Monday, March 4, 2013

MiM Mail: Time to hang up the stethoscope?


I am more and more convinced it is time for me to hang up my stethoscope.  I am a busy family medicine doctor practicing outpatient only family medicine who is increasingly longing for more time at home with my children.   I currently have two young children with one more on the way.

But I am scared, to actually make that plunge.
 
Scared to leave (what if I want to come back?), scared to leave the income (yes, I know FM doc's do not make anywhere near specialists, but my income allows us a very comfortable lifestyle but we do not depend on it), scared I might get bored being at home full-time, scared what the next step holds for me.  I often dread looking at my schedule, another day of people complaining to me all. day. long. and what seems like endless patient emails and phone calls to answer after listening to all the complaining.  I have always felt it a gift to share in peoples lives, but after doing this for 10 years, it is frankly boring.  I never thought being a family medicine doctor would be boring, but honestly, it is. 
 
Anyone else experience this?  I am a positive and upbeat person (my glass is always half full no matter what the situation is) and I wish I loved my job more but maybe that is unrealistic.  Maybe a job is just a job, no matter what the profession is?  
 
I already only work 3 days a week and the "firm" does not allow doctors to decrease any further so that is off the table.  
 
-Doctor to many, mom to almost three

16 comments:

  1. I always think to myself that if I get bored to the point where I can't stand it anymore, I could do another fellowship in something more interesting. Have you considered that? I just think that we all trained so hard to get our degrees, and it is SO hard to go back when being away from medicine for a while. You probably will want to work again when your kids aren't so small, and you don't want to make it very difficult to go back. These are the reasons I never a long absence, even those I've wanted to.

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  2. I've been in primary care for 5.5 years, and Friday I saw 5 patients in a row with URIs. I was thinking to myself that it might get old after a while. I agree with Fizzy though - maybe you should consider fellowship, or a "niche" training. I think it's good to keep your feet wet because it'll be very very difficult to come back if you leave completely.

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  3. I agree kind of with Fizzy, that if you're bored, you may need a new job. Not necessarily do a new fellowship (sounds like its not quite the right time for that), but maybe a more academic job, more teaching, policy, research? There is so much you can do with your training & skills & there are definitely creative career paths for physicians outside of direct patient care.

    Now if you truly just want more time with your kids, a new career path won't give you that---but it sounds more like you just hate your job and would rather be home than do it any more. You are about to be on maternity leave, right? See how it goes, being at home with 3 littles (keep them home with you if you can, after you are physically recovered from the delivery).

    Good luck.

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  4. Since you're not dependent on your income, could you quit your current position but still work a day or two a week in a volunteer clinic? You could keep your skills up in case you do want to go back at some point.

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  5. I agree with the above that i's really had to go back once you've been out for a while and you may want to work when the kids are older. You might regret quitting. That said, if you're 100% certain you want to quit (I didn't get that this is true from the email...), I think locum work seems like a good deal. You could work 5-7 days out of every 4-6 weeks, keep your skills and make decent $$. It does present a unique childcare challenge.

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  6. I agree with everyone above. It sounds like you need a new job. Maybe additional fellowship training will open new doors for you and allow you to use parts of your brain that have gone dormant, or maybe getting an academic job where you could do teaching would help. In family medicine, aren't there opportunities to do community outreach / quality improvement, that sort of thing? You might find some of the organizational / administrative aspects of those sorts of things fulfilling also.

    Personally (and I know this probably sounds horrible to some people) I find staying at home to be horribly suffocating, and yes, boring and exhausting also. So, if it's additional mental stimulation you crave, I worry that being a SAHM isn't going to provide you with what you're looking for. Plus, as everyone else said, it could be difficult to return to medicine later if you wanted to.

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  7. I would recommend taking a good long break, then going back part-time.

    The break allows you to recharge your batteries and get things in perspective.

    Working part-time allows you to maintain a professional side to your life, something that is very important for many people to feel fulfilled.

    Being with your kids "part-time" allows you to spend way more time with them than the average parent, but also allows them to grow more independent and get exposed to other stimuli.

    It worked for me!

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  8. Be careful not do confuse boredom with burnout. If you are truly bored, than it is possibly that a fellowship or additional training might be a good idea. However, if you are truly burned out (as many physicians these days are: http://well.blogs.nytimes.com/2012/08/23/the-widespread-problem-of-doctor-burnout/) and suffering from emotional exhaustion, depersonalization and lack of self-accomplishment; then maybe you need a job change, but not necessarily a career change.

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  9. I got bored with primary care, too. It took longer because I never did "straight" primary care - I did some teaching and I took on outside consulting/facilitation work as well. I always loved the patient relationships but after a while (nearly 20 years, in my case) the routine was, well, routine. I also struggled with the endless compromises required, which seemed to chip away at my ethics and values.

