brunches - after all I think it was you who suggested stop saying “sorry it’s been too long” and enjoy the relationships you have!
Soo glad you resonate with this post. I am so over the push for physician mindfulness without very real changes to the systems that contribute to our burnout!
Delete@ those jobs that brag about "high producers" - that is truly worrisome! I bet if you talk to the "high producers" and the "low producers" alike, they are all burnt out :-( Sadly - the administrators just don't seem to get it.
Did you know burnout is a term that was first coined in the 70's to describe end stage drug use?
ReplyDeleteNo, I didn't know that? Can you please share your source?
DeleteWould highly recommend Pamela Wible MDs resources for physicians who want to catch the dream again. https://beahappydoctor.com
ReplyDeleteYes! I know about her work. I have applied to one of her scholarships - I unfortunately cannot afford her retreats. Her work is so very important. I should have included that in my list :-( Ahhh - I forgot!!!
DeleteCleaning out your closet is a great thing to do to to make more space and make you feel like a job has been well done but it would not be my first thing to do when feeling stuck in the world of "successful providers". First step is to ask yourself what is most important to you??? Make a list: Be with kids after school, exercise X times a week, finances, more house, time to sit and read alone, see the world etc.. Then, decide how much of one you can give up for another. My choice was to be home with my children and enjoy my patients and I have sacrificed on the financial side for this freedom. . I am not the most "productive" physician when it comes to finances but the trade off was my choice and that is having time to raise five children and spending time with my patients. This has worked for me for the last thirty years. Of course life changes, kids grow up etc. and you might rearrange goals with time.
ReplyDelete5 kids - you go girl! Thanks for reading and thanks for your comments :-)
DeleteI think the biggest challenge for most physicians stuck in medicine is lack of good role models because everyone is complaining and there is no one who is happy and handling things well. Often, physician think that being stuck is the new norm and continue to deal with. When I made a major change to unstuck myself, I had no role models. It was very challenging but my sanity, self-respect and passion for integrative medicine was my top priority. Hence I took the leap of faith. Clearly faith in oneself is the second most important variable in getting unstuck.
ReplyDeleteThose are very important points you are making! When I made the jump from academics, I looked around and literally every single one of my role models in medicine was burned out. I was like - if I keep doing this, this will be in a year tops! These women were balancing families with academic jobs in a major academic center, taking their computers on vacation, getting snarky emails from admin about not closing their notes, and had tacked on tons of administrative tasks without being compensated nor promoted for it. My husband and I checked in regularly and honestly if it wasn't for him calling out the hypocrisy I never would have been brave enough. He kept saying "this is abuse! This is unsustainable! You didn't work this hard to do this!" Please share more about what you did - AND HOW ARE YOU PAYING IT FORWARD? Are you now a mentor for other docs? I know the American Academy of Pediatrics has some new programs and are looking for career mentors. Shoot - I need you as my mentor!!! Email me!
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