Tuesday, January 21, 2014

MiM Mail: Burnout (already)?


I am a hospitalist with a 3 year old child and a child on the way and I am burnt out after only four years out of residency.   The prospect of working sickens me and I want to scream when I receive yet another page from the ER about a patient who needs to be admitted with intractable pain/vomiting/weakness with no diagnosis that they could attain.   I am so tired of hearing people's complaints.   I feel like I have not made an ounce of difference in anyone's life.   I am a scut monkey for most physicians and a substitute doctor for their primary care providers.   I no longer get a rush from seeing someone critically ill and helping them become well.  To make matters worse, we are short staffed as many other hospitalist programs are with no candidates thus far.   I am in the process of looking for a job but cannot find one that will pay me not to work.   I wonder on an almost daily basis why I incurred more than $150K of debt to do something that makes me miserable.   I have contemplated switching to a clinic job but cringe at the thought of even longer hours....at least in my current position, I am free to come in and leave when I want as long as I finish my work.   The prospect of another hospitalist job is less than appealing and doing chart reviews seems like a surrender.   I have even wondered what things would be like if I had trained in a different specialty.  Would things be different?  Would I be more satisfied with my job?   My husband is a graduate student and thus the option not to work is not realistic at this point.   What can I do?  How do I overcome this overwhelming sense of disappointment and dread for my life's work?  All my life, I wanted to be a doctor and now I'm here and just want to stay home and play with my child.  

11 comments:

  1. Is there anyone you can talk to? This is a really tough place to be and it's not just about career. A good friend can help - but even better would be a good therapist. You need a safe place to talk this through.

    FWIW, I found outpatient work more satisfying because I got more emotional connection from the patients and continuity, which is what I find renewing and refreshing. That's not true for everyone - and you need to work through your own stuff no matter what you do professionally. Are you using all your vacation days?

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  3. You are not alone in feeling this way. I am currently on indefinite leave from practicing medicine after the birth of my fourth child. I am a board-certified ob/gyn and although I dealt with burnout since my first child's birth, not working was not an option until recently. I agree with counseling, it helped me. My husband and I also planned for me to exit from clinical medicine early, and having a future plan was helpful during the tougher, longer days and nights of work.

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  4. I remember hating my job before medical school. I mean REALLY hating it -- what I did, everyone I worked with, my commute. It was horrible. I was so paralyzed by fear that I couldn't get myself to even look for something different. Specific fears: What if the next job is even worse? What if I can't find anything better? What if this is as good as it gets? Can I really make it on a smaller salary? What if something bad happens? As you might imagine, I was not in a good place.

    I don't know what the solution will ultimately be for you, but I do know this: You are unhappy and you MUST try to change something in your life. Are there small irritations you can get rid of in your day to day life? Can you find a different job? Work part time? Take up a hobby outside of work that gives you pleasure so that when you are at work it's not as draining?

    Also, please have faith that things will get better. All of us struggle with things in our lives that conspire to steal our happiness, and you have to figure out a way to manage them so that they don't make you miserable. Things did eventually get better for me when I found a new job (at 50% of the pay) with a research group I loved doing what I always wanted to do. I am confident you can find something that makes you happy too.

    Hang in there.

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  5. You sound stressed out. Speaking to a therapist may help.
    I hated hospital work, but I love my outpatient clinic, and now that I mainly do outpatient, I actually love the hospital again (because I'm just taking care of my own patients, whom I already know well, usually). But that may not be right for you. Good luck.
    Also, yuo might find this recent article hlepful: http://www.slate.com/articles/technology/technology/2014/01/do_what_you_love_love_what_you_do_an_omnipresent_mantra_that_s_bad_for_work.html

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  6. That's how I felt when I quit residency.
    How about a fellowship?

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  7. would it be helpful to go part time (and perhaps find more work/life balance-although having two small kids could also struggle with work/life balance) maybe arrange transitional part-time after you have your kid and go back to work more slowly (keep in mind that transitional to less work=less pay may mean other stressors related to less money if your husband is in grad school)
    sorry, but hopefully therapy, or life coach maybe helpful.

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  8. I often feel like this. My husband is in his own training, and I find myself counting down the days until he starts working and I can at least go to part time. After all the years of early mornings spent whispering goodbyes to my children, it never has gotten easier and every single day, all I want to do is quit and stay home.

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  9. I felt like you did and six years ago I stopped working after having my fourth child. I stayed home with them and although it wasn't always glorious it felt right. I am now returning to work part time...partly for financial reasons and partly because I need to do something and it feels right. I never thought I would want to practice medicine again but actually feel optimistic about it. Is there any way you could take a break or at least go part time. It may be that you resent the time working because you want to be with your child more..that was the case for me. I am so thankful that I spent the time with my children that I did...I will never regret it. Seriously consider your options...

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  10. Thinking through your week are there any aspects of your hospitalist work that you DO enjoy? Perhaps that could be a clue to a job or field that would be more satisfying?

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  11. I'm 3.5 yrs out of residency and boy, I could have written this post last fall. I'm Military on top of it and everything was driving me nuts, I have no control over anything, I do the call schedule but that's just moving us few widgets to cover everything, patients complain and it's obviously our faults can't fire a military patient. Anyway, my point is, I look back at life and it seems to happen in 3-4 year increments ......HS, college, med school, residency... and now I'm at that 3-4 year mark and I think I was antsy to move on. So, I have resigned my commission and found myself what I hope to be a wonderful job 4 days/week in a beautiful town where the schools are also 4 days/week so my family can have some adventures and I can actually participate in them. I'm not so delusional to think I will love everything about the new job, there are aspects that will certainly be just as frustrating and there are some things I will miss, but I am excited to learn some new things and have a better life:work balance. Perhaps this is your time for a change too.... maybe you should look for where the next saga will take you?

    Funny thing, I've got 93 days until I go on terminal leave and I'm really enjoying 95% of my job since returning from my 3rd maternity leave a month ago..... probably because I'm also passing off my extra responsibilities.

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