Leaving your career in medicine is like breaking up in a long term relationship. It may have all started out with lofty expectations, excitement about the future, and becoming your best self. However, somewhere along the way things got messy and twisted and not what you signed up for.
There were hiccups along the way, signs that maybe it wasn’t good for you. There was the time you fell asleep at the wheel and totaled your car on interstate 95. You were in a daze, driving home after 30+ hours awake delivering babies, doing surgeries, and rounding on patients in the hospital. You walked away fine but the car was demolished. It was scary, but not enough to make you leave. It was like a big fight in a relationship. It made you realize your shortcomings and problems with a system that encourages working in unsafe conditions, but you decide it was just a mistake. Next time you’ll sleep at the hospital first before heading home. You think it is your fault and can’t be the relationship that is broken.
Or perhaps, the time when you were in your first year of obstetrics training. Your hands were shaking from adrenaline after a tough delivery. You breathe a sigh of relief when the baby’s limp body begins to move and he gasps for air. You attempt to obtain blood from the umbilical cord for testing. A large bore needle sliced its way through the flimsy protection of a rubber glove as you clumsily tried to obtain the sample. You were acutely aware that your patient has HIV. What was her viral load? Your head spins and suddenly you feel nauseated. Now you were potentially exposed to HIV through a needle stick. You take the antiretroviral medications prescribed to decrease your exposure risk of HIV despite the toll it takes on your body. You can barely complete your busy days in residency due to the nausea and fatigue from the medications. Thankfully, it works. After follow up testing for over a year, you are cleared from the infectious disease physician and no longer need to worry about the exposure. You think to yourself, this is just a test of my commitment. There are risks with being a doctor, ones we agree to accept. Just as you risk opening yourself to heartbreak in a relationship by giving of yourself. In medicine, you do the same. It is for a greater purpose. You acknowledge the risk and forge on.
There were happy times too. The day you emergently took a woman with a ruptured ectopic pregnancy to the operating room, her abdomen filled with a liter of blood. You transfused life-saving blood while swiftly removing the fallopian tube that had been irreparably damaged. Your patient hugged you afterward for saving her life and you discuss getting pregnant in the future. Two years later you embrace again, in celebration of a healthy pregnancy now growing safely in her uterus.
Or the time you discuss infertility with a patient, handing her tissues and listening intently while she tearfully describes her years of inability to get pregnant- the one thing she desires more than anything in this world. You discuss risks and benefits of a medication to enhance ovulation and review next steps. She returns several months later, absolutely beaming and you confirm her pregnancy. This is why you went into medicine.
The good times keep you going, holding on. Plus, there were the expectations and investments put into this relationship.
Now it’s been 7 years in a busy Obstetrics and Gynecology practice. You made it through 3 of your own high risk, complicated pregnancies. You have hit your stride in practice. Confident in your skills, comfortable with your decisions, and patients are waiting to see you. You are doing all of the right things but something has changed. Is it you? Is it the relationship?
You notice that increasingly over the last few years, health care has changed. Hospitals, administrators, employers, and even patients all seem to have a more powerful voice in the field of medicine than physicians. Physicians who have tirelessly devoted themselves to patients, often at the expense of their own families, are being marginalized. Expertise is being overlooked for cost effectiveness, “patient satisfaction scores”, and computerized check lists. Your love for the medicine has not changed, yet somehow everything surrounding it has.
The years invested in training amounted to 8 years after undergraduate school. In residency training you worked over 80 hours per week for little more than minimum wage. The debt incurred from medical school was enormous. You can’t just walk away. This is a commitment. You made a promise.
Change is hard. Especially when you have invested so much. You have lost years of time with your family and friends. You missed weddings, funerals, birthdays. You feel pressure that the noble thing to do is “stick it out” and not complain. No one wants to hear a doctor complaining about their job.
It takes a personal health scare to make you realize that you actually do matter. Your happiness matters. Your family and time are important. The only way to recapture yourself is to leave medicine. You decide to leave this destructive relationship when you realize that you are not the problem. You are not “burned out”. The problem is the current environment in medicine which puts physicians last on the list. Your stories are not unique, and all too common amongst others in the field. Leaving for you is taking control back. Control of your life and also making a statement for those still in this unhealthy relationship. You join the increasing ranks of young physicians that are finally taking a stand and demanding better from this toxic relationship.
