Physician burnout makes for interesting non-clinical career choices

A recent dialog on the LinkedIn SEAK Non-Clinical Careers Group page was sparked by this (all names removed):

I have retired from medicine after 42 years. I attended SEAK in Chicago and it only served to highlight my dissatisfaction with medicine as a career. I am now a bartender. I am planning to do private duty bartending and uniformed chauffeuring.

I think medical care has lost its charm. I started out in trauma and I couldn't get enough of it. I delivered babies, did c-sections and appy's, set bones. It was a gas. But the greed of other doctors for money and time off to the detriment of other doctors like me, and the profound unhappiness of my co-workers, doctors, nurses, and secretaries, reminded me there was more to life than medical practice. I am writing a murder mystery which may be so bad I may have to publish it myself. Ask me if I care. 

The largely congratulatory and sympathetic responses includes this sampling of (edited) remarks:

Fantastic! Bartending sounds like a great way to stay connected with people. I am leaving my general surgery practice to engage in a 1 year fellowship developing medical devices. I have no definite plans to return to clinical practice but will keep my license. Surgery is a wonderful profession but the headaches and call have outweighed the joys for me and my family.

Congratulations - I wish you the best. I am working on closing my Surgery Practice. I am currently starting an internet business, writing books, and in the future hope to create a wellness center. The practice of Medicine ran its toll for me after 11 years long hours, high malpractice, poor insurance payments, and heavy call schedules...., 8 years of this time was done without single day off! I woke up one day unhappy with the realization I always discouraged my patients against working themselves into an early grave yet I was doing just that. Anyway, I have finally slowed down enough to enjoy a sunrise...

I retired 6 years ago after 29 years in practice, tired of dealing with insurance companies. Today I play golf and spend time helping run our condo as a member of the board and although I keep a licence active and attend CME courses, have no intension of returning to practice.

I left orthopaedic surgery residency for same reasons. My unhappiness was profound and deep, and I just didn't see any light at the end of the tunnel. I went to industry for 9 years and then began working on creating my own remote mechanism for physicians and ancillary healthcare providers to provide and promote custom wellness programs for their patients, but done so remotely with programming (not face to face).

and

I am sorta out of medicine. 32 year navy career, 20 of which were in medicine in a variety of fields. Board Certified ER and loved the trauma center high acuity practice, but most ERs are glorified urgent care sites. I have also become philosophically against the way we practice medicine in the US (and I have done more than my fair share of international work). The entire approach to medicine needs to be changed. People go to physicians for everything, and it is breaking the bank. WRT practice, the paperwork, hours, all the non-clinical stuff, regulations,clinical practice guidelines, etc. Ughh! I now work in disaster medicine and counter terrorism medicine (yes there is such a thing). Better work hours, almost as good WRT remuneration, and I am a lot less crabby than I used to be. (PK comment - I'm not sure what WRT stands for)

And it seems, judging by the comments pouring in, that the LinkedIn conversation is not yet done!

So here we have physicians retiring early, leaving incomplete residency programs, practices closing -- and the pervasive thread of deep professional dissatisfaction and cynicism.

I recognize that this is a self-selected group, defined by a search for an alterative non-clinical career, but these posts are very much in line with the larger conversations happening elsewhere online.
 

A recent study reported in JAMA in May 2011 (whole article here) cites physician burnout estimated to be occurring in 30-40% of US physicians.
 

Physicians, younger and older, are leaving medical practice to join organizations in non-clinical roles, start businesses of their own, write books, retire sooner than planned, volunteer here and abroad, teach high school. 
 

What does this defection say about our future prospects for a high-functioning, reformed and revamped healthcare system?
 

Today, I feel gloomy.

Oh, and BTW, cheers, to you, Dr X. May you and Mike Flaherty have fun in your new jobs!

Comments

[clara arkins]

More and more physicians are growing tired and too much exhausted of their jobs that's why most of them just chose to try threading the other career path or do <a href="http://freelancemd.com">non-clinical jobs</a>.

