Has the pandemic caused anyone else to make career changes?

[myPsychAlt]

So we're now 10 months into this, and I started to realize a few months ago, I absolutely hate doing outpatient psychiatry now. When I started working from home, doing all my appointments by phone and video just started to feel draining. My (VA) department has been trying to get someone to do a half time inpatient slot with half time outpatient so I picked it up to give myself a change of scenery (and to have some actual human contact with coworkers again), and holy ****, doing both in a day makes me realize how miserable outpatient work has been making me, especially with my patient population's depression and anxiety symptoms cranked up to 11 lately.

I've been with my current department for over five years and we're trying to have a kid soon, so I really don't want to decamp for somewhere where I won't have accrued enough time for paid parental leave like I'd get at my current VA, but I'm at a point where I'm not sure I can handle the burnout of doing what I don't like doing anymore. (Also not helpful, my request that my patient list be cut in half when I moved from full to half time clinic was denied). My department isn't willing to slot me in full time onto the unit either so I think it's time to move on, unfortunately.

Anyone else been reevaluating things?

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[wolfvgang22]

Nope, just riding it out here.
Sounds like they have you doing at least 1.5 jobs. Probably time to find another position. I've found it is unlikely that an employer who is already overworking you will be willing to negotiate unless you have the leverage of another position in hand. Good luck!

 

[Monocles]

Yes. Considering finance and pharma now. I don't like this job enough to risk my life, lol.

 

[Bartelby]

I have considered it. Lots of colleagues in my system have left, including for all-telepsych positions. My workload really isn't bad but I feel the ongoing haze of burnout especially as more staff departures continue to strain the system. If I do go I think I might give solo PP a try (likely with a part-time position on the side at least in the beginning).

 

[Sushirolls]

Already doing solo OP private practice. Wouldn't ever think of working inpatient hospital setting again.

Contemplating changes that will allow me to live more rural with better hunting, more trucks, more guns, less people, more land, tractor traffic jams (rather than normal traffic jams), etc by keeping this practice 100% telemedicine post pandemic.

If I were at a point I could quit working, I would.

 

[myPsychAlt]

I have considered it. Lots of colleagues in my system have left, including for all-telepsych positions. My workload really isn't bad but I feel the ongoing haze of burnout especially as more staff departures continue to strain the system. If I do go I think I might give solo PP a try (likely with a part-time position on the side at least in the beginning).

I know a couple people who departed for telehealth jobs, one was forced to take a "temporary" pay cut due to COVID-induced changes in the productivity payment structure at their big corporate hospital system, so she said "see ya, I'm out!".

The workload vs burnout thing is definitely at play though. My afternoons are only q30min in a typical VA fashion, but I'm now booked up for 10 weeks, so I have to overbook anyone that's needing an immediate appointment and anyone I'd normally increase the frequency of visits due to worsening symptoms, I'm just telling them "well see you in three months!" I've had two overdose SAs to deal with in the last four weeks on top of things. I finally got a meeting to discuss my outpatient workload and I basically got a response of "well according to your productivity numbers, your output is what we'd expect for a half time clinician". I walked out of that meeting, sat at my computer and typed in "inpatient psychiatry jobs [location]". Like I get that you don't have anywhere else to put my patients if I drop them, but at some point that's no longer my problem.

 

[Bartelby]

Like I get that you don't have anywhere else to put my patients if I drop them, but at some point that's no longer my problem.

For sure, this year has really served to illustrate to me that I did not create my system's problems and I should not feel the need to take on personal responsibility for dealing with the fallout from those problems. My stance is that it is my employer's responsibility to provide reasonable working conditions, and if they can't because of staffing limitations I am taking off to another organization (or starting my own practice).

 

[Sushirolls]

Like I get that you don't have anywhere else to put my patients if I drop them, but at some point that's no longer my problem.

This is something I believe early career Psychiatrists allow themselves to internalize. That the the failings of the institition need to be shoulder by you. You need to carry these patients and do damage control for the ineffectiveness of the Big Box Shop. I'm guilty of this in the past, too.

Don't, for those reading this, you are not the rescuer of Big Box shops and its not your burden to carry nor fix. Perhaps alert to the issues, and if open channels of communication suggest improvements, but after that walk away. Big Box scat is their scat. They can fix it, and you never will.

Congratulations on your newfound desire to improve your wellbeing and career path. Hope you land where you wish.

