Long time EM blogger quits medicine

[futuredoc15]

Well, it’s been a long time in coming, but I feel that it’s time to share it with all of you. Doc Shazam is hanging up the stethescope. I’ve had it, I’m through. The healthcare field sickens me both literally and figuratively. I’ve gained weight, can’t sleep, suffer from migraines, have chronic shift worker’s disease, chronic sleep deprivation, and am horribly out of shape. I’ve sacrificed not only my physical health for this profession, but also my social health. I get anxious and feel panic well up inside of me when my friends mention going away for a weekend. Why? Chances are more likely than not I’ll have to work that weekend. If not the weekend, then definately the friday night before. Last year I didn’t get to participate in a single weekend bike race…a passion of mine, because I either worked every weekend, or every friday night until 1 or 3am. For long time readers of Doc Shazam, you know how much I love to bike.
For all the wonderful things that come from being a doctor…the priveledge and thrill of saving lives, running codes, knowing how to set broken bones and suture kids faces without scarring…there are far more downsides for me.
No matter what the paycheck, it’s not worth it if I’m constantly tired, constantly have a headache, cannot pursue relationships with friends or family on a routine basis.
Yes, I know that there are many other physicians that (seem) to be able to do all of this, but when I discuss my recent decision with them, they all express a wish that they too could follow the same path.
What will Doc Shazam do? Hopefully write. Ride her bike. Coach Triathletes & cyclists. Garden. Find myself again. Rid myself of insomnia, anxiety and panic. Restore relationships with friends and family. And become a better bike racer.
http://www.docshazam.com/2011/05/hanging-up-the-stethescope.html

Comment: Sad. She just finished residency in 2005 according to her blog and has already burned out it seems.

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[EctopicFetus]

Dont know this person and have never heard of them but seems like maybe they joined a crappy practice? No weekends off? Ill post my schedule anytime. I am 2 years out of residency. I went to vegas for 3 nights this month and at the end of the month Im gonna go hang on a lake with friends for a week. Just a regular month. If working 10-14 days a month is too much im not sure what else can make this person happy. I imagine they picked to wrong field. It is hard since we work weekends holidays etc but there is a lot of gloom and doom in there. The job isnt cake and im not trying to say that but the blogger seems overworked and perhaps outside stressors are making a bad situation worse. I wish her the best in whatever she chooses to pursue.

 

[deleted307836]

I know everything depends on her own individual preference and the details of her situation... however wouldn't it make more sense for her to simply go to part time for a while? Or to find a gig somewhere that can provide a better schedule for her, even if for considerably less money? It just seems like too radical of a solution. But I wholly wish her the best.

 

[DeadInside]

Agree with other posters... seems like she chose the nuclear option.

 

[tdavie]

I agree with everything that the repliers said. Seems to me like a knee-jerk reaction, especially after so much hard work to get to where you are. Take a year off, and come back part time, but don't give up entirely!

Ectopic, I'd love to see a copy of your schedule if you don't mind! 🙂 In fact, I'd love to see any schedules of residents and/or attendings. I'm wrapping up my 3rd year of med school, planning on EM, and would love to get a better idea on the various work plans out there. Even if you could just comment on number of shifts, length of shifts, and other general points.

If you could comment on whether your practice gives you better shift preference as you "mature," that would be great too. Thanks!

 

[EctopicFetus]

Regarding my schedule. My group (private democratic) requires people in years 1-5 to work 146 hours a month. I work at night due to a 35% shift differential by CHOICE. I do 12s also by choice.

As an example of this months schedule I can ask for ANY 9 days off in any given month.

I worked June 1,2,6,7,8 (vegas weekend 4 days), 15,16,17,18, 22,23,24, (trip for 1 week in Minnesota in a cabin on a lake).

There are a number of people who just work 3 runs of 4 12s giving them about 8 random days in a row off every month.

I have my schedule back for about 8 months. But that should give you an idea. I work 12 days a month.. Not too shabby.

 

[streetdoc]

I agree with everything that the repliers said. Seems to me like a knee-jerk reaction, especially after so much hard work to get to where you are. Take a year off, and come back part time, but don't give up entirely!

Ectopic, I'd love to see a copy of your schedule if you don't mind! 🙂 In fact, I'd love to see any schedules of residents and/or attendings. I'm wrapping up my 3rd year of med school, planning on EM, and would love to get a better idea on the various work plans out there. Even if you could just comment on number of shifts, length of shifts, and other general points.

If you could comment on whether your practice gives you better shift preference as you "mature," that would be great too. Thanks![/QUOTE


Eleven 10 hr shifts is full time, 2 weekends guarenteed off. mix of day/eve/overnight but overnights only come once every 2 months. no pref as you age, but you could probably tempt someone to take your overnight.
Schedule was the #1 priority for me when job hunting

streetdoc

 

[TysonCook]

...agree with the others! She chose a intolerable schedule, NOT an intolerable job.

Like any job you have ups and downs, but my example is last month. Went to Del Mar for 4 days, Salt Lake City for 8 days, and had multiple other days off.

Life is what you make of it, and I agree with the above, SCHEDULE (and control of it) is the most important thing!

