I started working on this post in August of this year (2017) – right before my old medical group and the medical board started acting a fool. 3 months have passed and the whole process seems much more manageable. So I thought I would finish this post about enjoying practicing medicine because it’s something that’s downplayed by healthcare professionals.
When I was living in Barcelona and doing some telemedicine here and there, clinical work had started to become quite enjoyable once again. I was looking forward to working a couple of hours despite the common work hiccups such as customer service issues with patients or admin emails.
The decreased need for the income and less worry about my perceived performance were the reasons why I was enjoying working medicine again. At 10-15 hours a week I was able to earn a healthy income, help people, keep up my skills, and still learn a few things.
Evolution of Career Satisfaction
Practicing medicine was one of my favorite things to do from 2006, when I first got my medical license, until 2013. Those were my golden years.
The Golden Years
I would finish my inpatient rounding, hop into the Hummer and drove an hour to get to my moonlighting gig. Oh man, heaven! I knew the whole crew of nurses and moonlighters – all of us a pack of hungry/happy wolves.
I would do the moonlighting work for free! That’s why I never saved any of the money, I think. It was just a side-perk of doing something I loved. Not in a million years did I think I would burn out from the work or get tired of it.
When the work became less challenging, other negative aspects of it started coming surfacing such as dealing with management and customer service. I started taking things personally such as when an incompetent clinical supervisor would tell me how to do something.
Working for a large medical group meant practicing conservatively and defensively. I prescribed more Tamiflu in one season than I had my entire career. Every other person got a chest x-ray just so that the QA committee would get off my back.
It took so much more energy to get through the workday from 2014-2017. I was constantly thinking about work and when at work, there was very little job satisfaction seeing patients as an urgent care doctor.
I wouldn’t say that I have the same enthusiasm now as I did in 2006. But because I work so little, there is a little room to miss the clinical work again.
Since I’ve been divorced once, I feel that it’s a valid comparison to make; when you’re married and can’t wait to be divorced, you take your partner for granted and everything about them seems a disaster.
Once you get divorced you can once again appreciate them for who they are – from a distance. It’s never the same but it’s more real.
The Illusion Of Less Stress
With a high household overhead and a lot of debt to pay back, you’re able to suppress your feelings towards work. The drive to earn is so high that you just plow through.
In 2016 money was no longer an issue. There was enough passive income from investments that it could support my lifestyle. This realization erupted some hidden feelings to the surface.
My lack of satisfaction with the career started manifesting as panic attacks and anxiety in the exam room. It was sudden – didn’t even build up gradually. And nobody understood it, least of all myself.
Up until this point, when my financial obligations were high, there was no room to develop any feelings towards work – the job was necessary and needed. It was a privilege to have a job and I bought into the idea of being “lucky to have a job”.
Work now has become like my nightly flossing routine; I see the value in it but wouldn’t say that I enjoy the process. The income covers my basic overhead and anything extra goes into an investment account or gets donated.
I don’t always want to do the work but when I do it in small enough quantities, I appreciate the value of it; it reminds me of back in the day when enjoying practicing medicine was the norm.
If I Never Earned Another Penny
I needed to test and see if I had completely fallen out of love with medicine or if there was some utility to the skillset. I took a few months off and soon found myself giving out free medical advice on Reddit/AskDocs.
This mentality of feeling like I was better than my job isn’t ideal in this world. Conforming creates less friction but it can gnaw at your soul. The drones of doctors zombying around the hospital is an eerie example.
This attitude towards work – desiring a pleasure in return for my dedication and time – is perhaps the reason I have chosen the early retirement path and financial independence.
If I don’t earn another penny until the day I die, I will likely do fine living off of what I have saved and invested in my portfolio.
Or perhaps it’s this income stream that has killed off my motivation to keep working a job. Maybe it’s a curse to be financially independent in a world where medicine is practiced in an assembly line format.
Perhaps the sheer volume of patients, the workload, and the risk are all subtracting from enjoying practicing medicine.
Focusing On The Good Parts
Currently, I cannot spend more than 4-5 hours a day on mentally intensive tasks. In my case, that’s a combination of writing blog posts, researching topics, and performing clinical work, whether telemedicine or F2F medicine.
My mind is gravitating a lot towards creativity. When I want to be creative then I build something or learn a new skill. Watching an inspiring movie or learning recipes on YouTube have been other creative outlets.
But I need structure as well. Logging on to a telemedicine website a few hours a week allows me to practice my skills and make me feel that I am doing something purposeful – in a way that’s me enjoying practicing medicine.
Seeing patients In Person
While away in Barcelona, I found myself craving the F2F visits – not a lot, just enough to help out and maintain my skills. I knew I’d have to plow through a few drug-seeking patients and have those exhausting viral:bacterial talks. But I knew I’d also have a couple of really pleasant interactions each clinic day.
Now, 3 months into the medical board investigation, I still crave the F2F visits but I don’t see the purpose or value, nor can I justify the risk of it. Whether I’m a nonconformist or indeed a bad doctor, something sparked both my ex-employer and medical board to come after me.
Exposing myself to that kind of risk again feels like getting my prepuce caught in my zipper – I’d rather not. Could I do it on a volunteer basis or do it at a low-income clinic and feel satisfied while exposing myself to less risk? Not at this time; the whole process has left too bitter of a taste.
Right on cue my ex-employer raised the hourly wage for per diems to $140 – that would have been perfect since I need the money to cover my legal costs for the medical board investigation. Though I’m not sure that enjoying practicing medicine is tied that tightly to its remuneration.
I feel productive doing these telemedicine gigs – but mostly because of the income. I don’t expect I’ll do that long-term but it’s an adequate replacement for the F2F visits and it’s covering some of my overhead.
I feel productive when I write, when I exercise, when I help out friends, when I invest my money, when I donate to a good cause, when I learn something new, and when I get involved in social causes.
But my ultimate goal is to find an encore career that I enjoy doing. Something that I would do for free and something that replaces the way I felt towards medicine the first few years when I started practicing.
Enjoying practicing medicine isn’t absolutely necessary. I realize that some don’t need that positive feedback from their careers in order to feel satisfied. Perhaps I’m wired differently.
Regardless, I’m glad that after cutting back a lot and not feeling as dependent on the income from medicine I’m enjoying practicing medicine again – a little.