OB GYN, Physician Training, retirement

Is it Ethical to Retire Early from a Career in Medicine?

Eight weeks after I delivered my 3rd child, I was diagnosed with a 4 cm lung mass.  Yes, you heard that right. For those in medicine, this is terrifying to hear as the first thing that comes to mind is lung cancer.  Lung cancer is notoriously hard to treat, typically fatal with a short life expectancy after diagnosis, and extremely unfair to a lifelong nonsmoker who has spent 12 years in the prime of her life dedicated to training to become a physician.

Luckily, I soon found out my situation was not as grave as first expected.  A PET scan leaned toward benign diagnosis (or at least consolidated disease).  I could temporarily push aside the paralyzing fear of leaving my 3 young children with no mother and focus on getting rid of this mass that was causing pneumonia, difficulty breathing, coughing for 2+ years, and go ahead with scheduling the thoracotomy.  After resection of the mass which was densely adherent to my pericardial sac and phrenic nerve, I lost about a 1/3 of my left lung.  To my amazement, after my ICU stay I left breathing better than I had been in years.  Benign diagnosis was confirmed.

This experience made me reevaluate my life and it stopped my “hamster wheel” of life I had been running on at a dizzying speed.  I viewed this health scare as a second chance at life.  I didn’t take this lightly as it almost seemed unfair that I got this chance to live while others who have a lung mass often have it turn out to be one of the most fatal of cancers.  Having to face the prospect of this potentially devastating diagnosis changed the course of my life. I was able to view my career for what it was and had become.

 

I had planned to work in my medical career as a physician indefinitely, or at least well into my 60’s.  It had always been my passion to work in obstetrics and I love my patients and the bonds I build with their families. It was never my intention to leave early, and it didn’t factor into choices along the way for my career.  But here I was, ready to retire in my late 30’s after several years of increasing disillusionment with the health care environment.  Apparently, I just needed this wake-up call for a chance to realign my priorities.

Loss of physician autonomy, pressure to increase productivity as opposed to quality care, and placing cost effectiveness ahead of best medical practice were weighing heavy on me.  In addition, the litigious environment in the US has become out of control and encourages frivolous lawsuits without any repercussions for those seeking damages without merit or basis for the claim.

I could no longer honestly tell myself that I was working so hard for the good of my patients, and I became cynical that my efforts were to the benefit of the financial bottom line of a health care system with its priorities out of sync with my own.  This is not specific to any health care employer, physician group, or hospital.  It is emblematic of the US healthcare system in general.  It is the reason I left medicine entirely and did not merely seek to work elsewhere. The problem is pervasive.

The decision to leave became a question of “why am I doing this, and for whom”?  I decided to retire early.

I have since learned that many feel this is not an appropriate thing to do in your late 30’s.  There is the argument that I owe a debt to society now that I have the skills acquired from all of those years of training. Or that the government paid for my residency salary and that I am indebted due to that.  Or that it is selfish to stop working to spend more time with my family.  There is the argument that it is not fair to leave my patients that I have been caring for over the years.
My response to the ethics of my decision to retire early: If you pay for the privilege of a medical degree and work hard to pay off this debt, should it be your decision if you want to continue to practice?  The government did pay my salary as a resident, which amounted to a little more than minimum wage for 4 years of 80 hour work weeks.  Do I owe something because of this?

As for leaving my patients, I actually do feel a little guilty about his one.  I love my patients.  I also struggle with no longer using my degree for clinical practice, something I worked so hard for.  We are already feeling the strain of physician shortages and this another thing that gives me pause.

In the end, the burden of practicing medicine in today’s environment no longer outweighed the positives for me.

Ironically, it’s my patients who hugged me and told me how happy they were for me to live the life I felt I needed to.  It’s my patients that spoke up (without me saying a word) about how the medical field has changed and that we are losing good doctors as the control of medicine is being handed to hospital administrators and politicians who are making choices about health care without a medical degree. It’s my patients that brought presents on my last days and thanked me for the care I did provide throughout my career instead of lament about what I “could” have done if I stayed longer.

It was a very personal and difficult decision for me to leave medicine and luckily, my colleagues who know me have been incredibly supportive.  On the other hand, one thing that has surprised me is the number of physicians contacting me who want out of healthcare but don’t know how, or can’t, get out.

How do we retain physicians? It is not by increasing salaries. Doctors aren’t in it for the money, we chose this profession to help people and save lives.  We do it by reforming the current health care environment and making this a profession that is sustainable.

Give medical decision making back to physicians.  Decrease the cost of health care by cutting out costly administrators and through tort reform.  This is the way to keep our best physicians and improve health care in our country for our patients.

Ultimately, is it ethical to retire early from a career in medicine? Or is it a bigger picture issue of how do physicians take back control of medicine so that we aren’t leaving at a time of shortage? This is a major concern for our country moving forward.

 

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8 thoughts on “Is it Ethical to Retire Early from a Career in Medicine?”

  1. I am sincerely sorry to read of any trouble that an OB has. OB’s are treasures as they “are there” even in the middle of the night, and even on the weekends. Nobody works harder and has such a great personality even when so sleep deprived.

    My wife had problems, and her OB “was there” every time, every day. I can not thank OBs enough.

    And when the “human” OB has her own children and wants to be a MommyDoc for years, how does she return to the clinic and OR? The Center for Peer Review Justice has worked for 17 years on that question. The AMA and others have their own “guidelines”, but they insist on draining your family’s checkbook, and that is unnecessary, and frankly, does not respect the fact that OBs, like all specialist physicians, are so overtrained.

    Great blog.

    Richard B. Willner

    Liked by 1 person

  2. As always, your words are so inspiring and full of wisdom. My heart breaks at what you have gone through and I am glad you have found peace and happiness among such a difficult time and decision. It’s scary going into this world of Medicine and knowing how things are. I also know that I will struggle for being a visionary and wanting to do things differently but I can only hope to give the best possible care to my patients and to always try to find a balance to be happy. Thank you for sharing your story and continuing to inspire so many of us.

    Best,

    Jani

    Liked by 1 person

  3. “Jani” It makes me so happy to know we still have a great new generation of OB/GYN’s on their way. We will continue to work towards improvement in health care for patients (and physicians too!). Excited to see the changes your crop of physicians will bring

    Liked by 1 person

  4. I’ve lurked in the shadows reading your entries, but this one was too spot on too pass up the opportunity to comment.

    First, thank you for sharing a frightening experience in a manner that helps us go through those highs and lows alongside you. You are a gifted writer, and I’m grateful your newfound “free” time away from medicine has permitted you to explore and develop this talent.

    Second, as someone transitioning to a lighter clinical load (with the eventual goal of no clinical load), I am completely in favor of fulfilling your individual needs as a human before feeling beholden to meeting society’s needs for physicians.

    The most redeeming part of your story is that your patients were able to see you as a complete human being with needs beyond the clinic. It restores my faith in others.

    Keep up the meaningful work!

    Like

  5. “Crispy Doc” thank you for comments. I truly appreciate your thoughtful reply. There seem to be many physicians out there with similar experiences and sentiments and hopefully we are starting to make our voices heard with our stories.

    Like

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