 

[Venko]

In fact, I'd love to see any schedules of residents and/or attendings. I'm wrapping up my 3rd year of med school, planning on EM, and would love to get a better idea on the various work plans out there. Even if you could just comment on number of shifts, length of shifts, and other general points.

If you could comment on whether your practice gives you better shift preference as you "mature," that would be great too. Thanks!

I am finishing an ultrasound fellowship / part time attending job which does have a better schedule for those who "mature" as you put it...

I am contracted for 900 hours for the year as an attending and am unpaid for the ultrasound fellows work (weekly 4 hours quality assurance review session, 10 hours ultrasound scanning per week x 48 weeks, research and teaching requirements as well) and prepare for exams (qualifying exam, oral boards, ultrasound physics, and ultrasound abdomen exams).

Because I'm not "mature" yet, I calculated that my shifts are 33% weekends, and 24% overnights. The shifts are credited as 8 hours mainly with a few that are 9 hours. Fellows work most holidays as well...

Its not a great deal and certainly in my opinion not sustainable for a career, but the fellowship part was a fantastic experience and I have grown tremendously over the year as a practitioner, business person, and sonologist.

I will be heading to a practice that is very similar to Streetdocs in the coming weeks.

 

[Arcan57]

I am finishing an ultrasound fellowship / part time attending job which does have a better schedule for those who "mature" as you put it...

I am contracted for 900 hours for the year as an attending and am unpaid for the ultrasound fellows work (weekly 4 hours quality assurance review session, 10 hours ultrasound scanning per week x 48 weeks, research and teaching requirements as well) and prepare for exams (qualifying exam, oral boards, ultrasound physics, and ultrasound abdomen exams).

Because I'm not "mature" yet, I calculated that my shifts are 33% weekends, and 24% overnights. The shifts are credited as 8 hours mainly with a few that are 9 hours. Fellows work most holidays as well...

Its not a great deal and certainly in my opinion not sustainable for a career, but the fellowship part was a fantastic experience and I have grown tremendously over the year as a practitioner, business person, and sonologist.

I will be heading to a practice that is very similar to Streetdocs in the coming weeks.

900 hrs /48 weeks is ~19hr/wk clinically, plus it sounds like another 20 administrative/wk. How is that not sustainable for a career (at least from a time commitment standpoint)?

 

[gman33]

I know this blogger is just one person, but these kind of stories scare me.
I have about 2 months before I need to send out my residency apps.

I really like the medicine part of EM.

A part of me is scared all the switching around of my internal clock will screw me up. When I was a little younger, not so much.
Now I like having a routine. Even worse, my wife really likes having one.
I don't mind so much working weekends, etc.
But if my days off are when my wife is working and she's off when I'm working, I could see that being a problem.

I've been like a crazy person, switching my feelings back and forth on this topic.

😱

 

[DeadInside]

As I said before, I do think is an extreme example.

But I have to admit, these stories make me take a step back too and think about the decision I have already made. Although I love, love, love what I do. No better practice of medicine, hands down. But when I am in my 50s doing this night to day thing, will I still be content with this decision I made in my 20s?

 

[TysonCook]

...trying to be nice here...

If you like MONEY - go for the MONEY
If you like ACADEMICS - go for the ACADEMIC CENTER
If you like SCHEDULE - go for the cushy SCHEDULE

(ETC).

I'm sorry, there are very few (if any) jobs that have EVERYTHING... So pick what is most important to you for the foreseeable future and roll with it.

Prioritize, and you won't find yourself in the situation as above!

 

[Arcan57]

If you can afford to retire to train triathletes after having been in practice for only 6 years, clearly that was not a career plan built on longevity. I'm 3 years out working ~160hrs/month, and am on the low side hours-wise for my group (all of whom have been in practice at least 10 years). For the students/residents, don't assume that anything over 120hrs/month automatically leads to becoming a misanthropic, flaming shell of a person. And if you find that it does, cut back. Many markets will support enough part-time work that you can pay your bills and loans while supporting a family living a solidly middle-class lifestyle.

 

[Venko]

900 hrs /48 weeks is ~19hr/wk clinically, plus it sounds like another 20 administrative/wk. How is that not sustainable for a career (at least from a time commitment standpoint)?

There are details I do not want to get into here, but if you're truly curious we can PM this topic. With that said, its not sustainable (in my opinion) to work nearly 2000 hours annually and be paid for only half of those hours.

 

[Greenbbs]

I agree with everything that the repliers said. Seems to me like a knee-jerk reaction, especially after so much hard work to get to where you are. Take a year off, and come back part time, but don't give up entirely!

Ectopic, I'd love to see a copy of your schedule if you don't mind! 🙂 In fact, I'd love to see any schedules of residents and/or attendings. I'm wrapping up my 3rd year of med school, planning on EM, and would love to get a better idea on the various work plans out there. Even if you could just comment on number of shifts, length of shifts, and other general points.

