“One initiative that more administrators should support is global medical outreach. The ability to practice pure medicine, like the neighborhood doctor from long ago, renews a love for the vocation that physicians sought when they first entered medical school. Humanitarian outreach will help reinvigorate physician workforces immediately, allowing physicians to have the opportunity to treat patients who are overwhelmingly grateful for the care provided while also teaching local partner doctors dedicated to changing the lives of adults and children in their own community. Meaning in medicine can be found again. I know, it happened to me.”

Danielle Sweeney is a pediatric urologist.

She shares her story and discusses her KevinMD article, “I left medicine. Then I found meaning.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow.

Today on the show, we have Danielle Sweeney. She is a pediatric urologist, and she wrote the KevinMD article “I left medicine. Then I found meaning.” Danielle, welcome to the show.

Danielle Sweeney: Great, thank you so much for having me.

Kevin Pho: We’re going to get to the article in a little bit, but first off, can you share your story and journey to where you are today?

Danielle Sweeney: Sure. I do not come from a family of physicians. In fact, I don’t have anyone really in the sciences. But at a really young age, probably 10 or 12, I kind of fell in love with the sciences, particularly biology, and from that moment on, I had set my sights on becoming a physician. So I didn’t really have any family pressure. It was all very much something that I was interested in and wanted to pursue, and I was pretty driven from that time.

I looked at colleges, specifically ones with heavy science programs. After college, I went straight to medical school. From there, I went into urology. I had discovered my love for surgery in medical school and pursued a six-year urology residency. So my path was pretty much set in my mind. I was driven from a young age: This is my life’s work, this is what I wanted to do. And certainly, when I got to that point, I was thrilled. I had achieved these goals that I had set for myself at an early age. Following residency, I did a two-year fellowship in pediatric urology and then took a job in Austin, Texas, working as a pediatric urologist.

Kevin Pho: So tell me a little bit about your story. What happened next?

Danielle Sweeney: Well, I have to say, I had my first child towards the end of my residency, before starting my fellowship, and I think prior to that, I was very happy with my career. I was very happy with my choices, and I never second-guessed them. Of course, it was lots of hard work and sacrifice, but really, I was thrilled to be achieving these goals.

I think after the birth of my first child, I began to feel a little stretched. I was struggling with the work-family dynamic. I would say that in the first year of my daughter’s life, I didn’t see her very much. I was not present, and I had very little to do with her upbringing, and I think that weighed on me pretty heavily. But I had my path, and I had my goals. This is what I wanted to achieve, and I pushed forward. I did my fellowship, and then once I started practice, I think for the first few years it was different. I was learning different skills, I was more autonomous, and I was responsible for my own schedule.

But after a few years, it just started to feel different. I started to feel like I was on the hamster wheel, so to speak. Every day, you would wake up and it was rushing and just trying to be the perfect physician, be the perfect partner, and be the perfect mother, and it started to weigh on me a lot. And then I think medicine was also going through radical changes at the time. I think, as you know, as you start to get higher up in your career, your responsibilities change, and it really became, in my opinion, less about patient care and the meaningful part that I loved about medicine so much, and more about paperwork and meetings. I just wasn’t finding the joy and the meaning as much.

I then had my second child and I think began to feel even more spread thin. I certainly started feeling the effects of burnout in my career. I dreaded going to work, and I was dreading coming home, because I just felt like I was failing in all aspects of my life, and I wasn’t really able to perform at the level I felt I should be at. Certainly, I think that was more internal pressure. If you asked people around me, they didn’t necessarily notice any sort of performance drop-off, either in my personal life or my professional life. But it really was something that weighed very heavily on me, and certainly I think I was probably hitting sky-high on every burnout scale that there possibly could be.

Kevin Pho: And you talk more about that in your KevinMD article. It’s titled “I left medicine. Then I found meaning.” Now, for those of you who get a chance to read your article, can you just walk my audience through it and share the story of why you decided to share it?

Danielle Sweeney: Sure. About 10 years into practice, I came to a crossroads. I realized that I was heavily burned out, and after talking to my husband and reevaluating where we were, I realized I needed to make a drastic change. I was terribly unhappy in my career. It was starting to boil over into my life, and I just came to the conclusion, I think when my older daughter was 10. I said, “This is it. I can’t do this. I’m missing out too much. I’m going to leave.”

