The Physician Philosopher Podcast

TPP #30: Part 1 – 3 Pillars of Freedom for Physicians Who Feel Trapped

Too many doctors feel like they are not the captain of their own ship, that they busted their tail to get to where they are, but that outside forces control their life. 

Physician Disability Insurance

When I was at the bottom of my burnout, I felt like I had no control over my life. I felt like I had to choose between being a good dad, a good husband, and a good doctor. And that was an absolutely miserable place to be. 

I didn’t want to have to choose any of that. I wanted to be good at all three things, and that lack of control, that lack of autonomy over my hours in my schedule led me to realize that what I wanted more than anything was the ability to control my schedule, to live life on my terms to make sure that I didn’t miss T-ball practices, gymnastic practices or singing lessons, that if I wanted to be there as a dad, as a husband, I could be my journey to figuring all of that out was a solution to my burnout. 

The Transition From Burned-Out Doctor to Physician Freedom 

My transition from being a burned-out doctor with no options, to feeling like a bad-ass physician entrepreneur, where I could live life on my terms, had a lot of ups and downs. 

The thing is, I didn’t know what I know now, which is that there is an order to this process, a method to the madness. 

And I got it all wrong.

So I want to save you from that journey. I want to save you from not knowing the order in which this should happen, this process, this journey. So what is this method? It is what I call the three pillars to find work-life balance and living life on your terms.

These are the three pillars that we teach inside the Alpha Coaching Experience. And whether we say it distinctly or not, it really is the fundamental roots and reason for success for physicians that get coaching. 

The three pillars are your:

  1. Mindset
  2. Money
  3. Balanced Life

And this is done in exactly that order. 

First Attempt At Ending Burnout As A Physician  

Now, this is not the order in which I did it. So don’t be confused by that. That’s why my journey had tons of ups and downs. And life is a bit about enjoying the journey, right? 

So as a coach, I always have to look back with my stoicism and say to myself, “Hey, what did that obstacle teach me? What did going through this process in the wrong order, teach me and how can I reach back and help other people go through this journey in the order that makes sense? In the way that will be most helpful for them?” And so that’s what I do now. 

For example, in my own life, I mastered my money and financial literacy long before I started mastering my mindset. So, while I knew I’d be financially independent in about 12 to 15 years, I was also completely miserable. And I recognized that 12 to 15 years wasn’t soon enough. 

I have three kids. My oldest is about to turn 10. I have a seven and a four-year-old. When I started doing the math and realizing the age I would be financially free and how much I might miss in the process, I was like, “there’s no way I’m waiting that long.” My kids are only young once. I want to see them and be with them, every chance that I get. 

This is when I realized that the problem wasn’t my money. The problem, wasn’t my financial literacy, because I had fixed that problem. That’s why I stepped into the personal finance space, started blogging and podcasting about money for doctors. 

The problem was my mindset, my thoughts about my current situation, and after working on those thoughts and then mastering my mindset, which again, I recommend doing first, but I didn’t, I then worked on my work-life balance. 

So the order in which I figured this stuff out was my money and then my mindset, and then my work-life balance. That journey, while it taught me a lot, has also allowed me to speak from a place of knowing how to help guide you to your own mastery of these things in your life. So you can create the life that you want. 

What I recommend for you is NOT this order because it led me straight through the throngs of burnout. As I was burning the candle at both ends as a doctor and a physician entrepreneur. I did not balance those things. 

Well, people ask me all the time, Jimmy, how do you get so much stuff done? How do you have all of the stuff that you do at work and research and teaching and clinical medicine? And you’re a dad to three kids and you’re married and you have this online business. How do you do it all? And the answer, I always tell people very transparently is that I didn’t do it well. That doesn’t mean that I didn’t learn a lot from it. It doesn’t mean that I’m not thankful for the experience. It doesn’t mean that I didn’t view that obstacle as the way to progress. 

I don’t want that for you though. There’s no need for you to walk a mile in my shoes. I think that’s silly when prior generations of people that have taken paths before others are like, “Oh, you have to go through this too. When I walked uphill, both ways and snow.” I think that this militant way of thinking in medicine is actually a huge part of the cultural problem that exists. 

So I want to save you from that. I want to put the snowshoes on you and save you the trouble of going through it all.

Step One To Overcome Burnout As A Physician  

So here is the order that the pillars (or steps) are going to go. You need to master your mindset, then your money, and then your life. 

I want to start by talking about the first and third pillars in part one, here, and I talk about the second pillar in part 2. Let me explain why we’re not talking about them in order. It actually makes a ton of sense. 

The first pillar, your mindset, many doctors suffer from an arrival fallacy, myself included. It’s the idea that the next accomplishment, the next big thing is going to be the one thing that makes us happy. It is going to be the thing that makes it all click and makes it all worth it. That provides that long-term sustained satisfaction that we’re all looking for in life. 

So professionally, this might look like you becoming an attending and expecting that to be the thing that makes you happy, or you making partner or getting promoted. Personally, this might look like the time when you buy the house or the car, or you could put your kids in private school, or you finally get the Peloton that everybody’s been talking about. 

But when we look at things like this, we’re asking the wrong question. It’s not really about figuring out what will make us happy. It’s about figuring out why we aren’t happy in the first place, right? This is why people get this journey screwed up. It’s why I screwed this journey up and did it the order in the wrong way. I’ve mastered my money so that I can fix my situation. And I did that before I learned how to be content in any situation. 