I’m an RN. I recently went into semi-retirement after a 30+ year career as a nurse. I agree 110% with your opinions about how healthcare has changed. I don’t see it getting any better. It’s sad because like you, I really enjoyed taking care of my pts. I just got sick and tired about all the peripheral stuff – hospital administrators who only cared about keeping costs down without looking at the whole picture or thinking outside of the box to control costs, very subjective patient rating systems tied into reimbursement, increasingly invasive insurance companies that are dictating care, poorly designed EHRs that keep us away from the bedside more. All this has led to more stress and less job satisfaction.
after a 30 year career, I can imagine you have seen the health care system change dramatically. I also would like to see a shift back to patient centered care. I think this will occur with less intervention from insurance companies and administrative figures and more input from the health care team (doctors and nurses specifically). Thanks for your feedback.
Just curious, what type of health scare did you have? Can you elaborate on how your able to retire at age 37? I’m 35 and drowning in debt associated with medical school but trying very hard to pay it off early so I could one day have the luxury of being able to retire.
I will likely go into my health scare in future blogs, but luckily I am 100% healthy now. Need to still process all that occurred before writing more. As far as retirement- I did pay off my loans first. It was a combination of being in a field with a high earning potential, living below my means during med school, residency, and after for a few years. I also chose a job with a loan forgiveness program. However, I think the most helpful thing was living like a resident and paying off the loans as quickly as possible to avoid paying even more through interest.
Hi Doctor Mom,
I so enjoyed your ‘blog’! I saw it on KevinMD.com today. My story is/was very similar to yours. I am now 46, but I practiced OB/Gyn for over 8 years until I was 38 and then Gyn only until I was almost 40. I had one child when I was a 35. Everything changed for me after he was born. It took a major break down for me to leave my job. I felt as if I had no options at that time. I am so happy to see other doctors speaking out and telling their stories. I now know that I am not alone or crazy. I wish I had had more support back then from colleagues and partners. I’m curious if you have figured out what to do ‘when you grow up’. I keep getting that question, and I still don’t know 7 years after leaving my career. I have nightmares about 2-3 times a week about residency, surgeries, patient care, labor and delivery, etc. until this day. I grew up with a father who is a general practitioner and was never home. You would think I knew what to expect for the life of a doctor, but as you said – so many factors have changed in the world of medicine. It is very sad to have lost this ‘relationship’ for which I devoted my heart, soul, and about half of my life. I would also like to point out that when I went through medical school and residency I feel there was very little if no preparation for the real world – mental health support, family counselling, contract and business advisement. Thank you for listening to my rant and for your words.
I know this is an old thread, but I identify with it so much that I couldn’t help posting! I am 37 now and totally worn out by OBGYN. I want to change my field but I am unsure whether I would like doing what I decide to do next. I have so many questions going around in my head. What if I am just bored and not worn out and then I get ‘bored’ again with my next venture. Should I be taking a loan at this stage of my life when all my friends have paid off theirs and buying a new house or new car. Half of my family are supportive, and the other half feel I should not leave this field because it is so noble and respectable. It is difficult to explain to them that it is not enough anymore. I also want to enjoy life like other people.
I am really glad to see that there are other people who think like me and I am not alone in this. Thanks for writing this blog and to everyone who has replied.
Shefali, Thanks for your comment. You are not alone in your thoughts! It has been a while now since I left medicine but I still fully believe you are in control of your own life. Your situation is a little tricky since finances are a factor (and you mentioned potentially taking out a loan) but at the end of the day, you ALWAYS have options. Good luck to you and don’t hesitate to reach out. happy to answer any questions you may have.
Great article on KevinMD. I’m FM & essentially quit practicing a few years ago after a serious accident involving myself & 2 girls followed by a terminal cancer diagnosis for my Mom (ovarian cancer) and brother-in-law (ALS). I did nothing but take care of myself & family for a couple years until telemedicine drew me back in part time. I LOVE it! While it might not be right for you, I wanted to tell you there might be options in medicine that you never considered. And obviously, you’re a really talented writer, so you probably already found your 2nd option! Thanks so much for your article & honesty!
Thank you for your feedback. It is so nice to hear of physicians finding balance in different ways. Sometimes life just happens and we must all make the right decisions for ourselves and families. Glad you have found yours!
