Colorado physicians share what they did to be happy in medicine again
by Kate Alfano, CMS Communications Coordinator
Featured in the July-August 2019 Colorado Medicine Colorado Medicine.
A survey of CMS physician members conducted in early 2019 revealed that 56 percent of those who reported that they are happy in medicine have enjoyed the practice of medicine throughout their career without any symptoms of burnout. But 40 percent of those who reported current joy in practice identified at some point that they were burning out and made a change to achieve their current state. With permission and without identifying the physicians, CMS shares some of the comments of those who took action to increase their wellbeing.
A common theme among the responses is that the individual found their individual way forward or, often, a way out of a negative practice setting. Some chose to transition from larger to smaller practice environments, others did the opposite; some went from a private setting to employed and vice versa; others made a change of location. Within this context, readers can approach the accounts below as inspiration for early stages of moving forward, one individual at a time. The stories can serve as examples of the various paths physicians can take to regain joy in medicine, with the acknowledgement that all stakeholders can and must advocate for change in health systems and work environments that will ultimately make life more sustainable for the servants at its heart.
It is also crucial to acknowledge and support our colleagues suffering from mental health issues that can accompany burnout: depression, anxiety, increased suicide risk, and others.
Help is available.
Chiefly, the Colorado Physician Health Program provides peer assistance services – aid for any problems that would affect one’s health such as emotional, psychological or medical problems – for licensed physicians and physician assistants of Colorado. They provide diagnostic evaluation, treatment referral and monitoring, and support services. Visit www.cphp.org for more.
Other sources for resources, screening tools and help are Mental Health Colorado (visit mentalhealthcolorado.org/help) or Colorado Crisis Services (call 1-844-493-8255 or text “TALK” to 38255).
In their words
I was working five days per week with two and a half hours of paperwork and calls each night, barely having time to eat with my family or interact with my children, and topping this with call every third night and my worries about pay and employee tensions. Patient satisfaction and consumerism made me feel like I just couldn’t win. Many patients were happy but being a perfectionist, I let the unhappy 3 percent monopolize my thoughts. I was having nightmares. I felt like I could not keep my head above water and that I was really short-changing my marriage and family. It was unsustainable. I got very sick. Fast forward: Now I am in academics and teaching medical students. I love what I do and leave each day feeling energized, appreciated, and feel that I have really made a difference. My work is diverse, my colleagues are great and it is a non-competitive but interesting environment. I am still involved in organized medicine and really feel that my career was worth it.
I reduced my schedule to three days a week instead of four, initially to spend more time with my teenage daughter and attend more of her school and sports events. I started taking Pilates classes the two days I was “off” and this morphed into starting yoga classes and then diving deep into yoga philosophy and meditation. I also became involved with the foundation board of the district library system. A huge change that has contributed to a more enjoyable and relaxed lifestyle for me is that our practice uses a hospitalist service for our hospitalized patients. Our call nights are much quieter since we take office calls only and thus we get more sleep. Another advantage is that we are not spending full weekend days at the hospital so overall I feel more rested.
I worked in different settings before finding the right setting for me. I was initially employed in a multispecialty group, then joined a solo practitioner and finally worked in a single specialty group. I found abiding by other practitioners’ demands and expectations led to friction and gradual resentment of work and burnout. When I finally gained the autonomy of my own solo practice I was able to do things like I wanted, specifically focusing on patient care and staff happiness, and it’s the best thing I’ve done.
I was working at an FQHC and was completely burned out. I was seeing 26 to 30 patients a day and then had two to three hours of work at home. Administrators were no help as they just continued to force us to see more patients. I literally was constantly one to two hours behind, never took breaks and rarely took a lunch. It was too much. Over the course of a year I built a direct primary care (DPC) practice and quit my employed job. I have been loving medicine again ever since. I completely removed myself from the model of insurance and managed care and transitioned to a model of a true patient-physician relationship. I couldn’t be happier.
After a painful period, I pursued a master’s of public health degree and focused more on population health. While I continued to see patients, I began to change my frame around what other factors were impacting health care. I think as a frontline primary care physician we can feel that it is impossible to get above the fray. I was able to see that the community was another “patient” that needed attention as well. When I dealt with a crisis in my extended family, I used this experience to join a group that allowed me to share my heart in a transparent way as well as to hear others share their experience, strength and hope. I needed meaningful connections, as well as prioritizing family relationships, physical and spiritual health.
I was doing full-service rural primary care, including OB (non-operative, though on call to help operative colleagues), inpatient care and 1:4 call. I was heavily involved in my church and was snapping at folks. I knew a change was needed and I was told I needed to change. I dropped OB, the hospital adopted a hospitalist program and I bowed out of inpatient care. I now practice exclusively outpatient primary care with 1:5 call and am confident I will make it another 10 years or so to retirement. I also began vigorous cycling and triathlon hobbies and thrive in those activities.
During the first 15 years that I was in practice I was always able to set aside some time to do volunteer work. I felt that the reward of caring for people without access to health care made the time and financial sacrifices on my part seem miniscule. Now that I am in my mid 50s and my kids are off to college I have even more time to invest in patient care for those in need. I have narrowed down my commitment to two non-governmental organizations (NGOs) that do phenomenal work in Africa. The time that I spend here in my practice getting paid to work as a physician feels as if it is what I do in order to stay on top of my game as a clinician and have some residual income to spend working with people in need. The people that I meet and the places that I work in make these medical missions some of the most rewarding work of my career. The joy of medicine is in my heart nearly every day now.
I was in private solo practice, making less money and working harder each passing year but left to become an employed physician with an enormous multispecialty group and am enjoying medicine again.