If you could comment on whether your practice gives you better shift preference as you "mature," that would be great too. Thanks![/QUOTE


Eleven 10 hr shifts is full time, 2 weekends guarenteed off. mix of day/eve/overnight but overnights only come once every 2 months. no pref as you age, but you could probably tempt someone to take your overnight.
Schedule was the #1 priority for me when job hunting

streetdoc

I work in a community based tertiary care center with an ED census of approximately 110k/yr (50 adult beds, 20 peds beds, 8 psych beds and ~ 20 obs/cdu/chest pain beds). The ED has an adult, peds and psych ED, and a CDU/Obs unit. My contract is for 1750 hrs/year. I work zero overnights (there's 25 docs in the group, soon to be 27, with 7 guys doing dedicated overnights).

Our shift structure is as follows:

Adult Attendings: 2x 7a-4p, 1x 9a-6p, 3x 3p-MN, 1x 7p-4a, 2x 11p-8a, 1x 10a-10p triage= 93 hours of attending coverage daily.

Adult MLP coverage: 1x 7-3 triage, 1x 8-5, 1x 10-6, 2x 3-mn, 1x 5p-3a, 1x 11p-8a= 56h MLP coverage daily

Total adult ED coverage daily: 149 hours.

This doesn't factor in the peds/obs/cdu/psych scheduling, which are done in their own way.

Since we have so many guys willing to do dedicated overnights (i.e. 7p-4a, and the overnight 11-8's), those of us who don't want to do those aren't obligated to. Triage shifts are weighted differently than the main ED shifts (even though they're only 3 hours longer, they count for 1.5 total equivilent shifts), so I work 12-13 main ED shifts (9 hours) a month, plus 2 triage shifts
to round out my monthly schedule.

Having so many docs in the group is nice. All requests are always met. Plus, we've got all that coverage daily for only 50 adults beds.

 

[Birdstrike]

Well, it’s been a long time in coming, but I feel that it’s time to share it with all of you. Doc Shazam is hanging up the stethescope. I’ve had it, I’m through. The healthcare field sickens me both literally and figuratively. I’ve gained weight, can’t sleep, suffer from migraines, have chronic shift worker’s disease, chronic sleep deprivation, and am horribly out of shape. I’ve sacrificed not only my physical health for this profession, but also my social health. I get anxious and feel panic well up inside of me when my friends mention going away for a weekend. Why? Chances are more likely than not I’ll have to work that weekend. If not the weekend, then definately the friday night before. Last year I didn’t get to participate in a single weekend bike race…a passion of mine, because I either worked every weekend, or every friday night until 1 or 3am. For long time readers of Doc Shazam, you know how much I love to bike.
For all the wonderful things that come from being a doctor…the priveledge and thrill of saving lives, running codes, knowing how to set broken bones and suture kids faces without scarring…there are far more downsides for me.
No matter what the paycheck, it’s not worth it if I’m constantly tired, constantly have a headache, cannot pursue relationships with friends or family on a routine basis.
Yes, I know that there are many other physicians that (seem) to be able to do all of this, but when I discuss my recent decision with them, they all express a wish that they too could follow the same path.
What will Doc Shazam do? Hopefully write. Ride her bike. Coach Triathletes & cyclists. Garden. Find myself again. Rid myself of insomnia, anxiety and panic. Restore relationships with friends and family. And become a better bike racer.
http://www.docshazam.com/2011/05/hanging-up-the-stethescope.html

Comment: Sad. She just finished residency in 2005 according to her blog and has already burned out it seems.

You guys are totally missing the point. When someone quits medicine all together to "coach...garden...and find their self", you shouldn't be sad, you should be jealous. I don't know this person, but it's abundantly clear that she does not need to work. If I had someone else paying my and my wife and kids bills I'd probably get a guitar and join a band myself.

 

[DocShazam]

You guys are totally missing the point. When someone quits medicine all together to "coach...garden...and find their self", you shouldn't be sad, you should be jealous. I don't know this person, but it's abundantly clear that she does not need to work. If I had someone else paying my and my wife and kids bills I'd probably get a guitar and join a band myself.

Thanks Birdstrike...you get it.

This was hardly a knee jerk reaction. it was the original plan all along. I knew from day one that I wanted to work as an ER physician to learn the field for 3-5 years, and then move on to other things taking my knowledge as an ER doctor with me.

Let me try to explain.

I entered medical school knowing that becoming a doctor was not an end, but a means to some other end. I saw medicine used as a tool to reach people in ways that they would not allow others into their lives. I worked wiht physicians who brought medical care to the homeless living under bridges in the city of Pittsburgh and I was fascinated that knowledge could actually let you enter peoples lives.

I learned a tool that allowed me to enter peoples lives in a way that few other people can do. I can meet total strangers and ask them the most intimate details of their lives and they openly share with me. I've delivered babies, saved lives, delivered tragic news, cared for bullet wounds, car accidents, people bleeding from their brains, people searching for answers, taken care of people who are lonely on Christmas morning and Thanksgiving eve.

None of that will ever be taken away from me. It's part of who I am and what I've done. Medicine is my 3rd career. Far from making me indecisive, it makes me wildly interesting to strangers, and yes, even my family. 🙂

Put this all in perspective...if I was put on earth for a reason...to save lives...wouldn't one life saved be enough?

