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Burned Out & Over It


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So, I’ve seen a few posts similar to this, but wanted to get some fresh advice.

I’ve been practicing in basically the same specialty for 5+ years- in outpatient, inpatient, and periop settings- and I’m just kind of over the whole “practicing medicine” thing.  I’m confident in my skills, feel like the work I do is important, and feel valued at my job, but I’m just not happy.

Maybe it’s because my life outside of work is more enticing and important to me these days, but I truly struggle to get out of bed and go to work everyday. I hate having to work weekends and take call, even though our schedule is super light.

I’m interested in teaching, but I’m not sure my 5 years of very specific experience would make me a valuable teacher. 

I guess I’m wondering- if you’ve felt this way- burned out for no reason other than wanting to be at home more than at work- what did you do?

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It's kind of a personal thing but personally, I would never discount your feelings that you're off-course. If you feel that way for a couple of weeks, that may be just life, but if it persists, it could be that little voice telling you that you're off-course. Maybe just a little off-course or maybe a lot. It could be time to get your job redefined or to change jobs. Or it might mean changing careers.

Before you leave to become an Australian sheep herder, you might want to take some time and consider some other PA positions that maybe have you work more hours in less days, try a new area of medicine, etc. Not all jobs are the same, no matter what so people might tell you (like "that's why they call it 'work.'").

Take some time to try things out. See if you can make that little voice a little louder so you can figure out what should be next for you.

Good luck

 

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That's how I've felt for close to 5 years.  I finally got a job in a laboratory this last August.  Prior PA employer called me yesterday offered me full time position in their family practice making 100,000.  I declined.  Just have no stamina for it at this time.  I wish you luck.  Was not an easy decision for me.

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8 hours ago, rev ronin said:

Have you worked in a specialty where you get to see the same patients over and over again?  I really like Occupational Medicine for that.

Rev I give you a ton of credit.  I have done a TON of occmed over the years and I have yet to find anyone who does it that likes it.  The constant fight between companies and injured employees.  Whose a malingerer and whose not?  The paperwork.  My first job out of PA school was pure occmed and it came very close to pushing me right out of medicine before I really got started.  

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5 minutes ago, Cideous said:

Rev I give you a ton of credit.  I have done a TON of occmed over the years and I have yet to find anyone who does it that likes it.  The constant fight between companies and injured employees.  Whose a malingerer and whose not?  The paperwork.  My first job out of PA school was pure occmed and it came very close to pushing me right out of medicine before I really got started.  

Same with spine as your first out of school position.  At least there you can sometimes find objective pathology that actually matches up with a patient's complaint.  I've since gone big league.  Runny nose, congestion, and cough for a couple of hours without any self treatment.

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1 hour ago, Cideous said:

Rev I give you a ton of credit.  I have done a TON of occmed over the years and I have yet to find anyone who does it that likes it.  The constant fight between companies and injured employees.  Whose a malingerer and whose not?  The paperwork.  My first job out of PA school was pure occmed and it came very close to pushing me right out of medicine before I really got started.  

I know!  I didn't WANT to do it, didn't pick it, it was kind of a "you gotta do occ med if you want to work our walk-in clinic" kind of thing for me, and then the PA who had been doing most of it left suddenly and wasn't re-credentialed by L&I, so I ended up with all of his long-term patients whether I liked it or not.

In Washington, they pay for our paperwork and phone calls, so I actually generate more revenue by doing a diligent job, which means I get to dig into things, politely argue with everyone I disagree with, and get paid for it. Oh, and management is fine with it, because my per-visit revenue outstrips any other payer, so I do get to know these patients.

I am glad I got into it with 3 years of family med under my belt.  I agree it probably would have wrecked me, too, as a new grad.  Also understand that I did most of my undergrad, both when I was still in high school, and then later with my Bio/Chem leveling before PA school, in a community college environment, so I wasn't unfamiliar with blue collar adults who didn't excel in school trying to better themselves as adult learners. I got over being a self-centered jerk about it after being called out on my attitude when I was 18, but that's another story..