[student]

I am tired of all the economic negative news. I think the reason the economy sounds bad has less to do with an actual recession than media sensationalism and doomsday pessimism. Everyone was in a panic in 1997 because of the Asian financial crisis, but the sky did not fall. I don’t think the media should lie about a high unemployment rate, but I would like to hear more positive news stories. Just like news reports about Y2K, killer bees, crack babies, Firestone tires, shark attacks, and the Gulf oil spill, people will soon realize any economic downturn is partly due to hype and life will go on.

http://www.usnews.com/money/blogs/alpha-consumer/2009/1/8/did-the-media-cause-the-recession.html

http://www.time.com/time/magazine/1998/int/980706/cover_story.one_year_aft33.html

I did some research and found that there is plenty of good news out there:

The recession officially ended in June 2009:

http://money.cnn.com/2010/09/20/news/economy/recession_over/?section=money_latest

The unemployment rate is falling:

http://www.greenbaypressgazette.com/article/20110402/GPG0101/104020692/U-S-unemployment-rate-falls-2-year-low?odyssey=tab%7Ctopnews%7Ctext%7CGPG-News

The stock market has risen 53% recently and is still cheap:

http://www3.signonsandiego.com/stories/2009/oct/15/cautious-optimism/?uniontrib

Apple, SkyWest, Kroger’s, General Mills, CarMax, Walgreen, Dell, Discover, and Nike are just some of the many respected American companies to have declared profits recently:

http://blog.seattlepi.com/microsoft/archives/182538.asp?from=blog_last3
http://www.usatoday.com/travel/flights/2009-11-05-skywest-q3-profit_n.htm

http://www.nytimes.com/2010/09/15/business/15kroger.html?src=busln

http://www.bloomberg.com/news/2010-09-22/general-mills-first-quarter-profit-rises-12-on-sales-of-cereals-snacks.html

http://www.fayobserver.com/articles/2010/09/22/1033100?sac=Bus

http://www.nytimes.com/2010/09/29/business/29walgreen.html

http://www.bloomberg.com/news/2011-02-15/dell-reports-profit-that-tops-estimates-on-business-pc-demand.html

http://www.bloomberg.com/news/2011-03-22/discover-beats-estimates-on-declining-defaults-boosts-payout-shares-gain.html

http://www.oregonlive.com/playbooks-profits/index.ssf/2011/09/nike_posts_15_first_quarter_pr_1.html
US housing starts have risen:

http://blog.al.com/breaking/2009/10/us_housing_starts_rise.html

Business confidence has grown:

http://www.bostonherald.com/business/general/view.bg?articleid=1203965&srvc=rss

Factory orders have increased:

http://www.telegram.com/article/20110203/NEWS/110209884/1002/busines

Consumer confidence has climbed:

http://money.cnn.com/2010/08/31/news/economy/consumer_confidence/index.htm?section=money_latest

Consumer spending is up:

http://www.reuters.com/article/idUSTRE65M2WK20100628?loomia_ow=t0:s0:a49:g43:r5:c0.051546:b35270006:z0

The US GDP rose 3.1%:
http://finance.yahoo.com/news/Stocks-rise-on-Oracle-apf-2813128403.html?x=0

US exports rise:

http://www.nytimes.com/2011/09/09/business/economy/us-exports-rise-to-record-as-trade-deficit-shrinks.html

North Dakota has an unemployment rate of 3.7%. South Dakota and Nebraska have unemployment rates of less than 5%. Singapore has an unemployment rate of just 2.2%. Unemployed people who move to these places can find work in agriculture, oil fields, schools, and hospitals. These newcomers will need to buy homes, food, and services creating more jobs. If you don’t have a job, move to an area with a better economy. If you can’t sell your house at the price you want, you shouldn’t have paid so much for it. If you don’t want to move and make trade-offs, I guess that you aren’t that desperate for work.

http://www.bls.gov/lau/

http://online.wsj.com/article/SB10001424052748703803904576152630710927512.html

http://www.jamestownsun.com/event/article/id/81609/

http://www.economist.com/node/18488276?story_id=18488276

The United States will face a labor SHORTAGE in the next few years as millions of baby boomers retire. There are 76 million baby boomers, but Generation X only has 46 million people.

http://seattletimes.nwsource.com/html/nationworld/2002185894_boomers21.html

http://www.argusleader.com/article/20091107/business/911070331/1001/news

If you really want to stay where you are and haven’t found a job, think of a way to make money from your hobbies. Find a need and fill it. Do you like to cook? Are you good at fixing things? Do you like to paint? Optimists make more money and I strongly believe that if you do what you love, the money will follow. Whatever the mind of man can conceive and believe, it can achieve. If there is a recession, choose not to participate. Just because someone says there is a recession, doesn’t make it true. Just because most people used to believe the world was flat, did that make it true? If you are feeling negative, I highly recommend the book “You Can Have it All”:

http://www.librarything.com/work/508754

http://www.entrepreneur.com/management/managementcolumnistscotthalford/article207648.html

You might also feel less sorry for yourself or the economy if put your life in perspective. How would you like to trade places with someone in North Korea? Would you rather live in Burundi where the GDP per capita income is $300 per YEAR?

