“Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”
The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to mine,” a respondent marvels to a fellow trainee. “Before you quit, think about what motivated you in the first place, and what changed,” cautions an emergency physician to an early-career doctor.
This networking site, and others like it, is where doctors come to discuss the verboten: leaving the medical profession. There are posts from medical school students questioning their career path, and from trainees unable to find a full-time job. And predominantly there are posts by physicians who, after years in the field, are desperate, at the end of their rope, looking for a way out.
Some of them are suffering from what doctors know simply by the shorthand of burnout — loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Burnout is on the rise among doctors: One study found that over half of all US physicians are experiencing it, for reasons such as long work hours and an increasing burden of bureaucratic tasks. With no nationally available, peer-reviewed data on physician turnover, it’s not clear precisely how many doctors leave because of burnout.
But more than most, doctors may find a career change daunting. There’s the time invested — four years of medical school and as many as nine more years of specialty training — and perhaps a lucrative salary that’s hard to leave behind. Doctors’ specialized skills may seem less obviously transferrable to another field. And the perceived virtuousness of a career in medicine may make some feel guilty to consider leaving.
So they come to Drop Out Club to air their worries, seek solace from those who’ve made the leap — and just feel less alone. The site’s forum is where they ask for and offer advice; there’s also a job board where employers post positions, and members can converse privately in individual messaging. Among its 37,000 members, about half are doctors, said Heather Clisby, a company spokesperson.
Two recently established Facebook groups aim to meet a similar need. Since their founding last year, Physician Nonclinical Career Hunters and PMG Physicians and Non-Clinical Careers have amassed nearly 3,000 members combined. (The latter group is visible only to those who are invited by current members.)
“The frustration with medicine is fueling our growth,” said Dr. Laura Fijolek McKain, the founder of Physician Nonclinical Career Hunters. “Doctors are frustrated with how much time they’re spending on paperwork and other activities that have little to do with patient care.”
And on the web they can find what is often hard to come by in daily life: a ready-made community of people grappling with the same questions.
Finding solidarity online
Dr. Maryam Shapland initially loved her job as an emergency physician. It was busy, exciting, and important. But after a few years, the work felt less exciting and more stressful. She reduced her work hours, but still felt worn out all the time. Then, seven years into her practice, one of her patients sued her.
Devastated, she decided to start searching for a new career.
At first, she felt guilty for wanting to leave. “People thought I made good money, helped people, and had a nice life,” she said. “All the checkboxes were marked off, so what did I have to complain about?”
Then she found Drop Out Club. She quickly became a “lurker” on the member forum, reading messages posted by others. “Reading all these stories of people trying to leave made me realize I wasn’t crazy for being unhappy in this career I had worked so hard for,” she said.
Shapland hired a career coach, started actively using LinkedIn, and in 2015 was hired as a medical director at a life insurance company. “Leaving medicine felt like giving up a big part of my identity,” she said. “But I’m proud of what I do now. Most importantly, I’m happy and thriving.”
And now that’s a message she’s hoping to transmit to others in her shoes. In retrospect, Shapland said, Drop Out Club suffered from too many mentees and not enough mentors. Once she made it to the other side, she decided to regularly provide career advice — and her email address — on the forum. Since her first post in 2015, she said she gets approximately one new person a week emailing her to seek advice on leaving medicine.
Grappling with leaving
One of those was Dr. Ashwini Zenooz, a radiologist who had practiced for over 10 years. Surrounded by colleagues who seemingly loved their jobs, Zenooz felt that she couldn’t discuss wanting to leave medicine with them. Finding Drop Out Club “was a way to extend my network to people closer to my needs,” she said. Browsing the forum, Zenooz saw Shapland’s email address and sent her a note — which became an extended email conversation, and, eventually, an hourlong phone call one afternoon. Zenooz ultimately took a job in health policy.
Many of the inquiries Shapland receives are related to financial concerns. Medical education can leave doctors with up to a half million dollars of debt, making many feel tied to a high-paying job. Others struggle with the “golden handcuffs” of medicine, unable to leave lifestyles supported by comfortable incomes.
Fear of the unknown can also be daunting, especially to those who have spent their entire careers in medicine. “Leaving behind the familiar and going into the unknown was scary at first. I had been doing this job for decades, and there was a certain comfort level with that,” says Dr. Joshua Schechtel, a hospitalist who left clinical practice this year.
Dr. K.K., an oncologist who requested anonymity in case she returns to clinical practice in the future, found Drop Out Club while trying to make sense of the various nonclinical career options. She posted questions and read stories of members’ career paths out of medicine. “I saw proof that a lot of people who left medicine found other jobs and were happy,” she said. “It made me realize that I, too, could find a way out.” She recently left clinical practice and now works as a consultant for health insurance companies. “Leaving my patients and their families was very hard,” she said — but “my new role allows for a much healthier work-life balance.”
Still, not everyone finds meaningful support through online communities.
Some simply want more hands-on support than a peer-to-peer site can provide. Dr. Mary Schultheis, a colorectal surgeon, joined Drop Out Club after 10 years in private practice. “The hardest part of leaving was accepting that it didn’t mean I was a failure,” she said. “Drop Out Club couldn’t help me come to terms with this, but working with a career coach did.” She left clinical practice this year and now balances part-time consulting and health insurance industry roles.