I've always wondered who it was. Who did God want me to save and have I saved them yet? Or maybe it's the other way around. Maybe someone was meant to die and my job...my whole purpose in medicine was to help their loved one...their child, sister, mother or father deal with the tragedy?

Seriously...everytime I've performed a life saving measure I've wondered if THAT was the person. Was THAT the one?

It's about relationships and it always has been. I have skills that are invaluable that are part of me and always will be. I can't think of any other way I could have aquired the knowledge and skills I currently possess. I can still go to Honduras and take care of the people in remote villages who are ever thankful and never pay me a cent..they pay me in other ways. One even named her baby after me. One teenager has fingers that work because I was there to sew the tendons back together...and thus he can earn money and provide for his family. THAT is the kind of payment that satisifies me.

I don't think of "being a doctor" as an inseparable category of my life. It's a stretch of the pathway I've been on and will continue to follow.

But rather than feel sad for me that I've made an impulsive reaction, be happy for someone who has the courage to continue on my chosen pathway.

Anyway, you are certainly all free to post a comment on my blog and interact with me directly rather than speculate about it here. My advice to anyone is and always will be to follow what you are passionate about.

Thanks,

Doc Shazam

 

[DocShazam]

As I said before, I do think is an extreme example.

But I have to admit, these stories make me take a step back too and think about the decision I have already made. Although I love, love, love what I do. No better practice of medicine, hands down. But when I am in my 50s doing this night to day thing, will I still be content with this decision I made in my 20s?

What does your username mean?

And you don't HAVE to do the "night to day" thing into your 50s. Everyone has choices. Do this now. Do something else then. Do what you want to do. This is a career choice. Not a sentence. 🙂

 

[DocShazam]

A final thought..if any one is wondering "HOW" I can do this with regard to student loans and such...

Doctors make a crap load of money. Be a good steward of it. Get yourself on an automatic monthly investment plan if you haven't already. Max out your IRA and your 401k/403b. Set aside additional money for after tax investments (yes, you'll have enough).

I have colleagues who work twice the number of shifts I do and have half the savings. If you want options and choices, rather than obligations and debts...simply pay attention to where your money goes and plan ahead.

 

[GeneralVeers]

Does anyone else think that DocShazam should be put on a legal hold? Clearly a bad case of "acute psychosis". She represents a danger to herself and others.

 

[Birdstrike]

Does anyone else think that DocShazam should be put on a legal hold? Clearly a bad case of "acute psychosis". She represents a danger to herself and others.

I think and hope you're being sarcastic. The answer to your question is: Uh..........no. The rest of us should be committed. Sometimes, someone is so far ahead of the curve they seem crazy, but the reality is that everyone else is that far behind.

This forum gets so frustrating because every once in a while someone posts pure genius and it goes totally unnoticed. It makes me wonder why I even read these forums. I might have to go off SDN completely.

DocShazam is living the dream. So am I. Get your wings and fly, people.

 

[WilcoWorld]

I really liked the statement "it's a career, not a sentence."

I am now leaving my current job for another job in academic EM. It was a tough choice to make, mostly because I felt committed to my current duties/the residents/the patients in my community. In fact, my contract was up, and I had no actual commitments. However people in our field often feel quite duty-bound. This is a source of strength, no doubt, but it is important to keep it in check lest it become crippling.

 

[EctopicFetus]

I think your career is what you make it. I work to live and enjoy time with my family. I study and continue to learn cause it challenges me and I want to be good at what I do. The thought of academic EM is so unappealing to me but I completely get why it would be appealing to others.

I work hard to enjoy my non work time. My commitment is to my family and thats where I enjoy spending my time.

I think the mantra of "keep your eye on the prize" should be everyones career goal.

You decide what you want to get out of your career and pursue those opportunities that will let you get there. I took a great job with good pay and enough time to do the stuff outside of work I love, and everyone else here should do the same.

 

[MB333999]

Thanks Birdstrike...you get it.

This was hardly a knee jerk reaction. it was the original plan all along. I knew from day one that I wanted to work as an ER physician to learn the field for 3-5 years, and then move on to other things taking my knowledge as an ER doctor with me.

Let me try to explain.

I entered medical school knowing that becoming a doctor was not an end, but a means to some other end. I saw medicine used as a tool to reach people in ways that they would not allow others into their lives. I worked wiht physicians who brought medical care to the homeless living under bridges in the city of Pittsburgh and I was fascinated that knowledge could actually let you enter peoples lives.

I learned a tool that allowed me to enter peoples lives in a way that few other people can do. I can meet total strangers and ask them the most intimate details of their lives and they openly share with me. I've delivered babies, saved lives, delivered tragic news, cared for bullet wounds, car accidents, people bleeding from their brains, people searching for answers, taken care of people who are lonely on Christmas morning and Thanksgiving eve.

None of that will ever be taken away from me. It's part of who I am and what I've done. Medicine is my 3rd career. Far from making me indecisive, it makes me wildly interesting to strangers, and yes, even my family. 🙂

Put this all in perspective...if I was put on earth for a reason...to save lives...wouldn't one life saved be enough?

I've always wondered who it was. Who did God want me to save and have I saved them yet? Or maybe it's the other way around. Maybe someone was meant to die and my job...my whole purpose in medicine was to help their loved one...their child, sister, mother or father deal with the tragedy?

