What specialties/work environments are the least stressful?

[Paigems]

I left my primary care job right before the pandemic started. It was more like internal medicine. I was working 70 hrs/wk and was completely overwhelmed by the volume of work that was required of me. I have both anxiety and depression and one day before work while sitting in my car in the parking lot I experienced such severe anxiety that I could not bring myself to go into work. Instead I drove myself to a psych hospital and was evaluated. I was basically just told I had burnout. 

During the pandemic I've been working on my mental health. I actually participated in a partial hospitalization program and intensive outpatient program through the psych hospital. I have a psychiatrist, still going to therapy, on meds, basically doing everything I can do to get myself to a better place mentally.

I am about to start working very part time for a telemedicine company that does covid screening. My plan is to do this while I continue to work on my mental health. I am now thinking about my future as a PA and what kind of jobs I would find manageable. Maybe I would have to work 3/4 time. Lack of work life balance really takes a toll on me. So does feeling like I'm rushing around the whole day (not able to drink water, go to the bathroom, work through lunch, etc.). Extremely high patient volumes is also stressful. I also think I would struggle in high stress environments like the ICU. 

Can anyone make any suggestions about what specialties might be a good fit for me? I'd love to work in aesthetics. I'm also very passionate about weight loss and preventative health. But really, I enjoy many fields of medicine. 

[Cideous]

Sleep Medicine.  Perhaps wound care.  Something direct and repeatable that you can become a complete expert in and thereby reduce many of the unknowns like in certain medical fields which leads to stress and anxiety.  Stay away from any form of walk in medicine like Urgent Care.

 

p.s.  Brave post, good on you for trying to help yourself.  

Edited July 28, 2020 by Cideous

[airslant]

Just because you can't work 70 hrs a week doesn't mean you aren't cut out to be a full time PA. Ease back into it but I think you're going to be just fine with time and therapy.

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[Paigems]

2 hours ago, Cideous said:

Sleep Medicine.  Perhaps wound care.  Something direct and repeatable that you can become a complete expert in and thereby reduce many of the unknowns like in certain medical fields which leads to stress and anxiety.  Stay away from any form of walk in medicine like Urgent Care.

 

p.s.  Brave post, good on you for trying to help yourself.  

Thank you for the response.

I wanted to also post this on the physician assistant facebook page group to get more responses, but I am concerned about losing my anonymity. I've also seen posts on there that are like like, "I see 50 patients in urgent care per day just fine, and I get all my charting done and take no work home. Very low stress." Then I wind up feeling like I am "less than" for not being able to do that too. 

[UGoLong]

Everyone is different or else we’d all want the same job. Take the time to find something meaningful and that you enjoy doing.


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[newton9686]

Yeah very brave post indeed. More of us struggle with anxiety and depression than we would like to admit. I agree with finding something that is narrow that you can feel very confident with as you move forward. I second sleep medicine. Inpatient palliative care might be interesting for you. Very rewarding and you never half to worry about missing something that leads to a poor outcome. Curious to see what other ideas everyone else can come up with.

[EMEDPA]

addiction med. relatively low volume. specific protocols and referrals for specific issues. have friends who do it as a side job. the hours and money are good. 

[GMM2019]

I left my urgent care job because I was so stressed out from it. I learned a lot, but what a nightmare. That was the first time I ever went to a psychiatrist. 

Maybe occupational health or surgery clearance? Those seem fairly routine, low ish risk, relatively low stress. 

 

[GetMeOuttaThisMess]

Employee Health. Not the PCP, no call, no weekends, and basically nothing more than URI’s, UTI’s, and healthy school athletic PE’s. Your reward is mindless medicine for the most part, great hours, prolonged holiday breaks if with a school district, and a pension.

 

 

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[PAinPenna]

1 hour ago, EMEDPA said:

addiction med. relatively low volume. specific protocols and referrals for specific issues. have friends who do it as a side job. the hours and money are good. 

It’s pretty easy work , patients are thankful - and not the litigious types . Colleagues tend to be quite open minded and tolerant . Overall a very pleasant specialty . Left family medicine for addiction and will never go back . Highly recommend .

And - agree with above posters a very  brave post . You’ll get through this and come out stronger . Best of luck 

[EMEDPA]

45 minutes ago, GMM2019 said:

 

Maybe occupational health or surgery clearance? Those seem fairly routine, low ish risk, relatively low stress. 

 

not me. not for any amount of money. hills of paperwork and folks faking illness and wanting narcs? no thanks...I would do prison med first. truly. 

[airslant]

It’s pretty easy work , patients are thankful - and not the litigious types . Colleagues tend to be quite open minded and tolerant . Overall a very pleasant specialty . Left family medicine for addiction and will never go back . Highly recommend .
And - agree with above posters a very  brave post . You’ll get through this and come out stronger . Best of luck 

I've been inspired to be brave here by OP. I'll probably take a beating for this question though. I always imagined addiction med providers being screamed at by the patients while trying to decrease their dose. Please enlighten my narrow mind.

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[PAinPenna]

36 minutes ago, airslant said:

I've been inspired to be brave here by OP. I'll probably take a beating for this question though. I always imagined addiction med providers being screamed at by the patients while trying to decrease their dose. Please enlighten my narrow mind.

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No beating will happen, as this is a huge misconception so I'll be happy to respond

. When prescribing buprenorphine the goal is not to decrease, but to settle in at a dose where patients are no longer craving opioids they have been obtaining illicitly. This is usually 12- 16 mg daily for most, and they can be on bup for years, as any other meds for a chronic disease. Patients are so happy to not wake up dope sick and craving they tend to be quite grateful and engaged.  I had a patient come in today with his smiling wife, 10 yo son and baby girl who said "This is life the way I've dreamed it to be". There is nothing more fulfilling than helping patients achieve recovery and get their lives back. 

