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Job Transition for a Physician

I get a lot of emails from physicians who have unexpectedly found themselves needing to change jobs. The stories are so different and sadistically interesting.

Witnessing seemingly stable specialty jobs disappear because of business restructuring or having to leave a job because of toxic management changes breaks my heart because I know how bewildering that is for the physician. It’s even worse when you get fired for health metrics or have to leave your job because of a divorce.

In this post I’m going to rehash the same old, same old – capitalizing on good financial times to prepare ourselves for potential career disasters and a job transition.

Financial security is often at the top of the list of worries for physicians when facing job changes. Next it’s the logistics of a job change and then our identity as healthcare professionals.


Job Transition

I have gotten emails from physicians who have been laid off, fired, divorced, or discriminated against.

When facing a job transition we worry about having to dig into our savings in order to cover our household expenses until a solid income is re-established. An emergency fund or a buffer could mitigate such a problem but few physicians have such funds available to them – or they have far too little.

The next matter is logistics such as retirement, vesting, pensions, health insurance, and having to dust off old resumes. This is especially a problem for doctors who have been engulfed by large medical groups – it is by far the most toxic position to be as a physician. On one hand you seem to have it so good on the outside but everything sucks like a Dyson on the inside.


Losing Your Job

Those of you who have read my blog know that Kaiser Permanente shafted me royally after working for them for 8 years. It was hurtful, it was unexpected, and it was my own fault.

I read the emails from y’all and I’m shocked that I’m not alone.

Where does this illusion of loyalty to medical groups come from?

Why did I go through 8 years of work with a medical group thinking that they would be as loyal to me as I was to them?

Why do I even give a rat’s ass now to write about it?

It’s because I’m a sensitive, vulnerable human being. As a physician we offer much more than a service. I’m not changing your tire. You’re not a rubber brand to me when I see you in my office. Once I see you as my patient then I will carry you around with me for the rest of my life.

Physicians are misunderstood because our empathy isn’t displayed with sad puppy eyes, drawn-out hugs, or crying with our patients. Even though we don’t act out those fake empathy displays on the outside, our empathy maps in the brain light up more than the average human being when studied on scans.

The reason that we can give so much of ourselves is that we sometimes mistakenly believe that we have less to worry about as far as our medical groups stabbing us in the back or the medical board screwing us over. We think we can handle patient complaints and job performance reviews – but few of us can do that successfully without harming ourselves. This perfection fetish in medicine is what has most of us burnt out.


Be Financially Prepared

You know that term ‘lifestyle creep’? It’s when you start getting your car washed every week. It’s when you build a backyard pool and hire a pool-person to clean it. It’s when you get a gym membership or start a new sport which requires ongoing expenses.

It’s when you move to a new neighborhood where your lawn has to be as manicured as your pubes. It’s when you roll within circles where people care what brand clothing you wear and which private school your kids go to.

Once we are used to a particular ongoing expense it’s incredibly hard to cut it out. It’s just as much of a shock to the system to have to cut that expense out as it is to lose our jobs – combine these 2 things with already feeling burnt out and it’s a recipe for disaster.

I don’t think that a household needs to live in poverty in order to be financially prepared but there are financial priorities to follow and I’ll list them below in my descending order:

  1. have a very large cash reserve (emergency fund or buffer account)
  2. get rid of your debt – nothing will make you feel more free
  3. save aggressively for retirement
  4. fight to disidentify from your career


Don’t Freak Out

Don’t freak out and don’t be hard on yourself. Sure, if you fondled a pediatric patient then you have much bigger problems to deal with and you probably should see a therapist to figure out why. But if you get fired, if your job disappears, or if you get divorced and are facing a terrible financial situation then don’t panic because panic will cost you lots of money.

The most important thing you can do when shit hits the career fan is to just take a few weeks off and don’t deal with the situation. It’s much harder to do this in practice but wanting to take action can backfire.

Get your resume out and slowly and steadily spend 1-2 hours a day applying to various jobs. These don’t have to be perfect jobs and they don’t have to earn you hundreds of thousands of dollars – something that will get you back in the game.

Let go of any judgement. Yes, maybe your job was toxic. Maybe they stabbed you in the back. Maybe you were a lazy sloth. Maybe you were getting greedy. Whatever the cause, don’t turn towards negativity because as healthcare professionals we can always find something negative in any situation.

Remember this paragraph if you are forced into a job transition: There are always more ways of earning money than you can even think of. I have come up with over 100 ways so remember that there is always one more thing that you haven’t thought of. And finally, when you think you cannot trim your budget any more, you can always go a little lower without affecting the quality of your life.


Go for the Exciting Opportunities

So many US doctors have dreamed of taking a locum tenens opportunity in Alaska or overseas in Canada, Australia, or New Zealand. This job transition time might be the perfect time to do that.

You might think that you don’t have the right state of mind – you are still hurt by what happened and your burnout is front and center. In that case you may not even want to return back to work right away.

Consider starting the application process with a locums company such as Global Medical Staffing, regardless. It takes months for things to go through anyways and this will be a nice way for you to dust off your resume and get back in the game.

