As far back as early medical school, Sylvie Stacy, MD, MPH, a primary care physician, realized she probably wasn’t going to be happy spending her whole career in an outpatient setting churning through patients. “I went to medical school because it was a childhood dream of mine; I always wanted to be a doctor. But I don’t think I ever really took the time to think about whether that was a good fit for me,” says Stacy.
An introvert, Stacy was surprised to find patient care exhausting and that she needed a good amount of quiet time to be able to recover after making rounds.
“I just never thought about how exhausting seeing patients in a clinic or hospital as a full-time job would be for me until I was actually in the weeds doing it during medical school, and then it hit me hard. ‘Oh no, this does not fit with my personality; what are my options here?’”
Today Stacy runs an online community focused on helping physicians have fulfilling careers in medicine. Called Look for Zebras after the saying in medicine, ‘If you hear hoof beats, look for horses, not for zebras.’" I tell other physicians that, when it comes to our professional lives, we need to look for zebras.”
Make the most of your regrets
A recent cohort JAMA study on physician burnout and regret found that 45.2 percent of second-year residents reported burnout, while 14 percent had career choice regret, (defined as whether, if able to revisit career choice, the resident would choose to become a physician again).
Characteristics associated with a higher risk of reported regret included being female and having a high level of anxiety in medical school, while those associated with a lower risk of career regret reported lower overall levels of empathy during medical school.
Maiysha Clairborne, MD, an integrative family physician and the founder of the website Stress Free Mom MD, has transitioned out of clinical medicine after 14 years. “Over the years I have experienced waves of physician regret, not necessarily for choosing to be a physician specifically, but for the career path I chose as a physician in family medicine.”
Medical school remorse?
Clairborne classifies career regret into several buckets including taking an unrealistic view about what life as a physician will look like. “As a physician coach who helps other physicians find their career sweet spot (often transitioning from suboptimal jobs), the first thing I tackle is finding out what their “ideal job” would look like.” She thinks many physicians have an idealized career view and make decisions based on money rather than lifestyle.
Also high on the regret meter is the system in which physicians often find themselves working. For example, Stacy says, dealing with insurance companies can be tiresome, and there’s tons of paperwork and meeting regulations and requirements for payers like Medicare, which can contribute to career dissatisfaction.
The Future of Healthcare: A National Survey of Physicians by The Doctors Company Foundation also found that EHRs and regulations are top causes of physician burnout, and that 7 out of 10 doctors are unwilling to recommend healthcare as a profession.
One of the consequences to the growing domination of large healthcare organizations over small private practices, Claireborne says, is that many physicians lose their autonomy in practice.
“We go into to medicine to make a difference. It’s very difficult to make that difference when we have insurance companies, hospitals and large medical systems telling us what we can and can’t do,” says Clairborne.
Some organizations try to implement a physician wellness culture, but there is still a long way to go. “We have to tackle the mindset of the leadership in these large healthcare organizations and hospitals if we are going to make a difference on this front,” says Clairborne.