I joke that each facet of medicine I gravitate towards appears to have been shaped by one of my high school experiences.  For diabetic foot care, it was wood shop. 🙂 for Occ Med... it was clearly debate.

The transformation I've seen, tag teaming with good behavioral health providers, makes
the hassle worthwhile.  I've seen gentle, consistent engagement and patient advocacy break the shell of a bitter older gentleman who arrived to my care pissed off and spoiling for a fight, leave a year later on pension to go reconnect with an alienated adult son and his grandkids... a truly changed man.

Those of you familiar with the New Testament may remember the parable of the shepherd leaving the 99 sheep to go after the single lost one.  I want to be that for my patients, because the rest of society has, for the most part, written them off.  This is what I got into medicine for, even if I didn't know it at the time.

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I've found a change of venue and/or specialty is great when you're feeling burned out.  Tired of FM.......try IM.  Tired of that, try rural med.  Tired of that, try ER or a surgical specialty like orthopedics.   The other nice thing about hopping specialties is it makes you a better provider as you've seen lots of different pathology and acquired a variety of skills.  Employers and recruiters recognize this, in my experience. 

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To the OP:

 

I'm burnt also. I would suggest trying another specialty or change of scenery... I have a BETTER (pretty good) job now in GI. 4 days per week but get paid for 5. 6 pt hours per day (11 pts) and bonuses, dues and society fees, UpToDate membership, bennies... But I'm still burnt out. I *kinda* dislike medicine but really don't see me doing anything else. Been in medicine since I was 19 and really all I know. That actually has been kind of depressing.

 

I, like you, find my life outside of work to be so much more fulfilling. Spending time with wife and kids, volunteering at my church, going on missions trips, vacations/travel, hobbies etc. My debt is *relatively* low (only have the mortgage) and I figure I only need a small amount of money per month to live on (even in the bay area) so I have thought about hanging up my stethoscope and finding something I can do from home. Just can't seem to really do it though. Lol. But I am thinking about it and may do it soon.

 

***Disclaimer: I had a particularly bad couple of weeks at work... My feelings and thoughts may change on this topic... Probably not [emoji23]

 

Sent from my SM-G975U using Tapatalk

 

 

 

 

 

 

 

 

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I recently had to have a sit down with a department chair/MD becuase I said "this isn't the purpose of my life. This is where I work so I can afford to have a life." Somehow this was felt to be a very bad thing and cause for concern. I suggested if it was his puropose in life he'd probably want to stop tking a paycheck...oh yea...you also can't get fired from your purpose in life.

Its no wonder people get burned out. We are expected to flourish in corporate medicine AND feel like it is a calling.

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On 10/2/2019 at 11:50 AM, rev ronin said:

I know!  I didn't WANT to do it, didn't pick it, it was kind of a "you gotta do occ med if you want to work our walk-in clinic" kind of thing for me, and then the PA who had been doing most of it left suddenly and wasn't re-credentialed by L&I, so I ended up with all of his long-term patients whether I liked it or not.

In Washington, they pay for our paperwork and phone calls, so I actually generate more revenue by doing a diligent job, which means I get to dig into things, politely argue with everyone I disagree with, and get paid for it. Oh, and management is fine with it, because my per-visit revenue outstrips any other payer, so I do get to know these patients.

I am glad I got into it with 3 years of family med under my belt.  I agree it probably would have wrecked me, too, as a new grad.  Also understand that I did most of my undergrad, both when I was still in high school, and then later with my Bio/Chem leveling before PA school, in a community college environment, so I wasn't unfamiliar with blue collar adults who didn't excel in school trying to better themselves as adult learners. I got over being a self-centered jerk about it after being called out on my attitude when I was 18, but that's another story..

I joke that each facet of medicine I gravitate towards appears to have been shaped by one of my high school experiences.  For diabetic foot care, it was wood shop. 🙂 for Occ Med... it was clearly debate.