Seriously...everytime I've performed a life saving measure I've wondered if THAT was the person. Was THAT the one?

It's about relationships and it always has been. I have skills that are invaluable that are part of me and always will be. I can't think of any other way I could have aquired the knowledge and skills I currently possess. I can still go to Honduras and take care of the people in remote villages who are ever thankful and never pay me a cent..they pay me in other ways. One even named her baby after me. One teenager has fingers that work because I was there to sew the tendons back together...and thus he can earn money and provide for his family. THAT is the kind of payment that satisifies me.

I don't think of "being a doctor" as an inseparable category of my life. It's a stretch of the pathway I've been on and will continue to follow.

But rather than feel sad for me that I've made an impulsive reaction, be happy for someone who has the courage to continue on my chosen pathway.

Anyway, you are certainly all free to post a comment on my blog and interact with me directly rather than speculate about it here. My advice to anyone is and always will be to follow what you are passionate about.

Thanks,

Doc Shazam

I don't post too often, but i wanted to take the time to say, Good for you. I have been contemplating my own life goals recently. Your words have certainly moved me and cleared some of the confusion 🙂 is it possible that i was the one 😛

and good luck on wherever life takes you.

 

[Venko]

Thanks Birdstrike...you get it.

This was hardly a knee jerk reaction. it was the original plan all along. I knew from day one that I wanted to work as an ER physician to learn the field for 3-5 years, and then move on to other things taking my knowledge as an ER doctor with me.

Let me try to explain.

I entered medical school knowing that becoming a doctor was not an end, but a means to some other end. I saw medicine used as a tool to reach people in ways that they would not allow others into their lives. I worked wiht physicians who brought medical care to the homeless living under bridges in the city of Pittsburgh and I was fascinated that knowledge could actually let you enter peoples lives.

I learned a tool that allowed me to enter peoples lives in a way that few other people can do. I can meet total strangers and ask them the most intimate details of their lives and they openly share with me. I've delivered babies, saved lives, delivered tragic news, cared for bullet wounds, car accidents, people bleeding from their brains, people searching for answers, taken care of people who are lonely on Christmas morning and Thanksgiving eve.

None of that will ever be taken away from me. It's part of who I am and what I've done. Medicine is my 3rd career. Far from making me indecisive, it makes me wildly interesting to strangers, and yes, even my family. 🙂

Put this all in perspective...if I was put on earth for a reason...to save lives...wouldn't one life saved be enough?

I've always wondered who it was. Who did God want me to save and have I saved them yet? Or maybe it's the other way around. Maybe someone was meant to die and my job...my whole purpose in medicine was to help their loved one...their child, sister, mother or father deal with the tragedy?

Seriously...everytime I've performed a life saving measure I've wondered if THAT was the person. Was THAT the one?

It's about relationships and it always has been. I have skills that are invaluable that are part of me and always will be. I can't think of any other way I could have aquired the knowledge and skills I currently possess. I can still go to Honduras and take care of the people in remote villages who are ever thankful and never pay me a cent..they pay me in other ways. One even named her baby after me. One teenager has fingers that work because I was there to sew the tendons back together...and thus he can earn money and provide for his family. THAT is the kind of payment that satisifies me.

I don't think of "being a doctor" as an inseparable category of my life. It's a stretch of the pathway I've been on and will continue to follow.

But rather than feel sad for me that I've made an impulsive reaction, be happy for someone who has the courage to continue on my chosen pathway.

Anyway, you are certainly all free to post a comment on my blog and interact with me directly rather than speculate about it here. My advice to anyone is and always will be to follow what you are passionate about.

Thanks,

Doc Shazam

DocShazam,

I Get the sense that there may be something that I'm missing that you want the reader to get. From this post it makes me feel as though you have always had another goal outside of medicine for which medicine was a stepping stone. What was the goal?

You speak so passionately about your career in medicine, and your work in Honduras that without knowing the goal or "some other end" that it seems incongruent to me to end a career that you only speak fondly of.

This is not to say, that I think you are wrong, or want to try and critique your decision, but just to ask what is it that is motivating you to quit?

For me, the motivation to continue (albeit in my young career) is to help more people in the United States who are suffering. Repair the tendon of the american worker so that they don't lose their job at home in the US and can support their family locally. I love the emotional roller coaster that is our specialty and cherish the chance to help people through sometimes the most horrific things they can perceive.

The details of some places to practice can be unsavory to me, and so I change locations, but my goals and end result is to heal the sick / wounded / troubled as best as I can on each shift. I have no higher purpose than this. For me its not to save one life only just as carpenter I presume doesn't aim to build one chair only. I hope to save as many lives as I physically and mentally can. I also aim to teach others how to do what I do so that through them my ripple effect can be far greater. I hope to honor my teachers, the schools, the community, and family that supported me on such a long journey by giving to each shift my very best and to not take my wealth and move on to anything else. They all invested in me and it is their turn to become wealthy from that investment.

What next goal would draw you away from such an experience?

TL

PS - Regardless, of whether I understand why you would hang up your stethoscope or not, congratulations on doing what you think is right and good luck.

