Leaving Clinical Medicine One Hour at a Time

Have you thought about leaving clinical medicine, but also want to maintain your salary? Are you feeling unhappy in your clinical job but also don’t have the time or energy to figure out what’s next? Often times the demands of clinical medicine require us to work so many hours that we don’t really have a moment to stop, breathe, and do the soul searching required to figure out the next career steps. In this week’s episode. Dr. Andrew Tisser offers a practical solution to this dilemma.

He discusses how you can use the art of negotiation to buy down your clinical hours, maintain your salary and improve your quality of life.

In this episode you will learn:

• Why you must understand the root cause of your career unhappiness to move forward
• How to effectively negotiate fewer clinical hours to free up more time and energy
• The best types of questions to ask within a negotiation to get what you want
• How to take inventory of your transferable skills and reframe them to appear marketable for alternative career paths

This episode is full of practical and tangible advice for leaving clinical medicine one hour at a time.

Listen in using the audio player above, or click here to listen on Spotify or Apple Podcasts.

How Dr. Tisser is slowly leaving clinical medicine

Dr. Tisser is slowly leaving clinical medicine one hour at a time. He took the traditional route of attending medical school and doing an emergency medicine residency. After residency, he moved to Chicago to be with his wife where he took several jobs part-time while he was trying to figure out what he really wanted to do with his life. Deep inside him was unhappiness all throughout his med school and residency days, but he stuck around believing others when they kept saying things will eventually get better.

Experimenting with your career

Most physicians have a “Type A” personality and  need to have the rest of their life or career mapped out or figured out early on or before they could begin taking any step.

Andrew struggled with this as well. He felt hesitant and apprehensive about “jumping ship” or moving from one field to the next in search of the perfect fit. He didn’t want to leave a miserable career/field just to be stuck in another horrible situation.

Before leaving clinical medicine, know the root of your unhappiness

For Andrew, several factors contributed to why he felt unhappy and miserable in his career path. First was boredom because he felt that med school was not challenging or intellectually stimulating enough for him.

He also had a major shift to more family-oriented priorities which caused him to think more and more about leaving clinical medicine. He grew up an only child and was distant from his family. But after getting married, he wanted to create a family life that was different and better than what he grew up with. Plus, the amount of work was non-stop, taxing, and punishing, and took a toll on his sanity.

You have to allow that to be okay that your priorities shift and change, the person you were at the start of your medical journey, is not the same person you are now—and that is okay. You can honor the new priorities, instead of holding yourself to what you thought you wanted, like ten years ago.”

Leaving clinical medicine doesn’t have to be all or nothing

Doctors having undergone med school, earning their degrees and doctorate licenses will always be doctors even after leaving clinical medicine.  But those who chose to add on to their identity may do so without losing their identity as a real doctor.

He uses the approach of “Buying Down the Clinical Time”. For example, 50% of the time he sees patients, 25% would be allotted for remote advisor/consultancy work and the rest of the 25% is for his administrative role as assistant chair of Emergency Medicine in the hospital. Through this approach, his clinical salary was not affected but his life has improved.

A way to decrease medical burnout is by decreasing the number of clinical hours that physicians work. Instead of taking 144-hour shifts per month, why not cut that to half the amount of time? This doesn’t just work for Emergency Medicine physicians. His wife juggles being a rheumatologist, a director for internal medicine in the hospital, and doing medical research. Specialists can negotiate these terms in order to find other areas that could buy down their clinical time to ultimately benefit their wellbeing.

Benefits of Buying Down Clinical Time

When he bought down his clinical time,  he got back more or half of his weekends in a month. Regular, full-time, ER doctors would normally take weekend shifts 4-5 times monthly. Whereas, he only had to take shifts 1-2 weekends a month. It meant that he had time in the week to  pursue other things; more time for his business, more time to spend with his daughter, and more time to spend doing his podcast. Hitting 7-8 Shifts in a month as opposed to the 15 or 16 monthly shifts for full-time clinical practicing physicians offered him more control over his life.

It’s important to create a sense of  control over what happens with your life and career instead of having somebody else dictate where you have to be or what you have to do.

Using negotiation as you are leaving clinical medicine

To successfully use the art of negotiation, first, you have to ASK.  Negotiation is especially important for those who are newly graduated or being offered new contracts. He always recommends that new grads negotiate for time over money. Taking more time off may keep you from leaving clinical medicine altogether.

When negotiating, always ask how-type questions. How questions are powerful because it puts your employer in a position where they think about what they need to do to address your concerns. He says, “you won’t get anything you don’t ask for.”

Identifying your transferable skills

Doctors sometimes think that they “only know doctor stuff” and it’s important to analyze this deeper. There are so many marketable and transferable skills that physicians have and exercise that they may not be aware of. When you are thinking about leaving clinical medicine you must make an inventory of your own skills that go beyond what you think they do in clinical practice.

Some ways to identify your transferable skills:

• Make a list of things that come easy to you, but not for others
• Look back at your past accomplishments- what skills did you need to have to be successful in those areas.
• Think about what others compliment you on
• What are topics that you could teach someone else
• What are areas where others ask for your help?

The mindset you need for leaving clinical medicine

Leaving clinical medicine can be an opportunity to gain benefits and privileges that most are not offered during clinical practice. This can include paid time off, vacation, investment opportunities, etc.

You will not be taking an entry level position but will come in as a professional with an extensive background and experience so don’t be afraid to negotiate.

You must ask these two important questions: “How much is it costing you to remain miserable?” and “What price are you putting on your time and your life?”

When you are leaving clinical medicine, it helps to have a plan. You can plan each step in the right direction and be prepared with short-term to long-term goals. But first, you must come to terms with your unhappiness and figure out its root cause. Also, be careful with the language and belief system you allow yourself to take in because what you think and what you say to yourself will feel extremely true to you.