As a physician, and I think a lot of physicians feel this way, it’s hard to make that break. It’s not like you have a lot of other career choices you can just transition into. I was a minimally invasive pediatric urologist, and that is a very niche specialty. It’s not that I didn’t have any other skills, but I really felt that I was limited as to what I could do as a career. So I said, “OK, well, I’m going to retire, and I’m going to figure this out.” So I made the choice at 42 to leave my clinical practice.

From there, in the first year, I dabbled in some consulting. I did some telemedicine, and I was doing some peer-to-peer consulting, and I just wasn’t finding anything that really stuck or really made me feel fulfilled. I did some work with the University of Texas Dell Medical School with a humanities program, physicians and humanities, which I felt was wonderful and interesting. But again, it just wasn’t giving me meaning. It wasn’t giving me purpose.

At the suggestion of one of my previous bosses, one of my mentors, who said, “You used to love to go on these surgical mission trips to low-resource areas. I’m going to be going to Uganda. Why don’t you come with me? I think this could be good for you,” we went, and it was such an amazing experience for me to rediscover that. I had been involved as a fellow and early in my career doing some mission work, both in Central America and in Africa, but I hadn’t done it for probably about five or six years. That trip was such an eye-opener to me. The type of medicine you practice there was really probably the most idealistic type of medicine, where you were helping people. I felt like there was actually meaning in the work that I was doing, and it was just so fulfilling. It filled that void that I was missing, and I had that aha moment that this is truly it.

I think if a lot of physicians experienced that again, it would really bring back the meaning of medicine. And so that’s the crux of the article: We all become very disillusioned, but really, there are meaningful ways to practice, and there are some meaningful experiences that you can have that really bring the joy back into your career. I was really fortunate, I think, to experience that.

Kevin Pho: So I want to talk a little bit about that transition, because I’m sure that a lot of physicians are in similar places to where you were. They’re burned out, thinking about leaving their clinical practice and doing something fulfilling like you described. How difficult was it for you to make that transition? Did a lot of people have a negative reaction to that? Did they push back and ask you, “Why are you doing this?”

Danielle Sweeney: Of course. I think it’s pretty rare for a physician or a surgeon to leave practice at 42. I did six years of residency and two years of fellowship, a lot of sacrifice, and then after 10 years to just hang that up. I think initially, a lot of people’s first impression was, “Oh, did something bad happen? Were you involved in a malpractice suit? Are you having some mental health issues?” And it really was none of that.

In some ways, I think a lot of physicians feel trapped. You put a lot of time into your training, there’s a lot of financial sacrifice, and making a radical transition like that is hard on families. So I feel like a lot of physicians do feel trapped in that role, and they think that they really can’t leave. I was fortunate enough to be in a situation where it was scary to take that leap, but I did. But I think it was a foreign concept for a lot of physicians to grasp.

I do feel like I had a lot more come up to me in a very positive way and say, “I’m really jealous. I wish I could leave, but I can’t. That was really brave of you to do that.” I think a lot of people are miserable in their jobs right now, but they don’t feel like they can leave. So I think there was more of a positive reaction, but certainly there were questions: Why would you quit at 42? It’s not the norm, but I hope that at least I’m showing that there are other options. If you’re feeling burned out, you don’t necessarily have to stay in your career.

Kevin Pho: Now, when you were disillusioned about medicine, was it that particular position that you were in, or did you try different positions and find that it was pretty much the same difficulties everywhere you went?

Danielle Sweeney: I didn’t necessarily try different positions, but I certainly have colleagues who have job-hopped, thinking, “Oh, I’m going to go to this place, and that’s going to be better.” Then years go by, and they leave again. I did consider taking a job in another city, but I realized that I wasn’t really necessarily leaving for anything different. It’s the system. I think the system is broken, and it’s not necessarily going to be better or different. I think the issues that were making me burned out are just universal in medicine. So going to a different city, sure, maybe for a year or two, as you’re building, it’s exciting, and you’re transitioning and putting a lot of effort into that. But once you get into the routine of it, it’s essentially the same. So for me, I knew that probably wasn’t going to be the answer.

Kevin Pho: So tell me about what your life is like now doing medical missions. Where do you go? How long do they last? What kind of cases do you see?