 

[Arcan57]

DocShazam,

I Get the sense that there may be something that I'm missing that you want the reader to get. From this post it makes me feel as though you have always had another goal outside of medicine for which medicine was a stepping stone. What was the goal?

You speak so passionately about your career in medicine, and your work in Honduras that without knowing the goal or "some other end" that it seems incongruent to me to end a career that you only speak fondly of.

This is not to say, that I think you are wrong, or want to try and critique your decision, but just to ask what is it that is motivating you to quit?

For me, the motivation to continue (albeit in my young career) is to help more people in the United States who are suffering. Repair the tendon of the american worker so that they don't lose their job at home in the US and can support their family locally. I love the emotional roller coaster that is our specialty and cherish the chance to help people through sometimes the most horrific things they can perceive.

The details of some places to practice can be unsavory to me, and so I change locations, but my goals and end result is to heal the sick / wounded / troubled as best as I can on each shift. I have no higher purpose than this. For me its not to save one life only just as carpenter I presume doesn't aim to build one chair only. I hope to save as many lives as I physically and mentally can. I also aim to teach others how to do what I do so that through them my ripple effect can be far greater. I hope to honor my teachers, the schools, the community, and family that supported me on such a long journey by giving to each shift my very best and to not take my wealth and move on to anything else. They all invested in me and it is their turn to become wealthy from that investment.

What next goal would draw you away from such an experience?

TL

PS - Regardless, of whether I understand why you would hang up your stethoscope or not, congratulations on doing what you think is right and good luck.

That struck me also that Shazam's second reply talked extensively about medicine and using EM as a springboard, but there was no mention of that in the first post. Given the current stated goals of training athletes, the only thing that immediately jumps to mind is working long enough to pay back your loans and then using the MD title to generate business for training/possible supplement line.

 

[Venko]

...if I was put on earth for a reason...to save lives...wouldn't one life saved be enough?

I've always wondered who it was. Who did God want me to save and have I saved them yet? Or maybe it's the other way around. Maybe someone was meant to die and my job...my whole purpose in medicine was to help their loved one...their child, sister, mother or father deal with the tragedy?

Seriously...everytime I've performed a life saving measure I've wondered if THAT was the person. Was THAT the one?

BTW, did anyone else hear this as they were reading this:

"...And so Dr. Beckett finds himself leaping from life to life, striving to put right what once went wrong, and hoping each time that his next leap will be the leap home."

It could just be me.... 🙂

 

[Birdstrike]

Some people let their careers in medicine, be it EM or another specialty define them, consume them and control them. It's typical of the over-achieving type A personalities that choose medicine as a career. Then as time goes on, some realize that their career, the doctor "badge", doesn't sustain them and in some cases controls them and the direction of their lives. This can lead to burnout. Some slowly smolder over time, getting more and more cynical, jaded and negative. Others flame out fast in a self-destructive fashion. I've seen it happen, and it ain't pretty.

But others have the courage to break the shackles. This goes for EM physicians, physicians in general, and life in general. If you're in a rut, GET OUT. If you're burned out, MAKE A CHANGE.

However, if you’re one of the lucky few that never seems to struggle with any feelings of burnout, “great for you”, I say. Keep living the good life. Ride that train as far as it'll take you.

There’s much, much more to life than carrying around the “ER DOCTOR” badge, or the “DOCTOR” badge in general. It should not define you, or rule your life. It is a noble profession, no doubt, but not the only one, by any stretch of the imagination. Most people, that is, people in general, change careers many, many times in their lives, yet as physicians we’re supposed to find eternal fulfillment in our careers for a lifetime unlike no others. This is not realistic for many people. Many people need a change of direction, specialty, job, state, practice setting, or a complete change of profession to remain interested and invigorated. It’s not sad, or a “shame” when this happens. This is what makes life and work interesting and what allows a person to grow and flourish.
What a person finds interesting, exciting and challenging, might become routine, boring, and draining at another point in their life. If so, it's time for a change.

If you're finding that your job leaves you feeling, drained, negative, cynical and that it's all around SOUL CRUSHING........

...break free.

 

[Venko]

Some people let their careers in medicine, be it EM or another specialty define them, consume them and control them. It's typical of the over-achieving type A personalities that choose medicine as a career. Then as time goes on, some realize that their career, the doctor "badge", doesn't sustain them and in some cases controls them and the direction of their lives. This can lead to burnout. Some slowly smolder over time, getting more and more cynical, jaded and negative. Others flame out fast in a self-destructive fashion. I've seen it happen, and it ain't pretty.

But others have the courage to break the shackles. This goes for EM physicians, physicians in general, and life in general. If you're in a rut, GET OUT. If you're burned out, MAKE A CHANGE.

However, if you’re one of the lucky few that never seems to struggle with any feelings of burnout, “great for you”, I say. Keep living the good life. Ride that train as far as it'll take you.