I’m right there with you – I made it to 48 but feel the same way you do and I’m in the process of “retiring” from a busy oncology practice.
It is such a hard process and not a decision made lightly. We all feel a commitment to patients yet often at the sacrifice to our own lives and families. I am sure you are doing what is right for you. The greatest relief for me came when I let go of my “perceived” expectations from other people/society and realized this is MY life based on my choices.
I am often pulled by from my desire to “retire” from clinical medicine for the guilt of believing – “didn’t I know my life was about sacrifice for this care for the greater good of the patient?”
I am not sure is this is from society’s and administration view of the physician or is it my own “spiritual” calling or a combination of both. After 10 years being a practicing physician, I recently made an error in clinical decision making and I can’t even figure out why my behavior was unlike my nature in that moment considering I know the answers and am usually prudent about investigation of things. I average 4 hours of sleep on 4 nights a week, the other 3 nights are 5-6.
I chart at home 2-4 hours a day including weekends to keep from drowning. I work 11 hours days before getting home I including my commute. How can I think straight?? I am forced to make medical decisions and move on because I have 20 phone calls and 15 patient portal questions to answer, 5 requests for urgent appointments … oh don’t forget to check your email about the meeting and you have 10 prior authorizations to complete. It never ends! My stress at home increases as my kids don’t want to go to bed ( don’t they know I need to finish my work) but I need to be present for my family even on weekends. I am overwhelmed, burnt out and in debt. Was not smart enough to heed the advice to pay off loans early. I need to find another option before this relationship with medicine completely steals my joy. Thank you for sharing with us. You are helping me.
I am 60! Feel the same way. I am drowning in debt as I poorly managed money. I’m looking for suggestions.
I am 60! Feel the same way. I am drowning in debt as I poorly managed money. I’m looking for suggestions. Please , I’m desperate
Great post! I’m obgyn practicing for 13 yrs. I worked for private practice office for my first 3 years then employed by hospital system. After the chronic fatigue and never ending work after leaving the office, I am moving to a non clinical carrier. I too paid off my med school loans quickly and now just have home loan. After a year of self evaluation and fighting with my identity as a physician and leaving the career I worked so hard for, I will start new job that gives me income, flexibility and an opportunity to learn new skills. I did reach out to my administrators 8 months ago and revealed how I felt. They just did not have tools to help me and potentially retain me. In my last few months in the practice I have felt the appreciation and support from my patients and staff. I’m eager to try new journey and know my skills as a physician can always open that door if needed. I also joined a very supportive group SAHMD for moms who are MDs stay home or have found ways to continue limited clinical practice or moved to new careers out of medicine.
Can you share a link to the group you’ve found? I’m in a similar situation and would love to connect with others. Thanks!
Hi the group on Facebook is SAHMD you have to be added on. You can message me on Facebook or send me friend request and I will add you. I had to send friend request to one of members to be added. My name is Adriana Canas-Polesel. It’s unfortunate but amazing how these groups can
Provide support to us as we make these decisions.
Hi – can you tell me more about your support group SAHMD – is it an online group?
Hi it’s a group on Facebook subset that grew out of the pmg physician mom group. You have to be added to group so if interested let me know and I’ll be happy to add you
Thank you for your comment. I also left on good terms with my staff and colleagues. You are right. There are not currently avenues in place to make the system more palatable to retain good physicians and I hope this can change for those remaining in the “trenches”. I am glad that you have found a new balance that works for you. I am not sure yet what my future will hold (I am trying out several different things) but I agree that hopefully the hard work of obtaining the MD will help open other doors.
Thanks for sharing your story! I am a third year medical student (almost 4th!) and I will be pursuing ObGyn but I always try to be as conscious as possible about self care and maintaining a balance. Residency will be hard, but after that I hope to be able to maintain the balance once again. I hope you can find peace and passion again in this journey, and thank you for sharing your story.
Best of luck in your final year of medical school. I don’t regret any of the choices I made and am happy to have gone through ob/gyn residency in the end despite my much earlier than expected exit from the field. We need good people in medicine- especially in demanding fields such as ob/gyn.
Reading your blog has been helpful to me as I manage my own retirement from medicine. I used to think that being a physician was like being a priest; a lifelong commitment. Now I’m beginning to accept that it is, or has become, something quite different. I think you may have said it best – the word you used is “laborist.”
