Academics is a vocation for teaching, research or both. Everybody takes care of patients, but you ought to have a big drive to do academics to be able to survive the early years. Assistant Professors/Instructors who only take care of patients would find themselves sooner or later in private practice. If you have the drive, you will find the ideas. I have taken a triaged grant from one place, have done cosmetic changes and submitted to other agency and got it fully funded. Creativity and thick skin are necessary, but persistence/drive will get you farther. Indeed, academics requires a narrow focus goal... your niche.
I would not discourage anybody having the drive to become an Academician. We had tough times in the mid 80s before (when graduate student).