There’s much, much more to life than carrying around the “ER DOCTOR” badge, or the “DOCTOR” badge in general. It should not define you, or rule your life. It is a noble profession, no doubt, but not the only one, by any stretch of the imagination. Most people, that is, people in general, change careers many, many times in their lives, yet as physicians we’re supposed to find eternal fulfillment in our careers for a lifetime unlike no others. This is not realistic for many people. Many people need a change of direction, specialty, job, state, practice setting, or a complete change of profession to remain interested and invigorated. It’s not sad, or a “shame” when this happens. This is what makes life and work interesting and what allows a person to grow and flourish.
What a person finds interesting, exciting and challenging, might become routine, boring, and draining at another point in their life. If so, it's time for a change.

If you're finding that your job leaves you feeling, drained, negative, cynical and that it's all around SOUL CRUSHING........

...break free.

Birdstrike,

With tremendous respect, may I suggest that this is a bit too dramatic?

If job satisfaction, work life balance, and happiness is a continuum (as most things are), the majority are not at the extremes (soul crushing or utopia), but rather in the middle.

When I have begun to feel overwhelmed, overworked, etc I take some more time off, or cut back, or change focus from practice to teaching to research etc. Granted this has worked for me in my short career and in my n = 1 story, and it maybe that if I had lived a life in your experiences I would see things as you do.

Regardless, I remain curious as to why DocShazaam changed careers since she only spoke fondly of her practice in the post. it seems as though she had a plan to move on before even starting in medicine and it would be wonderfully interesting to find out what it is. Did you take away from her post about saving a life and working in Honduras that she felt EM was soul crushing?

I didn't get that

Again, please don't find my post as argumentative as I truly hold your opinions in very high esteem, but i think this particular post may be a bit too extreme...

Respectfully,
TL

 

[peppy]

I can understand switching specialties if someone comes to the realization that a certain specialty is not what they thought it was. However, I'm not sure if it's really ethical to take a med school seat if you plan all along to leave medicine after a few years. That seat in med school could have gone to someone else who would have practiced for a lifetime.

 

[deleted109597]

I can understand switching specialties if someone comes to the realization that a certain specialty is not what they thought it was. However, I'm not sure if it's really ethical to take a med school seat if you plan all along to leave medicine after a few years. That seat in med school could have gone to someone else who would have practiced for a lifetime.

Wow. That's a new one. It is unethical to not be a slave to the field. What about the MedSchoolHell guy that never even went to residency? Yeah, it sucks for the people that try over and over and never get in, but really, the medical schools only want people who will pass their USMLE and not fail out. The rest they don't care about, even if they pretend like they do.

 

[deleted65604]

Does anyone else think that DocShazam should be put on a legal hold? Clearly a bad case of "acute psychosis". She represents a danger to herself and others.

Yes. Clearly suffering from some kind of psychiatric illness.

 

[Venko]

Wow. That's a new one. It is unethical to not be a slave to the field. What about the MedSchoolHell guy that never even went to residency? Yeah, it sucks for the people that try over and over and never get in, but really, the medical schools only want people who will pass their USMLE and not fail out. The rest they don't care about, even if they pretend like they do.

this argument has been made before and does have some foundation, but as do both sides...let me find the recent ny times article on this...

 

[deleted65604]

This article, Thymeless?

http://www.nytimes.com/2011/06/12/opinion/12sibert.html?pagewanted=1

Not using your education is a travestyfrom the perspective of the healthcare industry as a whole. It is evidence of laziness and/or unrealistic expectations.

 

[deleted109597]

I disagree. It is not lazy to refuse to see an unsafe number of patients per hour. It is not unrealistic to expect people to pay for their care.
It is unethical and incredibly patronizing for someone to tell me what to do with my education. What next, tests in school to force people into vocations?

 

[Arcan57]

I disagree. It is not lazy to refuse to see an unsafe number of patients per hour. It is not unrealistic to expect people to pay for their care.
It is unethical and incredibly patronizing for someone to tell me what to do with my education. What next, tests in school to force people into vocations?

It is a little dodgy to plan to only practice medicine for 5-6 years from the start. There's not a medical school or residency in the US that would accept someone who was upfront about that fact.

 

[GeneralVeers]

It is a little dodgy to plan to only practice medicine for 5-6 years from the start. There's not a medical school or residency in the US that would accept someone who was upfront about that fact.

I sure hope it wasn't a state-funded medical school, otherwise I think she owes some money back to the taxpayers who funded her education.

 

[deleted109597]

It is a little dodgy to plan to only practice medicine for 5-6 years from the start. There's not a medical school or residency in the US that would accept someone who was upfront about that fact.

I doubt it. There are people every year that start FM residencies that openly state they have no desire to do FM. But the residencies need the bodies. EM doesn't, but if someone was the top of their school I bet they could get in.
Also, if people want to get up in arms about someone else's decisions then what is a good enough reason to quit medicine? Do they need to run it by you first? What about disability? FMLA? How close of a family member does it need to be before it is ok? What if they win the lottery?

This is no different than if a woman wants to breastfeed on shift. You do what is important to you. The patients are important, but you are the most important. Without you, nothing happens.

 

[deleted109597]

I sure hope it wasn't a state-funded medical school, otherwise I think she owes some money back to the taxpayers who funded her education.

She's already paid it if she did 5-6 years. She provided about $750,000 in free medical care over that time, although that wasn't for people who actually pay taxes, so I guess you can make that argument.