Whatever it was that physicians once were, that world is gone forever. Capitalism, which, like cancer, must grow or die, is constantly seeking new markets. In my own lifetime I’ve watched it infiltrate medicine, until there is nothing left but an apparatus that includes oppressive administrators, parasitic organs like Joint Commission (with their endlessly trivial “Quality Measures”) and EHR’s filled with meaningless jargon. The goals of the system are soley to minimize cost and maximize labor/revenue (abstracted in the form of RVU’s).
I would *never* encourage a young person to go into a career in medicine.
I’m an RN and my husband is an OB/GYN. When a lot of the trouble started, somewhere in the ’70’s, we saw it coming, HMO’s and all. And we spoke out. And low and behold there were no doctors willing to fight for themselves and their careers. Unbelievable but true. It was as if there were no medical organizations that gave a flip. So where we are today I would not attribute to ‘capitalism’ (the best economy in the world, sure beats communism) but to indifference from the medical community at large.
Thank you for writing about your experience. I related so much to what you wrote!
I too left a busy, lucrative OB/GYN practice at 40 – initially I was forced to just take a little bit of time off to recover from some needed orthopedic surgery, but it became apparent after several months that I would be permanently medically disabled because my injury left me with permanent nerve damage. Looking back, my medical condition was a perfect, “legitimate” (as if anyone ever needed one!) excuse to prioritize myself and my family’s needs after years of neglect. Today I am 45 and have found an immensely gratifying second career as a part-time consultant to biotech companies in the womens’ health space. Though I have zero regrets about the 15 years I spent caring for patients, I am so grateful every day for the second chance at a fulfilling career that provides a great income and all the flexibility I need. Anyone who is willing to be open minded about learning new skills (and willing to embrace significant change) could do this too – I don’t have a monopoly. And I got my family (2 kids, dog and husband) back!
Wow, it sounds like you found a great niche. It seems like we had similar paths. I also agree with your statement about zero regrets. I’m still glad I went through medical school and cared for those patients for the years that I did. However, I don’t know that I would encourage my children to consider a career in medicine unless there are drastic changes moving forward. thanks for your comment!
Hi Elaine. Just wondering how you found your consultant job? I would love to do something other than the clinical medicine I have been practicing for the past 25 years! If you can email me with any details, it would be greatly appreciated.
I would like to address your comment, “somewhere along the way things got messy and twisted and not what you signed up for.” It really struck me as you were speaking both about a long term relationship and a job, that to group those two vastly different life experiences into the same category does a disservice to both as it distorts our perpectives of both.
In a long term relationship like a marriage, it is expected that none of us know what we are signing up for, but the commitment is to figure out a way to make it work for both spouses when it does get messy and twisted. Otherwise, there is no commitment. Marriage requires that kind of commitment. When we take the attitude that it is ok to get out of a marriage because it isn’t what we signed up for, we end up with the mess that we have today in our society because spouses will not put the effort into working things out.
In essence, our society has become serially monogamous. This has devastating effects on future generations who believe that concept is acceptable, not realizing that hard work can result in a deeper and more meaningful relationship than jumping from one person to the next when the relationship does not appear to be what was signed up for. Work, on the other hand, should not ask that commitment from both sides. An employer may liove it if an an employee is committed to that degree, but then the relationship is one-sided in favor of the employer.
I realize you probably did not have that deep an intent when you wrote those words, but please let me share a personal example. I am a sufferer of a chronic illness which I contracted after having children. When I brought up my concerns to my OB/GYN after the birth of my second child, they were simply treated as, “Well, everyone is tired when they have a toddler and a one-year-old.” Fifteen years later, I found out that my thyroid had been destroyed from my body’s autoimmune response and that I had actually been suffering from Hashimotos. My husband, who was a general surgeon, told me that it was my responsibility to fix myself and left our marriage because it was not what he signed up for. This has profoundly affected our children, who are just barely adults, in thieir own romantic relationships. Children are the future of our society, and do we really want to contribute to sending our society down the rabbit hole just because life got messy and wasn’t what we expected?
So grateful for your courageous post, Ma’am. Looking forward to hearing more of your story! https://www.linkedin.com/hp/update/6247047948669116416
Paul, Thank you for your comment. All the best to you.