Others find there aren’t enough people to provide advice. “There were a lot of people who piled on to commiserate, but it was hard to find actionable advice on Drop Out Club,” said a dermatologist in California. She reverted to networking the “old-fashioned way, meeting people locally and building a Rolodex,” which ultimately led to her current mix of part-time consulting and part-time medicine.
Shapland agrees that the site — and the medical field more generally — needs doctors who have left clinical practice to speak up and share their unconventional career paths. They need to make themselves available to help as she did, she said. “Just being a living, breathing example of someone who made it to the other side and will answer a couple questions can help someone take that leap of faith.” She’s proof of it.
Over the past 36 years as a physician in practice it has been steadily worse, especially in basic services, especially in primary care, especially in primary care where there are half enough in the workforce. The financial design is worse across these areas and is even worse in most states with lower concentrations of physicians.
Financial designs, blame the physician media, distractions as the result of health policy changes, and rapid meaningless health policy changes make the situation worse.
Our nation also is moving away from support resources making it more difficult for patients – especially the half of the population with half enough support.
The financial designs also support fewer and lesser health care team members where most needed.
Foundations and associations who are supposed to champion primary care and health access have pushed meaningless health insurance insurance, meaningless incentive based payment designs, and meaningless innovations – obvious to those who deliver the care.
Responding to Chad (great question by the way). The number one thing you can do is push back against this culture of entitlement that has gripped all of Western Society in the last 20 years or so. That’s one of the things that gets us the most… patient feels entitled to a perfect outcome… they don’t get it.. they lash out at us. Patient feels entitled to whatever time/date that is convenient for them… they don’t get it… they lash out at us. Patient feels entitled to their crappy insurance plan (that they chose) paying for everything… they don’t get it… they lash out at us. Treat your doctors with respect. Don’t call them by their first name in their office unless you have permission to. Don’t mutter under your breath comments about how much you hate doctors or hospitals.
Don’t be overly difficult to work with or on. Understand that yes, we make good money, and we earned every penny of it and are not going to apologize for it. Understand that we deal with biology… nothing is perfect… nothing is guaranteed. And don’t expect us to work for peanuts or for free (i.e. socialized medicine).
The burnout is real. A lot of it is administrative… only so much you can do about that… a lot of it is dealing with demanding and arrogant patients as well… lots you can do about that. Don’t be that person to begin with (you don’t sound like you would be)… but fight back against that culture when you see it. Someone whines and complains on FB that my doctor isn’t a magician… push back on them… hold them accountable for their ridiculousness and the damage it does to the larger picture.
FWIW… I have heard zero good things about EPIC
Responding to Eric, looking at it from another perspective, how is dealing with patients at your professional office any different than dealing with someone at a McDonalds counter? The educated professionals are just who they are themselves. The public is not a set of educated professionals. Essentially this is a RETAIL job like working at McDonalds but with professional pay. You have to deal with these things that you have mentioned and they should be expected. What is terrible is medical schools do not train these young kids to expect this and how to handle customer service with a wide variety of personality types. Medicine is only a part of the job, not all of it. Deer-in-headlights young kids out of medical school and residency fail to understand this. This is not the same as working in a lab at Pfizer. This is a retail job at its core. Be ready or don’t take the job and go into commercial medicine.
Great points, Eric and Joe. In general, I think the American culture doesn’t have much respect compared to other cultures. For example, after spending some time in India, I noticed how elders are respected. Teachers are called “sir” or “madam” and if you see your teacher in a public area, you greet them by touching their feet.
Joe – and i’m sure Eric can give some better examples – for pediatricians, the tough part are what are known as “helicopter parents”: these are parents who are hovering around the doctor and questioning every single thing that he/she does. I’m sure that’s incredibly annoying. But I agree with the great point you make that it is a retail job and requires you to be professional and candid with all personality types.
Anyhow, I have witnessed a colleague use Epic and it looks way better than some of the smaller systems like NextGen. Specifically referring to the ability to have shortcuts so that you don’t have to start your note from scratch every single time.
What can I as a young patient do to advocate for the system to change back to a better system ? Is it speaking with legislators? Is it becoming a lawyer and fighting for doctors? I’m so perplexed by all this. How can people who have so much experience be willing to quit a profession after so many years of investment…the burnout has to be really bad!
I must say though that to the person who commented on having to switch between EMRs: change is inevitable but also you could work for an ACO that has a lot of money and has EPIC; less likely that they’ll switch away from EPIC, right?
Other thoughts: The comments on here are damning. I – as a patient – who has a keen interest in the medical field, am alarmed by doctor’s who have extensive experience wanting to quit. That is awful.
As someone who pretty much avoids anything to do with the AMA, my heart goes out to those of you who seem to be experiencing such distress in your profession. I am 67 and I use alternative healing practices. I just want to say to all of you in the medical profession that it is imperative that you begin to guide the path of medicine, rather than follow its greedy, outdated, dysfunctional patterns. All of you who are frustrated are feeling that because you are called to make a change for the better. You chose to help people. Find a way to do that.