The transformation I've seen, tag teaming with good behavioral health providers, makes
the hassle worthwhile.  I've seen gentle, consistent engagement and patient advocacy break the shell of a bitter older gentleman who arrived to my care pissed off and spoiling for a fight, leave a year later on pension to go reconnect with an alienated adult son and his grandkids... a truly changed man.

Those of you familiar with the New Testament may remember the parable of the shepherd leaving the 99 sheep to go after the single lost one.  I want to be that for my patients, because the rest of society has, for the most part, written them off.  This is what I got into medicine for, even if I didn't know it at the time.

 

 

Rev - how do i sign up for this??  I am back in a small Occ health clinic that is primarly pre-employment, DOT, and drug screens, and then filled in with primary care - what you describe sounds like it could be fun

8 hours ago, GetMeOuttaThisMess said:

I'll speak for myself.  It isn't the medicine that I've become disenfranchised with.  Unfortunately, it's peoples expectations and lack of self accountability.

 

 

i find that a job change helps - I did 5 years in one practice out of school, then did 1-3 years in about 4-5 different places.   Was recently at a state job that I planned on retiring out of in 15 years (would have like been obese, DM, s/p AMI in 15 years from my ******* attorney boss who thought he was a doc but that is a different story).  I left and went to a small private practice and I am stunned with home much life has changed for the better.  

 

 

 

It is not medicine you are burned on, it is the co-workers and lack of support and challenge that has you bored......

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3 hours ago, ventana said:

Rev - how do i sign up for this??  I am back in a small Occ health clinic that is primarly pre-employment, DOT, and drug screens, and then filled in with primary care - what you describe sounds like it could be fun

Other coast, so I don't know how the rules differ. In Oregon, only physicians are allowed to be attending providers on long term claims. In Washington, I can be the AP for forever.  I don't advertise--everyone I get, I get from word of mouth.  I've had psychologists, translators, vocational counselors, lawyers, and even claim managers (indirectly) send clients my way.  Like I said, I wouldn't have really known how to start in the area--I just ended up in a "sink or swim" situation, and tread water until I got the hang of it. All of the patients have multiple chronic conditions, so each month's visit is invariably a 99214, and when you have 20-30 visits per month like that, it provides good relationships, stable revenue, and time to really comprehend these huge long cases over time.  I keep myself to about that level of chronic patient, so I can keep a good mix of long-term occ med, short term occ med, family med, and walk in.

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I'll second the above comments regarding specialty or focus change. Rather than doing periop stuff consider doing actual op stuff. Switch to a gig that gives you even more time off.

Sometimes changing your viewpoint may help as well, I may get flack for this but...I used to think that my job/career defined me, I was in EMS for a long time, did some rather "extreme" jobs for a while and honestly found myself a little dissatisfied after a couple of years out of school, even working at a quaternary academic ICU. I ended up doing a bit of a mental reboot to change my mindset and realized that I don't have to find my joy in life through my career, my career should provide me the means to find and obtain joy in my life. 

I transitioned to a different position which gives me significantly more time with my family and myself. Find the perception of burnout is significantly less, I'm a more enjoyable person to be around (even my teenage stepdaughter says so), and my health is better. 

I dunno, kind of a specific example I guess but give change a shot, concentrate on the you outside of work.

 

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I discovered that doing what I truly did not enjoy made me and my family very unhappy. I needed to get away from ungrateful coworkers and patients and worse Suits! I found that working for Corporate & Academic Medicine was working in a snake pit of back biting, hypocrisy, ego polishing was the  coin of the realm. Walk away and keep walking until you find your good place. You will know when you arrive there. Don't stay where you are stewing in your misery, it will not get better.

Edited by CAdamsPAC
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26 minutes ago, CAdamsPAC said:

I discovered that doing what I truly did not enjoy made me and my family very unhappy. I needed to get away from ungrateful coworkers and patients and worse Suits! I found that working away from Corporate & Academic Medicine was a snake pit of back biting, hypocrisy, ego polishing were the  coin of the realm. Walk away and keep walking until you find your good place. You will know when you arrive there. Don't stay where you are stewing in your misery, it will not get better.

 

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