Thank you so much for writing this. I am a fourth year Medical student who just matched into OB-Gyn, and while I do not regret my decision, honestly your story scares me. My entire family is in medicine and I have seen the field change so much in the last twenty years. I hope to keep your story in mind in the future and learn to have some type of work/life balance in the future. Your story really emphasizes the importance of self care and finding a healthy balance to me Thank you
I am (or was) in heme/onc until my husband developed a serious health issue a few years ago. I was 53, now 56. Medicine was a second career for me and we were financially able to retire but, I would love to find something non-clinical to do. Retirement can get a little boring. To anyone who has retired early, what are you doing. I already went back to school and got a masters degree in History (lifelong interest) but now??
I cried as I read this. Not because I’m sad but because ALL your words ring so true and clear. You understand!! I’m 37 and had to walk away too. Now I’ve my health, family and friends back! For the record, studying medicine is VERY different from practicing medicine. Also, medicine is NOT for people that are too kind, generous, sympathetic or sensitive. My program director said it best, “Medicine is a business, understand that and you will get far!”
I did not read all the comments and someone may have asked this before.
How do you deal with the financial come down? Though I am not rich but I am comfortable and this is due to the income from being a doctor. I went into medicine at 17 (India) and have no other training.
Excellent post. I am 51, and retiring from the UK NHS in two weeks, age 51, from an NHS consultant post. I am just exhausted by the demands, the relentless treadmill of patients and admin, 1 in 6 on call. There is a real freedom and power in deciding to make a change in one’s life. Practicising medicine in the NHS is like a being in a cult, you don’t question your commitment until suddenly you change your perspective and reach for your freedom.
YOU are spot on! We have been marginalized to the lowest common denominator.We all feel it but don’t want to say it. Its now obvious.
Yes, I was apprehensive about making this post public but I think the words need to be spoken in order for the public to understand the frustrations physicians are facing. Control of healthcare needs to be given back to physicians.
I was expecting some “alternative” income … not sure of the actual circumstance .. I read the article and it demonstrates compulsive , organized and responsible financial activity.. if that’s how you did it my hats off to you… sounds a litttle too good to be true … when banks payed 5 % you needed 20 million to generate 100
Thousand / yr .. at 1-2% you need 100 million to generate 100k … all the best, there s something else going on here???MJS MD FACP
Your story helped me so much. I retired from ob/gyn at the age of 38 after 11 years of practice. I really needed to read the stories of others who have left medicine for their own good reasons and who are not ashamed to admit it! Sometimes I get a sad feeling when I see my old classmates from med school and residency reaching out to me on Doximity. I feel sort of embarrassed and even like a failure because I’m not still in practice and honestly have zero desire to ever go back to medicine ever. I felt like I was the only one! I have beaten myself up for not choosing a more woman/mommy friendly field, because if I had, I might still be earning an excellent salary without having to sell out my family in return. It’s been hard mentally “breaking up with medicine,” but on the other hand, I love my stress free life! I love sleeping in my own bed every night, I love being with my kids and husband every single time they need me to be there for them. I love all of my free time in the evenings not having to work on charts, and all my weekends & holidays off which is afforded to me by my job as a consultant for a law firm. My life is my own for sure. Leaving ob/gyn when I did was absolutely the correct choice for me and for my family, and thanks to my husband’s whip-cracking, I had already paid back $80,000 in debt within 4 years of finishing residency. Thank you for sharing a bit of your life – it has helped me to kick that feeling of failure that I still get now and then.
MissTeri, thank you for your thoughtful comment. I am glad you are getting rid of that guilt as I don’t believe anyone should be ashamed to live their life the way that works for them and their family. It takes courage to change the course of your life.
You didn’t fail. You changed your mind. There’s a big difference.
Thank you for your article and all the comments – it makes me feel less alone. Like you said, no one wants to hear a doctor complain. After 17 years of service, I realize that I have been reduced to a “laborist” by “toxic administrations” who exorbitant salaries I have funded. Unfortunately, the logistics of early retirement are difficult and not possible for me at this time. Instead I have embarked on trying to find a “safe-haven” in which to practice. To date, I have found none. On a recent interview for a large medical system, I ask the “director of physician recruitment” why they chose to form a physician group. His response; “We realized we can’t control them [doctors] unless we own them”, and then chuckled.