Danielle Sweeney: Sure. I am the executive director of International Volunteers in Urology. This is a global surgery nonprofit that specifically focuses on the urologic equity gap that exists worldwide. About five billion people lack access to surgical care, and for specialty care like urology, that number is even higher. What I think sets this organization apart from others is that we don’t just focus on health care; we really focus on the training and education of other health care providers, specifically urologists and general surgeons, who are going to be providing urology care to their own communities. That way they don’t have to rely on foreign entities or other doctors coming in to treat their community. We really feel this is the most scalable and equitable way to treat the lack of access that exists.

For me personally, it hits upon lots of things that were very meaningful for me when I was practicing. Of course, the health care aspect of it is just tremendous, but I always enjoyed teaching. I always enjoyed being with medical students and residents and imparting these skills. A large part of what we do is training other physicians who don’t have access to the types of training and education we have. To me, I love that. So combining those two things together has just been extremely rewarding.

I feel like a lot of our volunteer surgeons who work with us feel the same way. We call a lot of them repeat offenders, because they come back and do two, three, or four trips a year. A lot of them are using a lot of their vacation time to do it, because they find that it means so much to their practice and so much to their life. I’ll be quite honest: I think a lot of our volunteers will verbalize that they feel burnout as well, and doing this type of medicine really re-centers them and connects them back to why they wanted to be a physician in the first place. So it’s tremendous work, and it really is very, very fulfilling.

Kevin Pho: Now, for those physicians who are listening to this podcast and listening to your story, what kind of questions should they ask themselves to see if they’re suited to medical mission work?

Danielle Sweeney: Well, first and foremost, you have to understand that the resources available in these other areas are not the same as what you’re used to. So I do think there has to be some degree of flexibility and the ability to operate and practice in conditions that may not be ideal or suitable, suitable to what you’re used to. First and foremost, you have to go in understanding that you’re not going to have the full instrument tray that you’re used to, or maybe you’re not going to have your choice of 10 different sutures. But I feel like for most people, getting back to basics is really important. Again, I think it re-centers them a little bit around pure medicine and why they became physicians in the first place.

I think anybody who’s interested in doing it, anybody who did this type of work, would find it so meaningful. I would say it would probably change the way they practice medicine and probably change the way they look at medicine.

Kevin Pho: Is there any additional training that’s involved, should a physician be interested in pursuing this?

Danielle Sweeney: Well, specifically for our organization, and there are lots of different organizations out there, we work with urologists in particular. We have a lot of general urology programs, and our urology training is focused on the more subspecialty areas, for example, oncology, pediatrics, and reconstruction. For a lot of our volunteers, those are their practice areas. But again, we have a lot of general urologists who may not have been fellowship-trained or really dialed down and practiced in one specific area, and they still go on these trips. Their knowledge is very, very important, and what they can offer is tremendous as well. So really, I feel like it’s something that’s open to anybody.

Kevin Pho: And which parts of the world do you typically send physicians to for their medical missions?

Danielle Sweeney: Sure. We have about 30 sites all over the world. I would say probably the biggest concentration is in sub-Saharan Africa, so we have programs in Ghana, Senegal, Uganda, Rwanda, Burundi, Zambia, Kenya, and Ethiopia. But we also have some in Asia. We have three sites: India, Mongolia, and Vietnam. We also have some sites in the Caribbean, so Trinidad, Haiti, and Jamaica, and then also Honduras. We’ll really go anywhere, but it’s important for us to be able to partner with physicians who are eager to learn, who need mentorship, and who really want to learn skills that they can impart to their medical students and really have that training. It just sort of amplifies it.

Kevin Pho: We’re talking to Danielle Sweeney. She’s a pediatric urologist, and she wrote the KevinMD article “I left medicine. Then I found meaning.” Danielle, what are some of your take-home messages that you want to leave with the KevinMD audience?

Danielle Sweeney: Yeah, well, I think the best message is, one, that you don’t always have to follow the path that you set forward for yourself. It’s OK to deviate from that. At a very young age, I thought that I was on a specific path and that was just the way it was going to be. When I realized it wasn’t working for me, I think it’s OK to shift gears and to try something different. I think that my life right now, my professional life, has much more meaning, and I’m way more fulfilled than on the original pathway that I anticipated. So yes, it seems scary sometimes to break away from the mold that you set for your life, but I think overall, you’re going to be much happier if you pursue something that you truly enjoy.

Kevin Pho: And how can people reach you?

Danielle Sweeney: They can reach me at [email protected] or also [email protected].

Kevin Pho: Danielle, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

Danielle Sweeney: Wonderful. Thank you, Kevin. I appreciate it.