Tina Tanner, MD

That was the question I found myself asking. Admittedly the last year had been extremely busy, at times very stressful, yet extremely satisfying. I had managed to work full time in the office, maintain my family life, lead the Michigan Academy of Family Physicians (MAFP) as their president, and continue my responsibilities on the civic and governmental committees on which I serve. Yes, I was exhausted physically, mentally, and emotionally at times but it passed with the appropriate rest. It didn't linger, it didn't leave me with regrets or doubts, or bitter about time I didn't spend elsewhere, as had happened when I had hit burnout.

If you have practiced more than 10 years, you probably have hit that mark and understand what I am saying. I still felt that I was serving a greater purpose, had fulfillment in all that I was doing and yet … something seemed to be missing. What was missing? I was seemingly at the peak of my career, I was in a small rural community doing what I loved: family medicine. I had my family, our dream house, my daughter was thriving, my husband was happy and our relationship was amazing, I was a respected member of our community and the family medicine community through my leadership role with MAFP. I should have been content, more than content, ecstatic and yet …

I set out to answer that question and solve the problem; because that is what we are trained to do. Now here is the perplexing answer: I didn't feel challenged. Strange, yes I know, but as I reviewed the situation, the challenges I had faced this last year were nothing new, they were challenges I knew how to deal with, they were familiar and comfortable. I was missing the thrill, the exhilaration of conquering something new, something you weren't quite sure you could accomplish.

Stop a moment and think about it. From college on, we were paddling against all odds to get top scores, get into medical school, then residency, then the challenges of your first practice, and then a second or a third even while starting a family; all things that were never certain. Dare I say it, my life had become too calm. After over 20 years of conquering one uncertain challenge after another and achieving what I had set out to do I was looking out on my life and wondering, "Now what?"

This question is not so easy to answer. In fact, I really don't have "the answer." I am starting to develop "my answer" but I will admit it is a process. The process starts with more questions.

First I started looking at all the things I am doing; at home, in my local and state community, and professionally. Then I had to ask myself: Do these "things/activities" serve a greater purpose that I want to be a part of? Do they bring me and the world around me joy? Ultimately, am I "called" to do these things? For me, medicine has always been a "calling," something so elemental to my being that not doing it would be like not breathing; impossible. I think that sometimes life just becomes cluttered with all the "things" we do and sometimes we forget to ask why we are doing them.

I am in the process of analyzing the things I do. Will they pass the test? Do they serve a higher purpose? Do they bring joy? Am I called to do them? I don't know if this process will work but I hope that by removing the clutter I will not only find my focus, and in doing so find that challenge that will give me a fulfillment that I only find when I grow as a person.

I chose family medicine because it did challenge me every day - intellectually, emotionally, sometimes physically - but it always challenged me to grow as a person. I know family medicine will be a part of the next chapter in my story, but I also know that there is something new on the horizon. What it is I don't know yet, but the thrill of the search and the certainty of a challenge has me excited to continue through my process which may just be part of the challenge.

I'll keep you updated. Remember though if you are felling restless, uneasy, and that something is just "missing," it may not be burn out; it may just be your career mid-life crisis.

, is a loving wife, devoted mother, passionate family physician, and advocate for rural and underserved populations. Tanner has spent her entire career serving underserved populations in rural health clinics and federally qualified health centers. She currently serves as president of the Michigan Academy of Family Physicians, is an active legislative advocate in Michigan, and has served as a gubernatorial appointee to state's pharmacy and therapeutics committee and various taskforces. Tanner can be found on Twitter 

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I recently realized I wasn't burned out, but experiencing something else at the peak of my career as a physician. Here's what I've discovered.