I’m still shock that comment. However, I’ve come to realize that hospital leaders are not necessarily wise, logical or intelligent. They’ve just been able to capitalize on doctors because we’ve been too busy taking care of patients, and bogged down with the seemingly endless and growing mounds of paperwork. I recall after some really rough 36+ hour shifts feeling like I could survive anything. Over the years I have been beat down and de-valued, and have often had to remind myself that my worth is still intact. Medicine is up-side-down, no doubt, and we need to become a unified front and regain control of our “turf”.
LP, thank you for your comment. I believe it’s helpful for others to know they are not in this alone, especially in the field of OB/GYN. I agree that physicians have lost their control over the field by being too consumed with patient care and administrative burdens to be able to see the “forest through the trees” with what is happening in health care. If more physicians like yourself speak up we can continue to work towards progress and change. I have left clinical medicine (unlikely to return), but I still have a passion to be a physician advocate. I do believe we can change things for the better in order to stop the attrition of fantastic physicians.
I left clinical practice in May 2017. It was one of the hardest decisions but I was burnt out. I was employed by hospital system and helped start and grow a practice for them in this location. Two years ago they came to me and said they would add another doctor if I agreed to open a second location so I did. Instead a NP was added who had left the organization 1 year before and wanted to return. She left about 1 year later to return to her old practice in the same hospital system. The patient load was high and they added an NP and new doc a year ago but my burn out was such that I could not recover. I blame myself for now establishing boundaries and standing up for my needs. I reached out last Aug and voices that I was burn out and there was no response sure the doctor in charge listened and was supportive but there was no follow up. Then in February I gave my resignation however 3 weeks later after the out pouring from staff and patients I decided to withdraw my resignation. They had interviewed another doctor for another group on the same hospital system and then offered her my position when I resigned. However she had not yet stated if she was accepting the position when I wrote I wanted to stay and that I would implement changes to reach a work life balance. There was no call to say let’s meet you are valuable to us and let’s talk about what we can do. After all you grew the practice with a lot of hard work dedication and have a good relationship with patients, staff. I think that was the worst part that the administration wasn’t even willing to discuss options with me. Burn out is hard and no one ever wants to admit it. I know that what I do now is ok but not the fit for me as I truly miss my patients. I hope to return to clinical practice but have a non compete and stuck here because if husband’s job. At least I guess I ventured out of my uncomfortable comfort zone, this experience has helped me to re evaluate my life. Good luck to all the hard working doctors out there.
To our MFM friend, your sentiments are spot on. You very eloquently stated challenges we are facing in Ob/Gyn (and medicine in general). I have also read “Lean In” and found it inspiring and helpful in understanding the role women must play in changing our current circumstances. I do believe we can change the current dysfunctional system. I am happy that you are continuing to press on and seek the change in your own clinical situation. Although I am currently out of clinical medicine, I do plan to continue to be a patient and physician advocate. We can do better. We also need a massive positive PR campaign for physicians so that our greatest allies will be our patients (and vice versa).
Retired RN here !!! I made it a 22 years as and RN not getting my degree till I was in my mid 40’s. Previous job was fairly high tech so I was already high tech just as nursing was becoming so. I only needed 2 more years for full retirement but was so disillusion at the way health care was going I had to retire to keep what little sanity I had left !!! Good for you to be able to do what you know is right for you and your family !!!!!!! I worked hard to put away a decent amount of money for retirement and I am enjoying it now !!!!! I miss they type of nursing where you could actually spend time at the bedside and not have your nose in the computer tho !!!!!