That sounds so unlike you GV.

 

[WilcoWorld]

So where do you guys draw the line? Are Program Directors, who, according to RRC requirements, can not work a full clinical load, not fulfilling their duties?

I entered med school at the age of 22. Should a 35 year old, whose career will be shorter than mine by about 13 years, not be able to matriculate? What about a 30 year old?

What about a doctor who recognizes that he or she can do a much better job if he works 10 shifts a month than if he works full time, because he is better rested and able to focus more while at work? Should he feel obligated to work full time anyway?

 

[Venko]

Without you, nothing happens.

McNinja, certainly you are asking important questions, but this is the line that gets people thinking that there is an ethical commitment to the public when you accept a medical education that could have gone to someone else.

Without you nothing happens. If more docs quit, the education that was intended to produce a physician so that something can happen is wasted...and as you said, nothing happens.

I am not sure where I stand on this issue, but I do see the argument on both sides.

At present, the best I can say is...certainly plans change, and goals change, but it is certainly not in my ethic to knowingly accept a medical education if I plan to only use it for a short time.

After this, to me its very unclear what is appropriate by my personal ethic.

BTW, thanks for the NYtimes article...thats the one

 

[Arcan57]

I doubt it. There are people every year that start FM residencies that openly state they have no desire to do FM. But the residencies need the bodies. EM doesn't, but if someone was the top of their school I bet they could get in.
Also, if people want to get up in arms about someone else's decisions then what is a good enough reason to quit medicine? Do they need to run it by you first? What about disability? FMLA? How close of a family member does it need to be before it is ok? What if they win the lottery?

This is no different than if a woman wants to breastfeed on shift. You do what is important to you. The patients are important, but you are the most important. Without you, nothing happens.

There's a hell of a difference between going into medical school planning on only practicing 5 years and pumping during a shift. They are not in any way comparable.

People have the right to do what they want, but don't expect me to applaud the waste of your medical training. Like it or not, we all have a responsibility that answers to something higher then self.

 

[GeneralVeers]

She's already paid it if she did 5-6 years. She provided about $750,000 in free medical care over that time, although that wasn't for people who actually pay taxes, so I guess you can make that argument.

That sounds so unlike you GV.

That I don't think taxpayers should get value? There's nothing unconstitutional about states paying for state-funded secondary and post-secondary education. Where I think there's a problem is when they discriminate based on race, gender, or social situation. Someone who's family pays taxes should not be denied a place in school in order for someone who's family doesn't pay taxes to be accepted.

 

[deleted65604]

I know a lot of people that would have given their left reproductive organ to get a position in Emergency Medicine. They couldn't, and are therefore slaving away in emergency medicine in rural locations, flying by the seat of their pants, rather than having the solid training that shazam and birdstrike are throwing in the trash.

I'm not advocating forced servitude, I'm pointing out waste. I also believe there is a lack of honesty on the part of shazam. What did she say in her med school interviews? "I just want to go to medical school to see if I can." Was she honest about her lack of commitment? I can guarantee that she didn't tell the PD in her residency interview that this was an effort to become "wildly interesting" or have unique "relationships" not available to other people. "It's always been about relationships" is the hands-down stupidest reason to go into emergency medicine that I have ever heard. We don't have "relationships" in the emergency department. We have brief encounters with normal people and repeated encounters with borderline personality disordered patients and drug addicts.

She hates her job so much that she quits it, after years of blogging incessantly about her experiences. Then, rather than admit she can't cut it anymore, she claims "this was the plan all along". She is at least disingenuous (now and/or in medical school interviews and residency), and likely suffers from narcissistic personality disorder. What a flake.

As previously proven again and again by the fact that everyone here believes it... people who love cats are usually mental. Correct me if I'm wrong, but the number of cats owned contributes to the tooth/tattoo ratio equation.

 

[Arcan57]

She is at least disingenuous (now and/or in medical school interviews and residency), and likely suffers from narcissistic personality disorder.

Apparently it's not a disorder anymore because it's narcissistic traits are so common. Which tells you a lot about why things are the way they are...

 

[GeneralVeers]

Why couldn't she become "interesting" and have "unique relationships" while doing Family Practice? At least she would have temporarily helped with the shortage, and no one else would have been denied a spot.

 

[Arcan57]

Why couldn't she become "interesting" and have "unique relationships" while doing Family Practice? At least she would have temporarily helped with the shortage, and no one else would have been denied a spot.

You can't work 2-3 days a week in FP, at least not without severe financial penalties. Although I don't know what would make me think about that as a reason.

 

[Hamhock]

As previously proven again and again by the fact that everyone here believes it... people who love cats are usually mental. Correct me if I'm wrong, but the number of cats contributes to the tooth/tattoo ratio equation.

I don't know anything about docshazam, but I do know that the above is true...

HH

 

[gman33]

I'm not down for telling anyone what they should or should not do with their education.

Personally, I think it's a waste to go through all that training to work for such a short period. But that's just me.

If the taxpayers need to get ROI, put a contract in place before you enter school or residency. While you are at it, put one in place before you enter public school in the 1st grade...