So you no longer want to practice medicine

July 20, 2018

The right support and a thoughtful strategy can maximize job satisfaction for physicians who are ready to transition to a second career.

Studies have shown an increase in physician burnout in recent years, and those statistics aren’t likely to improve any time soon. Burnout is a common factor behind job dissatisfaction along with a lack of work-life balance and ongoing stress levels. Add to that decreasing reimbursements and increased administrative burdens, then sprinkle in some boredom and repetition. No wonder doctors sometimes wonder what happened to the art of medicine.

For these reasons and many others, physicians may consider leaving the ranks of daily medical practice to start a new adventure. Some doctors may move into consulting or join a tech firm, while others seek careers on the periphery of the healthcare sphere. No matter where their path takes them, changes in the medical field are not uncommon.

However, some doctors may consider a career change and hit a wall almost immediately. Julia Pewitt Kinder, DO, says physicians’ first response when they feel the desire to do something that doesn’t involve patient care is to try to talk themselves out of it. She says the most common protests she hears in her consulting business, Physician Career Opportunities, revolve around the time and money doctors have already invested in their career, education loans for which they may still be paying. “They say, ‘Why would I consider changing? That would be crazy. I’m respected, I make a difference, and I make a good living.’”

It can be difficult-and families aren’t always supportive-but acknowledging they deserve to be happy in their jobs may be the first hurdle many doctors need to overcome. Once physicians realize they no longer want to focus on clinical practice, the prospect of changing their career path can be daunting. Throughout their extensive medical training, no one ever talked about career transitions, and they don’t have a clue where to go from here.

Many doctors are reluctant to ask for help, but Peter S. Moskowitz, MD, encourages them to reach out to a career coach who understands medicine and can provide the necessary support. “It will shorten the transition time dramatically and save doctors a lot of heartache by having someone to help guide and mentor them through the process,” says Moskowitz, executive director of the Center for Professional and Personal Renewal and emeritus clinical professor of radiology at Stanford University School of Medicine.

An honest assessment of potential career directions, along with a physician’s skills, abilities, values, and work preferences is key to success. It’s also a process that can be difficult for physicians to follow, especially those who have already been unhappy for a long time. Heather Fork, MD, CPCC, owner and founder of Doctors Crossing, encourages physicians to view the transition as a journey and an opportunity to find out more about themselves. She also reminds doctors they don’t have to find one “perfect” career to transition into. “You already did that when you became a doctor, but that’s not where you wanted to stop,” she says, adding she recommends doctors consider several career possibilities.It’s not easy, says Michelle Mudge-Riley, DO, MHA, RDN, founder and CEO of Physicians Helping Physicians and Docibr in San Antonio. “The fact is, it’s messy. That’s just the reality,”  Mudge-Riley says of her own career shift and the transition process other doctors encounter as they move away from clinical practice. But in the rush to find something other than clinical work, physicians sometimes overlook figuring out what they want and need. Mudge-Riley acknowledges it can be a long and arduous process, but unless doctors have a clear idea of their larger goals, that longed-for job satisfaction may continue to elude them.

Determining how-and when-physicians should explore a career shift can be difficult. Pressure from colleagues as well as family, not to mention internal guilt, doubt, and fear may lead doctors to simply stay the course, even if that means an unsatisfying career. But there are other paths, some in medicine and some not, that allow physicians to transfer their hard-earned skills as they pursue their passions. Four doctors who forged ahead and made a career transition share the lessons they’ve learned.

 

Giving burnout the boot  

After 17 years in a busy hospital-based private clinical radiology practice, Moskowitz experienced significant professional burnout. The effects were devastating and impacted his marriage, his children, and even his health. “It forced me to confront the fact that my work life was killing me and my family,” he says. Moskowitz, then a managing practice partner, took time away to gain perspective. As he focused on getting healthy and adopting a better work-life balance, he began to see more clearly just how much he disliked his job.

Moskowitz knew his long-term happiness rested on making a career change but didn’t know what he might do as an alternative, a situation that created a lot of anxiety for him. Having never heard of career coaches or similar support systems, Moskowitz struggled along on his own. Through his reading on career options and managing career transitions-along with recovering from burnout and dealing with competing pressures of stress, family dynamics, and job satisfaction-Moskowitz discovered he was drawn to those issues far more than radiology.

He volunteered at his son’s boarding school, where he acted as a facilitator for parent-student discussion groups. Moskowitz enjoyed sharing his experiences with other struggling parents. It was an illuminating moment. He realized his skills and background perfectly aligned with his growing desire to provide coaching support for other doctors coping with the same stress, burnout, and career and family difficulties he faced.

Moskowitz completed a coaching certification training program in 1998 and opened a physician coaching practice the same year. Today, he is retired from clinical radiology and estimates he spends about half his time doing one-on-one career and life coaching for physicians throughout the United States and Europe. He claims he spends the rest of his time playing, but his professional productivity is as high as ever. Moskowitz’s second book on physician career management was published in 2017, and he continues to participate in keynote lectures and workshops. It’s evident Moskowitz loves lecturing, teaching workshops, writing, and coaching. He says he derives immense satisfaction from knowing he has made a difference in the lives of thousands of physicians over the past 20 years.