My break up with Medicine occurred at the age of 46 after nearly 17 years of practice. It occurred after three years of battling a diagnosis of systemic lupus, Hashimoto’s thyroiditis, and Sjögren’s syndrome. None of the medications I was given Put me into remission, they served only to suppress my immune system and land me in the hospital again and again. Despite this I return to work five times, in five different capacities, even attempting to work in telemedicine for put me into remission, they served only to suppress my immune system and land me in the hospital again and again. Despite this I returned to work five times, in five different capacities, even attempting to work as a telemedicine “Doctor”- which was basically code for giving out anabiotic‘s to anyone who called and wanted them. I was exhausted, gravely ill, slowly dying, and killing myself. My career prior to my diagnosis had been filled with frustration. I loved my training as a family practitioner in. I loved learning every aspect of medicine. I loved taking care of patients from birth until death, spending time in the OR, the ED, delivering babies and seeing my patients in clinic. Once I left my training I realized what medicine actually had become; a gigantic machine with me as a tiny cog existing only to generate revenue, high satisfaction scores, and ever increasing throughput of our “commodity”- patients. I felt so tricked and disappointed. I worked hard for 14 years at Kaiser Permanente as a part of that machine, Suffering through to high-risk pregnancies as well, feeling cheated that I could not spend the time I desired with my children even though the man I was married to worked as a sub specialist and made a great deal of money. He always wanted more, he wanted me to produce more, more money, more output, and eventually I couldn’t take it anymore and divorced him. The divorce Made me feel that I could not stay at Kaiser, because he worked there as well and was higher up in the administration. I left and went into private practice with a friend who had an established practice but unfortunately that didn’t work for long. I then bounced from urgent care to urgent care until I found a job working both in the urgent care and as a primary care provider. My salary dropped markedly and I was losing most of it to the absolutely hideous divorce I was going through. My ex, who is a full blown narcissist, was so furious that I had decided to leave him that he used his money to nearly bankrupt me. I luckily got the majority of the custody of my children as he does not have the time to take care of them or the inclination to attend to them. And I do believe that my lupus showed its face When it did as a result of the stress of practicing medicine, the stress of my divorce, And the years of training in turmoil- lack of sleep, constant stress from hazing, the constant exposure to illness, needle sticks (of which I had two), resentment, anger, frustration, and the recognition that as a doctor I still have no control over my practice or my environments or my life. I am now officially disabled. I haven’t worked for year and I am living on disability from Social Security, and The private disability policy I was lucky enough to have when I became ill. I receive some child support but I waved spousal support in Lou of having my ex pay for the kids private school. He is so toxic that I cannot interact with them at all. I had to garnish his wages just to get him to pay $2000 in child support a month. This is a man who makes over $600,000 a year. I am barely surviving. I am lucky enough to have met someone who makes me happy. I have known him since I was eight years old and we were lucky enough to have run into each other again. Unfortunately he’s in school retraining right now to be a nurse because his job in IT as a programmer was no longer viable as a career. So I have slipped way down the social and economic latter. I am no longer Dr. Kritz. I don’t know who I am. I am a mother. I am a wife. I am a woman who is trying to figure out if she is without the career she worked so hard for. I am disabled. I’m too sick to work. My lupus still very active but I am lucky enough to not have any kidney dysfunction or other organ damage at this time besides one episode of lupus cerebritis which was the event that ended my career permanently. I hope I can figure out who I am. I hope I can achieve remission. Strangely, even with no money, no career in, and my life upside down I am still happier, far happier, that I was as a married unhappy rich dual income doctor/Doctors wife.
I apologize for all the misspellings! I was using voice recognition and it is notoriously hinky. I hope my comments make sense in their totality. Thanks!
Tracy, thank you for sharing your story. You have been through so much. Hopefully anyone else who is going through something similar will see your post and it will let them know sometimes change can be a good thing even if it doesn’t feel like it at the time. Hoping for remission for you and good health in the future.
I’m nearing the end of my career as an ob gyn and I have a few observations:
1. Most physicians DO go into medicine for the money, as prestige and autonomy have been eliminated. I’m one of the few who truly saw it as a calling. I decided to become a physician when I was 13. The physicians coming out now see obstetrics as a job to be endured until they have enough money to retire.
2. I’m not sure what “patient-centered care” is, other than a buzzword that people like Regina Herzlinger popularized 20 years ago. If you’re taking care of patients, they’re at the center of what you do.
3. I got out of the rat race in 1997, having tired of the people who sign my paycheck continually lying to me. I did locum tenens for 21 years and now I’m a hospitalist. I always hated gynecology anyway, so this is still fun.