 

[Sushirolls]

For sure, this year has really served to illustrate to me that I did not create my system's problems and I should not feel the need to take on personal responsibility for dealing with the fallout from those problems. My stance is that it is my employer's responsibility to provide reasonable working conditions, and if they can't because of staffing limitations I am taking off to another organization (or starting my own practice).

Do it.

Start a practice, and make a longitudinal post/thread about your journey. Loved to see how things progress. Heck, start the thread now! Talk about the issues and how you are going to transition. Share the journey.

 

[ArdorAyurveda]

For sure, this year has really served to illustrate to me that I did not create my system's problems and I should not feel the need to take on personal responsibility for dealing with the fallout from those problems. My stance is that it is my employer's responsibility to provide reasonable working conditions, and if they can't because of staffing limitations I am taking off to another organization (or starting my own practice).

i've been waiting for a good union battle

tried finding a good union meme on google but they're all pretty meh

 

[calvnandhobbs68]

Yes. Considering finance and pharma now. I don't like this job enough to risk my life, lol.

How are you risking your life....are you inpatient seeing covid patients a bunch or something?

Even if you are, hopefully you’re slated to get the vaccine pretty soon then?

 

[myPsychAlt]

How are you risking your life....are you inpatient seeing covid patients a bunch or something?

Even if you are, hopefully you’re slated to get the vaccine pretty soon then?

If nothing else I got dose #1 on Monday. Inpatient and ECT ppl got it a whole two days before everyone else at least.

 

[singasongofjoy]

You've got a lot more negotiating power once you have another job offer in hand. Folks in other types of careers leverage that often. in your position, I'd use it to my advantage. Who knows, you might get other offers you don't intend to take but then find out they are really appealing and you could straight up negotiate for additional paid time off the first year or some other kind of compromise that would work for you. And if not, maybe you could pull that card with your current employer to look at what you're doing vs what you were hired to do / expectations and come to a more realistic expectations. come armed with numbers of all sorts. It's a lot harder to argue with numbers than words after a certain point. Good luck.

 

[Merovinge]

You've got a lot more negotiating power once you have another job offer in hand. Folks in other types of careers leverage that often. in your position, I'd use it to my advantage. Who knows, you might get other offers you don't intend to take but then find out they are really appealing and you could straight up negotiate for additional paid time off the first year or some other kind of compromise that would work for you. And if not, maybe you could pull that card with your current employer to look at what you're doing vs what you were hired to do / expectations and come to a more realistic expectations. come armed with numbers of all sorts. It's a lot harder to argue with numbers than words after a certain point. Good luck.

That's generally true but a lot of VA negotiation is like just banging your head into a wall repeatedly. Somehow even numbers tend to not push the machine much in this instance.

 

[wolfvgang22]

Yeah, with the VA it really just depends on how willing local administration are to work through the red tape, how badly they think they need to fill a position, their personal feelings about mental health care, etc. A lot of them lack vision and feel tied down by all the regulations and forget doctors have a lot of competing opportunities.

 

[myPsychAlt]

Yeah, with the VA it really just depends on how willing local administration are to work through the red tape, how badly they think they need to fill a position, their personal feelings about mental health care, etc. A lot of them lack vision and feel tied down by all the regulations and forget doctors have a lot of competing opportunities.

This has been the problem. We replaced our #2 in the department a couple years ago and the quality drop off from the person they replaced is glaring. My immediate supervisor also changed this year when my previous one was promoted to run a piece of the department outside of my chain of command, and that person has been perpetually annoyed that they lost half a FTE of clinic productivity has has been using that fact to be as unhelpful as possible. The latter person is the one who tried running their numbers as an excuse to justify not helping.

Mostly though, tele and remote clinical work just SUCKS. I've had so many phone appointments where I'm just not able to pay attention when they're c/o anxiety and depression getting worse. I can get more people to do VVC, but that basically means my clinic runs 45 minutes behind rather than the usual 15-20, and we still don't have a uniform system to get patients checked in/out and rescheduled. The last 6 months or so really showed me what I actually value in my job and what my current gig is and isn't giving me.

A full time position is likely to open up in the second half of 2021 in a place I'd really like to work so I'm trying to hang on where I'm at for a few more months before committing elsewhere, but I really don't think I'll last much longer if I keep trying. I really also thought that I'd be able to travel around Europe for a month or so between jobs when I finally left this one...alas...

 

[NewYorkChildPsych]

Definitely. I found/signed onto a part-time job in an academic medical center for stability/benefits given an increasingly murky private practice market. It's been great so far.