New plan, new career satisfaction

For Mudge-Riley, a longstanding unhappiness ultimately led her to shift her career path away from practicing clinical medicine. She had already come to grips with the fact that she didn’t enjoy direct patient care, a realization that drove an initial move into pathology. There, she found the culture to be so negative and the environment so toxic that she knew she couldn’t stay. “I wasn’t willing to spend the next 40 years being one of the angry and burned-out doctors I saw all around me,” she says.

Feeling stifled and dreading the future, Mudge-Riley took a year off from clinical practice and worked for a medical device firm. One year turned into several years, during which she got a business degree while continuing to explore her options.

“I felt alone, like I was a huge failure,” she recalls. “It was pretty awful.” Despite the support from friends and family, Mudge-Riley felt very alone in her pursuit to find a career outside clinical practice. She was surprised when her speaking and outreach efforts started prompting other doctors to approach her with tales of their own job dissatisfaction. Learning that others in the clinical profession harbored similar longings for something that didn’t involve practicing medicine, Mudge-Riley began sharing her story more widely. As she helped other physicians forge new careers, her own coaching business grew organically.

Her planned return to clinical practice never happened. Instead, Mudge-Riley estimates she focuses 80 percent of her time coaching and mentoring other physicians in some capacity. She conducts workshops, spends one-on-one time supporting doctors who are in need of their own career adjustment, and travels to different organizations to help address workforce issues from the inside. Never wanting to find herself in a situation where she’s unsure what she’ll do next, Mudge-Riley maintains other areas of interest, too. She consults on wellness for Fortune 500 companies and teaches a course for undergrads at a university.

 

Doing it all

Sometimes things happen in life that make clinical practice a less attractive, even impractical, full-time career. Pewitt Kinder was just out of residency when she and her husband had their first child. Ella was born with an extra chromosome (Down syndrome), so Pewitt Kinder wanted to ensure she could devote time to maximizing Ella’s developmental potential. Knowing there would be a lot involved in raising her, Pewitt Kinder’s first goal was adding flexibility to her career schedule.She was frustrated by the lack of information available at the time about childhood issues she expected she’d face, such as teaching Ella to crawl, walk, and potty train. As she navigated those waters, Pewitt Kinder sought to tweak her career further so she could speak with and consult other parents who had many of the same questions she did.

A few years later, Pewitt Kinder had twins. One was born with multiple medical problems, making a career of clinical medicine even more difficult. But Pewitt Kinder still wanted a career, still wanted to be a mom, still wanted to do it all. Quitting work to be a stay-at-home mom wasn’t going to cut it, but neither could she continue clinical practice full time and still give her family the attention they needed. She asked herself what she needed to do to make it happen.

Pewitt Kinder, like many physicians who have transitioned away from daily clinical practice, now enjoys a portfolio career-where multiple part-time jobs replace the traditional single revenue stream-that combines several different occupations in order to meet her many goals. “I discovered there wasn’t one job that checked all the boxes for me,” she explains. The process took more than a decade of trying different things, adding a job here and cutting back on clinical practice there before eventually finding a way to fit everything into the puzzle.

Today, Pewitt Kinder has two consulting businesses: one working with new parents who have children with Down syndrome and the other helping doctors navigate the career transition process. She also works for a hospice company and a major health plan. All of her jobs are done from her home Tennessee, but Pewitt Kinder’s arrangement still offers occasional travel. She also has opportunities to speak at conferences and workshops. Altogether, she says she makes good money. It isn’t the traditional path most doctors envision at the outset of their careers, but Pewitt Kinder says it’s a path that has worked for her.

 

A transition toward what matters most

Fork enjoyed her dermatology residency and immediately purchased a private practice in Austin, but she was questioning her career path after four or five years. She found gratification talking with her patients during longer procedures, but shorter visits left her with little opportunity to get to know people. She made some changes to enjoy her work more. Nine years later, things had improved, but Fork still felt there was something else she was meant to do. She just didn’t know what that was.

Seeking space to find out what came next, Fork took what sound like drastic steps. “I left medicine, sold my house and everything in it, and I lived in an 800-square-foot cabin out near Willie Nelson in the Texas hill country,” she says. It isn’t something everyone can do, but it worked wonders for Fork. She had the time and space to do some volunteer work and ruminate on things she enjoyed without the pressure to make any of them a bona fide career path.

When she was ready to think about what was next, it took Fork only two weeks to settle on a course. Fork says it was obvious to her that she she should coach and help others figure out their career paths. She launched her physician career coaching firm nearly nine years ago.

Fork continues to support other doctors as they find their own answers about what they want from their jobs and develop a strategy to get them where they ultimately want to be. And in helping others, Fork found a way to help herself lead the life she always wanted-just not in the way she initially imagined.