Do YOU Regret Becoming a Physician?

 I am a family physician of 14 years who has transitioned primarily out of clinical medicine in the last 2 years. I over the years I have experienced waves of physician regret, not necessarily for choosing to be a physician specifically, not even for choosing my specialty (I love the specialty I chose), but for the career path I chose as a physician in family medicine. I think physician regret comes from a variety of things.

1) Not stopping to consider what you actually want as a physician; By this I mean that most physicians by the time they are coming out of residency just want to get a job. They don't consider what they want their life to be like. It's a myopic view that leads into making decision based on money rather than lifestyle. It's similar with medical students. They choose a specialty based on what they think they like rather than what they like AND whether it matches their core values…and the lifestyle they'd want. For example: I loved delivering babies. I almost did an OB fellowship; but I really like my sleep and so the first time I was awakened at 3am to leave my bed, my house and go into the hospital I realized that would not work for me long term. 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. While there is a lot of skepticism in answering the question at first, I often find that those clients of mine end up finding that ideal (or at least 80% of it) most times.

2) Another cause of physician regret is the system - Let's be honest, the system of medicine is not like it used to be. Healthcare organizations are turning physicians into workhorses. It's all RVU's, Meaningful Use, patient satisfaction, Quality indicators and a thousand clicks just to order a lab or medication. Not that these things aren't important, but when our salary is tied to these things in a way that puts pressure on us while at the same time restricts our autonomy, it creates a set up for physician to burn out very early in their career. I'm seeing docs in their 4th and 5th year coming to me wanting out already! That's horrible. It's not something we think about when we are in med school. Seeing this in evolution early in practice is what triggered my "I've got to get out" response. Having burned out twice before, I knew if I didn't create something different I'd b in the same position as many of the doctors I now coach. I think some organizations are trying to implement cultures of physician wellness, but we still have 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.

3) Loss of autonomy - one of the consequences to the growing domination of large healthcare organizations over small private practices is that many physicians are losing 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. We don't get to practice medicine the way we know how… the way we know is best for the patient. I think this is the reason for the growing popularity of the concierge and direct primary care model of practice amongst physician. It returns autonomy back to physician and allows them to BE with the patient in the way they can make a difference

Are we as family physicians and internal medicine doctors more prone? Honestly, I don't think so. I have spoken to hundreds of physicians of ALL specialties and I haven't seen a predominance of physician regret in these two specialty. I think the reason is because these two primary care specialties are actually more versatile than some of the subspecialties. As a family doc, you can do Urgent care, traditional family medicine, women's health, pediatrics, integrative medicine, hospital only work, or Emergency medicine. Internal medicine is similar except for women's health and pediatrics, but also includes geriatrics as well. So in some ways regret could be less because of the ability for family and internal medicine docs to pivot.

As I said early, I have experienced waves of this regret. In those times, I wish I had stepped out of the traditional earlier, and made my pivot into integrative medicine much sooner than I did. However, now coaching other physicians on their various career paths, I realize that the path I took was necessary to be able to now help others to find their career happy place.

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Maiysha Clairborne MD

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