What better thing than turning a shit situation into something more rosy? Don’t start thinking about the logistics of what to do with your partner’s job and the kids’ schooling – work on securing the gig and deal with each step at a time. Tons of other doctors are doing it so why can’t you?

My buddy Dr. S. is over in New Zealand right now with her husband and 3 kids. The husband has a very solid high-level corporate job and after they mentioned this opportunity to his work they allowed him to work remotely.


You Can Always Downsize

Because we earn a high income we also tend to be rooted deeply into our lifestyles with debt and commitments. This doesn’t mean that you can’t downside.

There are so many doctors that I’ve spoken to who could immediately retire if they really wanted to. Sure, they bring up 401 excuses why they can’t but it’s all excuses.

One of my medical colleagues recently chopped off 3 of his fingers in his bandsaw at home. As an Urgent Care doctor that sort of limits you. However he is convince that he needs to keep working because his financial adviser told him he needed to. This boy has no debt, has a paid-off home, no dependents other than the wifey, and he has a very respectable retirement balance.

Rent out the house, sell the cars, sell your excess shit, move to Spain for a couple of years, learn a new language, live off online income for a while, or teach some English to get by and live off some of your savings.

Believe me guys, you don’t need cars, you don’t need fancy kitchen gadgets, you don’t need expensive snow gear. You can skip air conditioning, you can get by without eating out, you can live without a TV, and your kids will not become criminals without soccer and tennis practice.


Disidentification from Medicine

I’ve written about this a lot probably because it was a pathological situation in my own life. Perhaps most of you don’t identify with that or every physician does but isn’t ready to admit to it.

From the start of medical school until 3 years after residency the majority of my self-worth and personal value stemmed from identifying as a physician.

I was somebody because I was a doctor. I finally ‘made it’ and I could now hold my head up high even if I had a lot of flaws. I was a physician. It completely encapsulated who I was.

When you disidentify from medicine then you no longer take things personally. Your patients can blow you off as a quack and you know that you’ll still go home knowing what you know and you’ll still get paid the same amount of money.

The medical board can investigate you and it won’t throw your world for a downward spin because you know it’s all a rigged system and you’re a spoke in the the medical industry.

You can lose your job and know that you are a better candidate for almost any job in this economy because you are the poster child of customer service, retail work, brute memorization, hard work, taking abuse, persevering, and knowing how to work the system.

Teachers bitch about how hard it is to teach students. We teach medical students, residents, see patients, handle nurses, and deal with work metrics all in the same goddamn shift!

Baristas and bartenders complain about how hard it is to memorize 5 orders and push out lattes. I can run 5 ER beds at the same time while running a code.

I’m not trying to belittle what other people do but guys, we are smart mofo’s! We are hardworking people and we have the ability to learn and adapt. We can become mechanics, professors, investors, consultants, managers, and writers.


Action Items for Physicians

1. Downsize

If you have already lost your job or in an unhealthy work environment then consider downsizing so that you can feel less financially fragile and to help you be more nimble with your job transition.

2. Earn on Your Own Terms

If the thought of taking on another large medical group gig seems daunting then get creative. Start calling local medical groups or private clinics who perform your speciality and see to what capacity they could use you. Could you train their PA’s? Could you help fill in a few times a week for another clinician? Can you help them build a telehealth option for patients?

3. Let it Go

Finally, if you are just fucking burnt out and ready to slit that radial artery, dude, just quit medicine for a minute. I promise you that you’ll find something better on the other end. Take that beautiful and precious time of yours and do fun things with it – go paint, read, draw, masturbate, dance, play music, hang out with your folks, exercise, surf, or travel.

4. Fail at Something You Love

Go fail at something that you actually love. Start a diet clinic, an exercise class, a yoga boutique, a small cafe, a used bookstore, small art gallery, a coworking space. Fuck it. Who cares if you might fail. At least you sparked your internal flame again and you’ll feel reinvigorated. When your mind is ready then you’ll get back to medicine in your own way, in your own time, and on your own terms.

 5. Prepare Financially

I am convinced that as physicians and healthcare professionals we are in a very unique position to extract the most pleasure from life by reaching financial independence earlier than others. The recipe for this is simple: budget, save, pay off debt. With a healthy emergency fund you’ll never feel financially insecure – ever.

6. Capitalize on Good Times

As of this writing in 2018 we are experiencing very healthy economic times. It’s a shame that we need to use terms like ‘inflated economy’ or ‘a bubble’ and be told that it’s all going to come crashing down. Why think of this as something negative instead of capitalizing on what’s good and using this time to make ourselves more financially secure?

Increase that emergency fund. Keep paying down that debt. Invest in low-risk funds. Create more income opportunities for yourself.

7. Connect with Other Docs

The final advice that I’ll offer is to connect with other docs. The best thing that I can do for other doctors on my platform is to share with them the shit that I went through my Kaiser Permanente and the turmoil of a medical board investigation. These taboo topics that we aren’t supposed to talk about could be immensely helpful to others. I have gained nothing but positive energy and fabulous advice by connecting with other doctors. I hope that every doctor starts their own blog, whether anonymous or 100% transparent.

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