Physician burnout continues to increase as we enter into year three of the COVID-19 pandemic. In August 2021, the Physicians Foundation reported data from a survey of 2,504 physicians conducted from May 26-June 9, 2021. In this survey, 61 percent of physicians reported experiencing burnout, an increase from 40 percent reported in the 2018 data. This burnout is often seen in those who, during their midlife, may feel what Brene Brown calls “the unraveling.” This is a time when many physicians may want to turn off auto-pilot and re-evaluate their goals. Pair that feeling with a never-before-experienced pandemic, and physicians may be leaving their field in larger than ever numbers.
I found myself at this point of “unraveling” in 2021. I had been in a pediatric outpatient practice for 20 years. As a pediatrician, I had wanted to care for children from birth through college, and I had successfully done that with many of my patients. It felt like it was time to think about my career goals again. I was absolutely feeling like I was on auto-pilot and decided to take a critical look at what I was doing and how I could change things before reaching a state of burnout. In retrospect, these feelings may have been the early stages of burnout not yet recognized.
I had slowly been experiencing an internal need for change, but I hadn’t fully recognized that need.
Six years ago, during a holiday party, my boss gave a short speech recognizing my 15 years at the practice. When describing me, he did not reflect on my value as a colleague at the practice, a caring physician or a knowledgeable clinician. Instead, he talked about how he admired my “grit.”
At the time, I have to admit, I was somewhat insulted. I had just listened to a TED Talk about grit and was sure that he had probably listened to it as well. Having nothing more personal to say, I suspected he drew from some of the concepts in this TED Talk.
Five years later, amidst a pivot in my career, I am reminded of those words. By definition, having grit means “courage and resolve; strength of character,” and I believe that these characteristics helped me find the strength, resilience and courage to take a chance. I did not want to continue on “auto-pilot,” a path that would surely lead me to burnout. Instead, I found an opportunity for change.
As I reflect on how I knew that it was time to make a change, I realize that although I loved what I was doing, I was looking for additional challenges.
I explored other avenues in medicine but ultimately concluded that I wanted to continue on a clinical path. I asked myself what I could do that would allow me to continue clinical practice of pediatrics but would allow for growth.
I had to stop and think about what my interests were and had been when I was in the early stages of my career. Early career goals of mine included an interest in academic medicine, in particular teaching/training new or soon to be physicians.
As a private practitioner, I had some opportunities for teaching and had found them rewarding. I had also furthered my interest in behavioral and mental health in pediatrics by obtaining additional training in those areas.
When an opportunity arose to apply for an academic position, I decided to go for it. It was not an easy decision. I struggled with the concept of the unknown, the fear of failure and the discomfort of proving myself all over again. I had spent 20 years building a practice and being a part of an amazing community in Northern Virginia. At the same time, I wanted a professional challenge and the ability to grow. The opportunity would allow me to practice clinical medicine in an under-resourced community, focus on my interest in behavioral health and instruct resident physicians and medical students. This was the change I had been searching for. I accepted the position and packed up and moved to Georgia.
It is almost six months into my new role as associate professor of pediatrics. It has not been the easiest adjustment, but it has been a positive one. I found that making this mid-career change has brought new energy to my practice. I look forward to learning new information, meeting new patients, and teaching learners. I recognize that not all physicians will have the ability to change mid-career. There may be limitations secondary to geography, children’s needs, or a spouse’s job. I was fortunate to be an empty nester when I made my change and to have a spouse who moved with me for a mid-career change of his own.
My experience has shown me that change is possible, and when I advise new physicians going out into the world, I am going to remind them of my career arc. Physician burnout is real, and there are ways to practice and continue to thrive in our field. I loved taking care of my patients in Virginia and do not regret a moment of that path I took, but I am also thrilled to be able to look back on my early goals and find myself working towards fulfilling those in this next phase of my career.
Shreeti Kapoor is a pediatrician.
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