I am a pediatrician ; I grew up in a big family and always took care of children. I loved biology and nearly did graduate work in that. I always did a lot of other things as well. When I finished residency, I took a job traveling my county in public health pediatrics. I had had private practice offers, but none that were as timely. I had moved home during my residency and paid off any loans. One of the best pieces of advice I have read before is living like a resident until you are out of debt. I had friends who drank expensive wine because they “deserved it,” struggling forever with debt. I always loved old houses, gardening, sewing, cooking, artwork, consignment stores and mastering other skills, like I have designed and laid some fabulous tile projects. For me, I always sought out not putting all of my eggs in one basket. I went from 9 years at the health department to a managed care pediatric position from which 4 of us started our own practice 20 years ago. I am now 68, in good health and looking at retirement at age 70, I think. Luckily , after some false starts we lucked into an excellent office manager with the expertise to keep us a successful group financially. We set our practice up years ago to work fewer hours than most and it pays off in personal happiness and in productivity. When you make rounds in the AM and start at 1, you have the time to grab that yoga class or pedicure. I still feel privileged to be involved and trusted in the lives of the children I have taken care of. We lost a son 5 years ago, a brilliant, anxious gorgeous soul who thought chemicals and alcohol could soothe his anxiety. He said he didn’t want to do medicine; it wasn’t upwardly mobile enough. My point in bringing him up is to say that we are simply hourly workers, differentially paid and if you go into medicine to be rich or for status, you may wish you’d put those years of training into something else. We need to make medicine work as a career for all of us, through the young years with families, embracing differing needs of the workers, us and our support people.
I’m sorry to hear of your son’s passing. I am glad you found the right balance and you were able to enjoy your work.
Thank you for sharing your path in medicine. I am sorry for the loss of your son and how difficult that must have been. I agree that a career in medicine can be a beautiful thing, and it definitely isn’t for people looking to be rich or have status ( I have yet to meet someone who went into it for the money). However, the field of medicine has changed, and we need to realize this and make adjustments as needed if the desire is to maintain a long career. This path will look different for everyone, but we should support our colleagues in what they choose for themselves/families. Thanks for commenting, and for your long career as a pediatrician.
Thank you for writing this. This is such a novel concept for most people who have spent their lives in medicine. I graduated two years ago, and have been working as a rural GP locum in Western Canada, and spending as much time in the mountains as possible. I’ve payed off my student debt in 18 months by living out of my Subaru between contracts. I didn’t know this was called financial independence, I just called it being a dirtbag, since it’s common in the climbing/ski bum community. I work 25-30 weeks a year and yet I feel exhausted. Everybody keeps asking me whether I’m waiting to find a permanent position, and I always dodge the question. As I’m starting to think about starting a family, the thought of having to join a practice once my kids are in school to pay for our family expenses seems like a slow, suffocating death. I don’t hate medicine as much as I did during residency (that was clearly a very dysfunctional/abusive relationship!), but the truth is, it does not feed my soul as much as being out in the wilderness and sharing adventures with fellow humans does. There is so much more I want to do with my time. Some of it is selfish (climb 5.10, snowboard down beautiful, steep remote terrain, play outdoors with my (future) kids, like really take the time to be with them and show them the world) and some of it is altruistic and very fulfilling (volunteer for search and rescue and outdoor education programs, particularly those helping young, less privileged woman gain skills and confidence). I felt I could never do all this, be a doctor, start a family, and achieve my “outdoors” goals. Or I could but it would be exhausting. But hey, look at that, a youtube rabbit whole led me down to this financial independence/early retirement tangent. And its such a great way to plan. The math just makes so much sense. Don’t get me wrong, rural family medicine is super rewarding, and I would probably keep doing it 10-20 weeks/year even if I was financially independent, as long as I can keep my skills up. But the fact that’s its not unreasonable to think that, by the time I’m 40, I might have the freedom to not work if I don’t want to, that is such a great goal to look forward to, and a reason to skip the lattes, cook breakfast off the back of my buildout SUV, resist buying that piece of gear I don’t need, and keep living the dirtbag life!
I know this is an old post, but I really appreciated reading it today. I made it to age 36 before I decided I needed out. 2 years later I’m not out entirely but I work maybe 0.1-0.15FTE scattered over the year in 1 week blocks. I’d like to get out entirely for all the reasons you mentioned, but we’ll see how feasible it is. But the most important thing for me was the realization as you describe that my own health and wellness matter and it is good that I care for those things. Ever since I made that mental shift, even when I am at work it is more bearable (and esp since I’m hardly ever there). This post just resonated with me so much. thank you for writing it!
Esther, thank you for your comment. I sometimes wonder if I am too open/vulnerable in the things I write but if it helps or resonates with just one person it’s worth it! Good luck on your journey.