Things I Quietly Stopped Tolerating as a Physician
I didn’t make a big announcement.
There was no dramatic moment when I decided I was going to change the way I practiced medicine. I didn’t quit anything or suddenly become exceptionally good at saying no. I just started noticing how many things I had quietly agreed to. The message I answered immediately even though it wasn’t urgent. The responsibility that landed in my lap because nobody was quite sure whose responsibility it was. The request that began with, “It’ll only take a minute.”
I became particularly suspicious of that last one.
Because after enough years in medicine, you learn that very little takes only a minute. And even when it does, the minute itself usually isn’t the problem. It’s what happens when you accumulate hundreds of them. At some point, I realized I was doing work I didn’t actually remember agreeing to.
And I don’t think I’m unusual.
How physician careers quietly get bigger
I see this happen all the time with physicians. Someone needs help, so you help. There’s a gap, so you fill it. Someone asks if you can cover something “just this once.” A new responsibility comes your way, and you think, I can handle that. And you can. That’s part of what makes this so difficult.
Most physicians I know are extraordinarily capable people. Give us a problem and our instinct is to solve it. Give us an overfull day and somehow, we’ll get through it. Add another responsibility and we’ll find somewhere to put it. For a long time, I considered that one of the requirements of being a good physician and colleague. To some extent, it is. But there is a point at which being helpful becomes something else.
The favor you agreed to six months ago becomes an expectation. The extra task you picked up because nobody else could do it quietly becomes part of your role. Your clinical day ends, but the workday doesn’t. Nothing dramatic happened. Your job just automatically got bigger.
That’s one of the ways physician career misalignment develops. Not because you made one terrible career decision, but because you made a lot of perfectly reasonable small ones.
The question I stopped asking
For years, when an opportunity or request came my way, my internal calculation was pretty simple: Can I do this?
Usually, the answer was yes. Can I fit in another patient? Probably. Can I answer this tonight? Sure. Can I take on another project or leadership responsibility? I’ll figure it out.
The problem with Can I do this? is that it only measures capacity in the moment. It doesn’t ask what that yes will do to your Tuesday six months from now. Or whether the work is taking you toward the career you want. Or what gets displaced when you keep making room for things simply because you are capable of doing them.
Eventually, I started asking a different question: Does this actually belong in the career I’m trying to build?
That has turned out to be a much more useful question. It’s also changed the way I think about physician career satisfaction.
We often assume satisfaction comes from finding the right job. Sometimes it does. But it can also come from becoming far more deliberate about what we allow our existing jobs to become. That is a different kind of career work.
“I don’t want to leave medicine. I just can’t keep doing it like this.”
I hear some version of this from physicians surprisingly often. And whenever I do, I want to slow the conversation down. Because there is an enormous difference between:
I don’t want to practice medicine anymore.
and
I don’t want to practice medicine this way anymore.
When you’re exhausted, frustrated or questioning your physician work-life balance, those two things can start to feel remarkably similar. You begin wondering if this is physician burnout. Then you start asking all kinds of (potentially) dangerous questions… Should I reduce my FTE? Do I need better boundaries? Perhaps it’s time to look for a new position?
Inevitably, some physicians start wondering, Should I quit medicine altogether?
Any of those decisions may ultimately be right. But they’re solutions.As a physician. I have a hard time jumping to treatment before I’m reasonably confident about the diagnosis.
The same principle applies to our careers.
Before you change your career, look closely at the one you have
When I work with physicians who feel stuck, I’m often less interested initially in what they want to change than in what an ordinary week actually looks like. That’s where the useful information tends to be. I am interested in knowing the patterns that exist in an ordinary week and month of a physician’s work-life.
The clinic that routinely runs late. The inbox that has quietly moved into the evening. The leadership role that once felt exciting but now consumes far more time than anyone acknowledges. The administrative responsibility you somehow inherited. I also ask: What part of this work do you still genuinely love but barely have enough energy left to enjoy? Look closely enough at these patterns and the impact on the individual physician, and you begin to see the architecture of the career they’re actually living—not the one described in their contract or assigned FTE.
Sometimes the answer is a significant physician career change. But not always.
Sometimes a physician who thinks she needs to leave medicine actually needs more control over her schedule. Someone who assumes he has lost his passion for medicine discovers that the work he loves has been crowded out by everything surrounding it. Another physician realizes that a role that fit beautifully ten years ago simply doesn’t fit the life they have now.
None of those problems are solved by trying harder to tolerate them. They require clarity first.
That’s where career redesign actually begins
I think we sometimes make physician burnout recovery and career redesign sound much more dramatic than they need to be. Redesign doesn’t necessarily begin with quitting your job, dropping to part-time or making some enormous declaration about your priorities. It can begin much more quietly.
You start to notice. You get curious about why your days look the way they do. You stop assuming that every part of your current job is inevitable. And eventually you start distinguishing between the parts of medicine you still want and the accumulated obligations you no longer want to carry in the same way.
That is the beginning of Career Architecture: designing a sustainable medical career intentionally rather than allowing years of small decisions to design it for you. And before you redesign anything, it helps to know where the misalignment actually is.
If you don’t know where to start, start with the diagnosis
That’s why I created the Five-Minute Physician Career Misalignment Audit. It’s free, and I intentionally made it short. Not because five minutes can solve a complicated physician career. It can’t. But it can help you step outside the momentum of your workday long enough to see where things may have drifted.
You may discover that the problem isn’t medicine at all. You may discover that your career needs a much larger change. Either way, you’ll know more than you did before. And if you’ve been thinking, I don’t want to leave medicine, but I really don’t want to keep doing it like this, I think that’s a much better place to begin.
Take the free Five-Minute Physician Career Misalignment Audit at BounceUP Coaching.
You don’t have to decide what to do with the rest of your career today. First, figure out what isn’t fitting anymore.
👉Take the 5-minute Physician Career Misalignment Audit NOW!
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