Empathy. If you don’t already have it while in medical school, it will get beaten into you through practice-based learning, role-playing, and in the brutalities of the inpatient ward. I’d expect that every single doctor has had to deliver unwanted news to her patients, and it is never an activity that one volunteers for without hesitation. That’s okay, because we should care as doctors. We heal, but we also face the frailties of life. Each uncomfortable encounter we face fortifies our will so that we can prepare better for the next stressor. In some instances, unfortunately, the doctor breaks down too. We are, after all, humans.
If you add in the privilege of working in the exceedingly imperfect healthcare complex, our mental fortitude becomes tested even further. Meaningful use. Pay cuts. Extra hours. Extra clicks. I’m all for regulation and oversight, but it’s clear that something is awry when healthcare premiums rise along with the inherent cost of healthcare expenditures. My naive view as a doctor is that if I have to significantly alter my ability to care for my patient, whether spending less time with them, spending more time checking boxes, or hearing more about why I need 12 digits in my login password but cannot use a ‘-‘ or ‘#’, I cannot perform at the level that I am capable of as a doctor.
This is one way you can get burned out as a doctor: by caring.
My colleagues will never run out of anecdotes about the inane tasks that they have to complete. It really sounds miserable. We also hear enough about the mental health of doctors. It’s clearly being taxed by the imperfect system. The problem is that there is evidence that caring doctors in general are better doctors. But caring too much burns you out.
The late-career physician has an escape plan to happiness
Late-career doctors have an easy out—they’ve put in their decades of hard work, didn’t throw too much of their earnings away with misguided investments, and can hang up their hat at any point. The trade-off, of course, is that late-career doctors are perhaps late-career in life as well. There are plenty of otherwise fully capable doctors who have practiced 30+ years in their professions who often retire before they truly wanted. Why? Retirement for them was a means to escape the whatever ails them about their job as practicing physicians. More often than not, the reason for retirement is not the dislike or inability to do their jobs.
Everyone else will need to create an escape plan
The goal of being in medicine is hopefully not to quit medicine, but it sure seems like a goal for some doctors. Some of the gals I work with seem to be counting down the years before they can throw away the white coat. What’s holding them back from handing the resignation letter in right away? Over time, I am becoming more suspicious that medicine may be the golden handcuffs for some doctors, or at least handcuffs of any sort.
The mental, physical, and financial investment to becoming a doctor is overwhelming. Maybe only sushi chefs who train to make tamago train longer than doctors. Doctors are invested in their careers. It would be uncommon for doctors to go through this amount of training only to switch careers. Doctors commonly have two reasons to stick out their jobs even though it may seem unpleasant at times: (1) we like taking care of people, (2) it would be difficult to find another career that has a similar pay rate. Golden handcuffs indeed.
We just have to figure out a way to escape the handcuffs.
How to care…but not too much
I recently had a discussion about this with a retired high-ranking Navy physician who now practices medicine as a civilian doctor. We discussed the common gripes about where medicine is heading, and also how different it was to practice medicine in the military. After about fifteen minutes of channeling our negativity into the system, he aptly stated:
No matter where our health system spirals down to, you’re probably not going to starve, get put into prison, or die.
An interesting take on our situation, but I could not agree more. The sky is not falling. As long as you are ethical, competent, and conscientious, you will not starve. A doctor’s skill is always marketable, and we all have to realize that we shouldn’t sweat the small stuff. You should care about your profession, but you shouldn’t need to care about the issues that are out of your control. Focus on what you can control, how you can improve, and control your finances intelligently.
Now, this is a financial website after all. The key solution to escape the golden handcuffs is not to become beholden to the gold. Again, reasons why doctors stick out their jobs include the love of the job and the need to support our lifestyle. If you eliminate the need for salary, you’d only be tied to your profession by your enjoyment of it. Find your way to financial independence, and you might actually enjoy practicing medicine even more. What are you waiting for?
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