So why are we not focusing on how to enjoy the journey? And what about our current situation is driving us to burnout or to feel overwhelmed or to feel trapped in medicine. Like we don’t have any options or feel like we have to choose. Like I did between being a good parent, a good physician, a good spouse, a good partner. 

And so in the Alpha Coaching Experience (ACE), we help doctors sort through all this through life coaching. That’s where the term life coaching comes from. We hash it out and figure out their thoughts. We spent a lot of time discussing facts versus stories and having them realize what’s driving their feelings; what drives our feelings is our thoughts. It’s our mindset. 

For example, we had a client in ACE who hated meetings he was required to attend. To him, they took too long. They were completely unproductive. They felt pointless and never led to really any change. They were a waste of time. They bothered him so much that he was actually thinking about changing his job because he hated the structure of the meetings. He hated the administrative side of it. He hated the fact that he had to go to them. He hated the results of the meetings. And so when we worked on this and exactly what it was about the meetings that bothered him, he realized that it wasn’t really the meeting itself. It was the anticipation and the thoughts leading up to the meeting, which is a fascinating thing, right? 

But when you dive into those thoughts and when he shifted his perspective to notice that these meetings only happen like once or twice a month, and at the other 95% of his days were spent doing clinical medicine in pediatrics and loving what he does when he focused on that, he realized that his misery was coming from focusing on the one or two things about his job that he absolutely hated. Instead of focusing on the things about his job that he loved. And with this new mindset shift, he realized he didn’t hate his job at all. He actually liked it a lot, nothing changed about the meetings. The meetings still happened, and now he just chooses not to focus on them in the same way they did before. This is the ability to not let your feelings become the master of you. 

This is why it’s important to work on your thoughts and your mindset before you change your work situation. Because I cannot tell you how many doctors I’ve coached, who are miserable in their job. And they think the solution is to change jobs because they hate their current job. They hate the current culture. They hate the administration. They hate their bosses, whatever they changed jobs. And then they are miserable at the second job too. And the reason that this happens, the reason that doctors become a statistic, right? 

There’s a study out there, it actually comes from an Atlanta Healthcare Recruiting Firm, that showed that 50% of doctors changed jobs in the first five years out of training. I bet that number is actually higher. I bet it’s 70%. And we also know that turnover is huge in part because of physician burnout and moral injury. 

So when you piece all these things together, we recognize that a lot of doctors think that the solution to their problem is changing jobs. When I speak to client after client in the Alpha Coaching Experience, who changed jobs before they found coaching and learned how to change their mindset. They say they were just as miserable. It was better for three or six months, but after that, just as miserable just for different reasons. 

So if you don’t do the tough thought work, you don’t do the mindset work before you do this. It is inevitably going to lead to similar results at the next job. So this is why your mindset is the first thing that you have to master. This is why you have to learn how to shape your thoughts, which then shape your feelings and how you show up in this world. 


End Physician Burn Out With A Balanced Life 

If you just mastered your mindset, it’s transformational. In fact, if you just get life coaching, for example, truly transformational, because recognizing that it is your thoughts about the situation that’s causing, how you feel super important. It is all about that and not changing the access situation. It’s really helpful. 

There are definitely some situations that make it easier to have better thoughts than others. Thoughts that lead to better feelings, better actions, and better results. But to really transform your life and end your burn-out you must find a work-life balance. And so for me, changing my situation into my ideal work-life balance meant going part-time, that’s what I did the solution for. 

You may be completely different by the way. But I started out by dabbling my feet in those waters of part-time work. Still loved practicing medicine. Still love teaching residents in particular, but I’ve got a dependable schedule right now. 

I took a massive pay cut for that almost a six-figure number, but that’s how I got my work-life balance. I could drop my kids off in the morning when I wanted to work on my business during the day, and then pick them up from school. We could go hit golf balls afterward or go to the park. And then I could do my group calls for the Alpha Coaching Experience at night, once my kids were in bed, I loved it. 

So while it may be my thoughts about these situations that improved how I felt, it was a hell of a lot easier to have these better thoughts. Now that I controlled my schedule. Everyone’s path looks different. It might be stopping certain kinds of procedures that you don’t really enjoy. It might be it’s focusing on a specific or, you know, a niche that you really enjoy taking care of. It could involve becoming a physician entrepreneur, which I’m a huge fan of. I think that every doctor could benefit from a side gig. Just my thought, you can take it, do what you want with it. But I think everyone can benefit from it. 

Coaching is the secret sauce that helps with all of these pillars: mastering your mindset, mastering your money, and your life. It is the key is learning how to enjoy that process. Enjoy the journey because it’s not about the end. It’s about enjoying the middle. It’s about enjoying the journey to getting there. 

In fact, that’s probably why some people say that the idea of work-life balance isn’t even possible. I know that there are haters out there every time I use that word or that phrase work-life balance. You know I think that people that don’t believe in work-life balance just haven’t found it. It seems like a fountain of youth to them. It seems like an impossible goal. It just means that you’re still in the process of learning how to enjoy that journey. 

A lot of you just heard that and you’re like, yeah, Jimmy, that’s great, but I can’t do that. I can’t afford to go part-time I can’t afford to really master my life in this third pillar. And that’s why the second pillar exists because the only way that you can really take control of your life, that you can really set boundaries, that you can really practice medicine because you want to. 

So in order to find a work-life balance as a partner, parent, and physician, you have to master your mindset, your money, and your life – in that order.

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