Sure we have the occasional grumpy patient , but these are few and far between and wayyyyyy less entitled than patients I had to deal with in Family Medicine . 

[EMEDPA]

45 minutes ago, airslant said:

I've been inspired to be brave here by OP. I'll probably take a beating for this question though. I always imagined addiction med providers being screamed at by the patients while trying to decrease their dose. Please enlighten my narrow mind.

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Keep in mind that addiction med and pain management are two different fields. In my mind, pain management would be the harder of the two. Addiction med folks for the most part WANT to get better. They want to get off heroin, oxycodone, whatever.  Folks at pain clinics are there because their PCPs can't handle them anymore. 

[dfw6er]

1 hour ago, PAinPenna said:

No beating will happen, as this is a huge misconception so I'll be happy to respond

. When prescribing buprenorphine the goal is not to decrease, but to settle in at a dose where patients are no longer craving opioids they have been obtaining illicitly. This is usually 12- 16 mg daily for most, and they can be on bup for years, as any other meds for a chronic disease. Patients are so happy to not wake up dope sick and craving they tend to be quite grateful and engaged.  I had a patient come in today with his smiling wife, 10 yo son and baby girl who said "This is life the way I've dreamed it to be". There is nothing more fulfilling than helping patients achieve recovery and get their lives back. 

Sure we have the occasional grumpy patient , but these are few and far between and wayyyyyy less entitled than patients I had to deal with in Family Medicine . 

So the goal isn't to eventually get the patient off Suboxone, but to keep them on it permanently?  Sounds no different from all the methadone clinics I've seen over the years.

[EMEDPA]

1 hour ago, PAinPenna said:

No beating will happen, as this is a huge misconception so I'll be happy to respond

. When prescribing buprenorphine the goal is not to decrease, but to settle in at a dose where patients are no longer craving opioids they have been obtaining illicitly. This is usually 12- 16 mg daily for most, and they can be on bup for years, as any other meds for a chronic disease. Patients are so happy to not wake up dope sick and craving they tend to be quite grateful and engaged.  I had a patient come in today with his smiling wife, 10 yo son and baby girl who said "This is life the way I've dreamed it to be". There is nothing more fulfilling than helping patients achieve recovery and get their lives back. 

Sure we have the occasional grumpy patient , but these are few and far between and wayyyyyy less entitled than patients I had to deal with in Family Medicine . 

This is what I have heard from my friends who do it. Folks are there because they want to get better, not because they want to get high. 

[UGoLong]

Regardless of the field the OP eventually chooses, the therapy he or she is now doing is crucial as any job can have its bad days.

Undestanding how to deal with excessive demands can be a critical lifelong coping skill. Learning how to disconnect and to politely say no/ask for help can make all the difference.


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[PAinPenna]

7 hours ago, dfw6er said:

So the goal isn't to eventually get the patient off Suboxone, but to keep them on it permanently?  Sounds no different from all the methadone clinics I've seen over the years.

They do get off Suboxone eventually. Average length of engagment in our clinic is 2 years, but the desire to wean off is patient-led. This is evidence based practice . 

We have one guy 7 years clean who is in no rush though, so we don't push him. Better than the alternative of going back out and using. 

[Bcana]

I’m gonna be Blunt to the OP...Brave...more than that, you have BALLS!! Good for you!

PA here for 12 years (graduated when I was 32. I was a Firefighter/Paramedic. I’ve only done surgery & EM and ive only known burnout and toxic work environments!! I went part time as a PA at Urgent Care and went back to Fire Department full time 6 years ago got promoted, another toxic boss more stress. I’d love to find a chill PA gig where you could actually take vacations. Good luck OP much Respect for getting help!! Hang in there, the sun always rises on a new day!

[GetMeOuttaThisMess]

5 hours ago, Bcana said:

I’m gonna be Blunt to the OP...Brave...more than that, you have BALLS!! Good for you!

PA here for 12 years (graduated when I was 32. I was a Firefighter/Paramedic. I’ve only done surgery & EM and ive only known burnout and toxic work environments!! I went part time as a PA at Urgent Care and went back to Fire Department full time 6 years ago got promoted, another toxic boss more stress. I’d love to find a chill PA gig where you could actually take vacations. Good luck OP much Respect for getting help!! Hang in there, the sun always rises on a new day!

I forgot to mention in my last position, a built in weeks vacation during the week of July 4th.  It was an energy saving policy where the entire district was shut down.  It didn't count against vacation time.  When you factor in three days off at Thanksgiving and about two weeks off at Christmas it was hard to beat...except for just pulling the plug.  I'd be open to hourly work for them if one of the providers needed to miss a day here and there, especially if I got health insurance.

[Randito]

I think most IM specialties are lower stress than EM, surgery or primary care. I previously worked in outpatient hepatology. These were pretty sick and complicated patients. But from an outpatient perspective, it was all about management of decompensated cirrhosis, HCV treatment and HCC treatment. Same themes over and over again. When patients had other concerns, they were directed to follow up with their PCP. We did a lot of direct admissions from clinic and referred patients to go to the ED. Because I only worked outpatient, I didn’t see the acutely sick patients. 

There was still lab review and paperwork to deal with, but nothing like working in primary care. 

[rev ronin]

I'll second sleep medicine.... It's safe, but it's pretty boring/repetitive, honestly.  AASM online CME, front the money yourself, start looking for a job.

I'd also encourage you to look into eating disorders medicine.

I find occupational medicine tolerable, but it's more stress than the above two.  I like doing UC and family medicine too, but not at the pace corporate conglomerates want us to practice.