Letter to a burnt-out doctor
Published first on KevinMD on May 29, 2023.
Dear Burnt-Out Doctor:
As I leave a conference organized for a group of physician entrepreneurs, I have so many thoughts running through my head. Some of these thoughts revolve around how to make my small, fledgling medical practice run more smoothly, reach more people (and serve them better), and always remember my why. These are the “business mastermind” skills I signed up to learn at the conference. But I may have come out of this with something way more valuable in the long run. I was also reminded of why I left what I was doing before and why I am continuing to follow this incredibly challenging path of being a medical practice owner “outside the system” even when the odds are against me.
I remember where I was a year ago. I was stuck in a system that was literally sucking my soul out of me. I would zoom through my workday, constantly feeling bad that I was running behind, skipping lunch to try to catch up, leaving patient rooms feeling like I had not served my patients well, missing time with my family, and feeling defeated, exhausted, and most importantly, like I had no options that promised to truly be different.
Those of us who become physicians do so with a clear path set forth ahead of us: pre-med classes, medical school, residency (possibly followed by a fellowship), and then years of service to patients, our communities, science, and to the education of future generations of medical professionals. Along this path, there is rare, if any, exposure to alternative paths. Many of us choose to work for larger organizations (academic or non-academic) because we want to focus on patient care and/or academic pursuits and have no interest in the business of medicine. More importantly, we would not know HOW to become business owners even if we wanted to do so. We are led directly into the path of employment more now than ever before, as large hospital systems are buying out small practices and the insurance system is making it increasingly difficult for small private practices to survive. We physicians are taught to be dependent on our organizations for our livelihoods, regardless of how often we get taken advantage of, are underappreciated, and even emotionally abused by upper management.
Many of us feel trapped by this system. We didn’t learn business skills in medical school, and we didn’t learn about other ways to put our medical degrees to good use during training, either. Sure, there are physician-owned organizations and private practices that take better care of their doctors (and therefore of their patients) than the larger ones, but those are becoming scarcer every day. By joining a typical private practice, we take the risk of ending up right back in the same situation we left. So we stay where we are because we feel we have no other viable options.
This is how I felt a little over a year ago. I remember coming home from work one evening, kids already asleep in their beds, my husband standing at the sink cleaning up from the dinner I missed, and breaking down in tears because I felt so helpless in this system that was no good for me or for my patients.
It has been so refreshing to be with a group of people who are scared (like me) to go out on their own but are doing it anyway. These amazing doctors are strong and brave, often fighting an uphill battle against the larger medical organizations, insurance companies, and negative stereotypes poised to make us fail. Some are leaving the practice of medicine entirely and are finding other ways to serve, while others (like me) are finding ways to stay within medicine but doing so differently, in ways that are more sustainable for us not only as doctors but as human beings (and in turn dare I say providing better care for our patients than we could within the confines of a broken system).
I have been reminded that I deserve to be as happy as the next person – which for me includes practicing medicine in a way that feels right to me while also being the mom, spouse, daughter, sister, and friend that I want to be. When I was in the system, the culture was such that “making my numbers” was more important than anything else as I took pay cuts while working longer hours, doing more and more of the grunt work, and feeling more burnt out every day. I am so proud and honored to be a part of a group of physician entrepreneurs that are so incredibly supportive of each other – not competitive and money-grubbing, but truly supportive of each other, each one of us using our unique experiences, skills, and resources to empower, advise, and help others in the group around us.
If you are a physician and are feeling stuck, beaten down, exhausted, and like there is no way out, know that you are not alone. There ARE other options out there, and you CAN succeed with the right people backing you up. You may even be able to find ways to make your current situation viable. Yes, it’s scary. Yes, it won’t be easy. Yes, there may be some things you need to sacrifice (at least temporarily) to make it happen. But it is worth it. You are worth it. You have amazing gifts to give.
It likely will never feel like the “right” time to take the leap. It’s good for you, it’s good for patients, and it’s good for medicine.
- Cindy Rubin, MD, IBCLC