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2004rank.html?countryName=Burundi&countryCode=by&regionCode=af&rank=228

Even if things are really bad for you and you become homeless, there is a safety net of food banks, shelters, general relief, and food stamps. You could join a commune or a monastery.

America needs a good pep talk instead of negativity. I really think Obama would be more helpful to the economy by talking about the positive sides instead of pushing expensive stimulus programs. People should live within their means to avoid crashing the economy, but even when overextended, the United States has managed to pay the massive debts of the Depression and WWII.

http://zfacts.com/p/318.html

http://reuters.com/article/2011/09/29/idUS412302169920110929

Americans need to think more like immigrants. Politicians are too afraid to say it, but Americans should stop whining, get up, take responsibility, lower their standards, bite their lips, tough it out, and get busy. Americans should stop buying SUV’s and McMansions they can’t afford and pay off their debts. I have no sympathy for the sheep who went in debt to buy expensive restaurant meals, clothes, vacations, cars, and overpriced homes when times were good instead of saving for a rainy day. Buy LOW and sell HIGH. If people had put their money in the bank instead of wasting it they would still have it. NOW is the time to buy stocks and houses, not when the stock market and real estate prices are hitting record highs. The United States is capitalist not Communist. There is social Darwinism and survival of the fittest here. If Americans want a handout, they should move to Sweden. I have seen refugees from places like Vietnam immigrate to the US with NOTHING and own houses and cars five years later, while some lazy Americans who have lived in public housing and on welfare for GENERATIONS complain about how poor they are. Why can a third world immigrant who doesn’t speak English make more money in five years than some Americans who have lived in the US their entire life?

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2010/09/27/financial/f063017D17.DTL&ao=all

http://online.wsj.com/article/SB10001424052748704895004575395491314812452.html

The negative thinking about “tough times” and the supposedly “decline of the US” kills me. The USA is by far the richest and most powerful country in the world. Who invented the assembly line, telephones, movies, light bulbs, airplanes, air conditioning, elevators, skyscrapers, television, the atomic bomb, the pill, calculators, microwaves, lasers, the Internet, mobile phones, the space shuttle, and landed on the moon? What country wins the most medals at the Olympics despite having only 5% of the world’s population? If the United States is dying, why do so many people want to immigrate there? If the US economy is so bad, why do so many people flock to buy US treasuries as a safe haven?

http://www.statemaster.com/encyclopedia/List-of-United-States-inventions

http://englishrussia.com/index.php/2010/02/14/russian-or-not-russian/

http://sports.espn.go.com/oly/summer08/medals

Maybe I am the last optimist in America, but I think the best years of the United States are ahead of us, not behind us. I would be shocked if the USA won’t be the first country to put a person on Mars, invent mass-produced hydrogen and solar cars, and cure cancer. Americans who worry about the future are ignoring the facts and aren’t doing anyone any favors.

I have lived through many booms and busts. Every time there is boom, people think good times will last forever. Every time there is a recession, people think it will never end. While I am not blind to the difficulties that may exist in the present economy, I just think people should be more optimistic and look at the good sides. I remember when I was in middle school in the mid 1980’s and had a teacher who asked my classmates whether the USA was on the way to the peak of power, at the peak, or on the way down. I was the only student who said the US hasn’t reached the peak yet. A few years later the Soviet Union collapsed, the Japanese economy crashed, and America was the only superpower.

I am not sure if there is a recession, but if there is one, I think it will soon be a distant memory.

http://www.nytimes.com/2010/07/05/opinion/05douthat.html?_r=1

http://www.thedailybeast.com/newsweek/2010/04/08/the-comeback-country.html

http://www.nytimes.com/1994/03/12/business/consumer-spending-in-rebound.html?pagewanted=all&src=pm

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Remember: Whether you think you can or whether you think you can’t, you’re right.

See the glass as half full, not half empty.

Anyone who bets against the United States will always lose.

[Philippa Kennealy]

Wow - thanks for your strong reminder, and this well-buttressed forceful argument against whining!