    So I changed to hospice and palliative care, but that won't help because you're not me. It might help, though, to hear the process: I spent some time figuring out what about the job I still loved, and what other skills or parts of myself I wanted to use more at work, and went looking for something that gave me what I wanted. I was lucky to find it without having to re-train or relocate my family, and I'm now approaching my fourth anniversary in a job and a field I truly love. I said it took until I was 45 to figure out what I wanted to be when I grew up.

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  10. I just finished visiting a former young attending above me when I was a fellow - she became a good friend. She is eight months into a break from being a part time physician - and sooo happy. Her kids are 8, 5, and 2. I watched her try to make two part time positions (after she started a family) work at academic institutions - her husband is a superstar academician and has been moving a lot for his career - and they fizzled for various reasons. When they moved to their current location in July of last year, she decided to do something she hasn't done before - nest, support her family, get her kids plugged in to school and activities, and rediscover something she loves. She is a former ballet dancer and is now choreographing rising star teenagers at a studio. She is meeting neighbors and moms and creating a support system for herself and her family. She is spending time with her kids.

    Her husband's institution has been offering her a part time position for months. She is considering taking it, when she is ready and has sitters in place beforehand, not as a frantic afterthought. She misses that challenge (she is an excellent superstar physician as well - double fellowships from amazing institutions) but does not seem to regret at all the nourishment she is giving herself and her family with her break. It shows. She looks happier and calmer and more beautiful (if that's possible) than I've ever seen her - sewing sequin constellations into and bordering burlap with golden thread as a backdrop for a dance she is working on as we chatted while kids orbited in the background and snow was falling outside.

    I know it sounds like you aren't in the position to move, I don't mean to compare apples to oranges. Maybe, however, a little time off might give you a breather and offer you some perspective around what you want to do. If you do not have the financial need, however cushiony, I would go for it. Maybe try to volunteer to keep your hand in things, if necessary based on future job possibilities - I'm not as versed in that arena as those above. Good luck!

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  11. Sounds like with #3 on the way it's a great chance for a breather - you can take a year long (or whatever length) mat leave if you so wish and "try it out". I would be tempted to keep skills up with some very part time work... ie get on a locum pool for a youth clinic, women's health clinic, or fill in a few shifts at a walk-in clinic each month - just to stay in the game. If we could financially do it, that's what I would do -- just take 3 or 4 shifts a month in an area of interest, that you wouldn't need to do re-training for.

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  12. So many insightful comments above, I almost don't want to add anymore. But have you considered the boredom you feel is related to your desire to be home? For me, I always loved my field of medicine until I feel deprived of my time with kids. Then I will spend a week of vacation playing a SAHM, and the first day I am back, I remember why I went into anesthesia. Then as I feel more and more anemic in my time with kiddos and I fall out of love with anesthesia again. If I were in your position financially, I would quit and work either very part time (once or twice a week) or work locums to keep my license current. Good luck to you.

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  13. So many insightful comments above, I almost don't want to add anymore. But have you considered the boredom you feel is related to your desire to be home? For me, I always loved my field of medicine until I feel deprived of my time with kids. Then I will spend a week of vacation playing a SAHM, and the first day I am back, I remember why I went into anesthesia. Then as I feel more and more anemic in my time with kiddos and I fall out of love with anesthesia again. If I were in your position financially, I would quit and work either very part time (once or twice a week) or work locums to keep my license current. Good luck to you.

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  14. Thank you for this post - I feel exactly the same way. I am also in family medicine, 1 child (1 on the way), but have only worked in my field for 4 years. I couldn't agree more with your paragraph on dreading the day, the complaints, etc. However, I do work full-time, and we are dependent on my income. And while it's an eye-opener to read comments by others suggesting an alternate job, personally I feel completely overwhelmed by the thought of changing careers and quite simply don't even know where to start looking outside of my current 100% clinical out-patient work. So alas, while I don't have much advice myself, I wish you the best of luck - whether it's more time with your family or a new position - or a little bit of both.

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  15. I think many people feel the need for change after 10-15 years. Fortunately after 12 years of practice, my family has moved to France for a year. I am having an amazing time and love not working. It has been a wonderful break. It has taken me 7 months to figure out what I want to do when I come home. I have decided that even though I love the doctor-patient relationship and feel guilty about not returning, I don't want the commitment of a practice right now. I hope to find a few hours/month of urgent care and/or volunteer opportunities on my return. I do want to keep my feet wet and keep my skills up but my priority is to my family and myself.

    I encourage you to take a year off when your baby is born. You should journal during this time to help you figure out what you value, enjoy, and what sort of position you want to return to if any. I think change is good. You can always go back to something similar to your current job if needed.

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  16. Can you do a LOA for some time for a break or some time to think? Few months.. or a year or two.. Or for personal reasons. Like being a mother. Or being pregnant. Or burnout. Or fatigue. Or mental health. I bet they will let you if you talk it through. I am a workaholic and got to the same point as you after 12 years and now I am returning to college pre-nursing. I have some credits that are not expired so it wont take long to get a health science degree. I have an 8 year old and a 3 year old. Work is work. You are correct. But you are very fortunate to be a family doctor.

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