Editor’s Note: Want 2 FREE CME credits?  Today and tomorrow are the last day to sign up before the 2-Day Training called The Rise of The Self Determined Physician starts.  At this live event, we will be teaching doctors how to defeat their burnout and find work-life balance without leaving medicine.  P.S. Two FREE Category 1 CME credits will be available if you attend live.  Click here to learn more. Tomorrow is the first day, so don’t wait!

If you are a hard-working doctor, you have already accomplished so much in your career.  You take great care of patients, likely make good money compared to most other professions. And you work in a respected profession.  You might be married with kids, and yet there is also a good chance that you aren’t content.  You might not be able to put a finger on what can be done about it… you just know that you don’t feel fulfilled in medicine.  

On top of this discontentment, doctors have to fight against a thousand different things.  You have to wage war with the EMR that is really a glorified cash register meant for patient billing. And certainly not for patient care.  Then there is the fight with the endless charting you bring home, answering the 457th email, or making sure you return the patient message or lab result in your inbox.  This doesn’t even include all of the ridiculous and unnecessary check-boxes doctors have to check for things like online modules, maintenance of certification requirements, or fighting with insurance companies about pre-authorizations. 

Death By A Million Paper Cuts

Working in medicine can seem like a death by a million paper cuts.  And each of these paper cuts places an ask on your time, on your money, and on your mental health.  When you are hiring your third nanny or finding a new source of childcare because you are stuck late at the hospital again. Or when you cannot eat dinner with your family without thinking about all of that charting and work you still have to do… it gets old, really fast.  

It is a treadmill that never ends, no matter how hard we run. We can crank up the speed, but it is a never-ending hamster wheel.  

This is what leads doctors to dread going into work.  I cannot tell you the number of doctors I’ve talked to who tell me about sitting in their car asking whether they really have to go in for this next shift.  

They talk to their chairs and administrators to see if they can make some changes. Can they go part-time? Can they see less patients?  Is there a way to make sure that they get home on time?  What about a scribe? Can I hire a scribe to help with all of this documentation?  Could we try a different electronic medical record system that actually helps us take care of patients safely?

Time to Make a Change

When physicians get told “no” to all of these asks… that is when you take a good hard look at your bank account, add up the numbers, and try to determine if you can walk out the door.  Can you change jobs or go part-time?  Maybe you can work as a physician in utilization management or for a pharmaceutical or biotech company?  What if you started a real estate empire so that you could live off your non-clinical money instead?  If you cut back, could you just claim financial independence and retire early?

This is when doctors enter the world of physician coaching. They want clarity on how to take the next step. They want to find that ever-elusive work-life balance.  And they need help working through the transition at their current job or in finding a new one.

These doctors who feel trapped in medicine have often read personal finance books, listened to podcasts, and determined that while they could do it on their own, they don’t want to do it by themselves.  Like watching a YouTube video to create a better golf swing, it might work but it is going to take too long. Or they haven’t had success solving the problem. 

Setting Boundaries

One of the biggest reasons that this happens is because you don’t know what you don’t know. Or maybe it is better said, you can’t see what you can’t see.  

At times, we all require that objective second opinion or third-party opinion that can help us sort through our problems.  To help us transition from feeling trapped in medicine to becoming Self Determined Physicians who can determine for themselves who control both their personal and professional satisfaction. Who have created work-life balance and found their dream job.

In order to reclaim our personal and professional autonomy, it requires us to set boundaries with our mindset, our money, and our time.   

Financial Boundaries

For example, many of you know that I started this journey off in medicine as a personal finance blogger for physicians. At one point the tagline of The Physician Philosopher was actually “fighting burnout with financial independence.”  While the end goal has always remained the same – to help doctors defeat burnout and find fulfillment in medicine … the method used to be only financially focused.

And the reason why I had this financial focus was that I thought that if I could save enough money to eventually FIRE, then I could stick up a middle finger to the healthcare system that was burning me out.  Once I was financially independent, there is nothing they could do to touch me.  So, I spent time creating boundaries around my spending so that I could save enough money to walk away from medicine in my mid-40s.  Then, I taught other doctors how to do the same thing.

When I realized that I wasn’t willing to wait until 45 to be able to walk away from medicine, that is when I started to focus on creating non-clinical income through my physician side gig.  

Yet, after doing this, I still found that I wasn’t fulfilled.  I continually asked myself, “Is this really it?  Is this really what I worked so hard to get to?” I wanted to know why I wasn’t happy.  

That journey led me to realize that I suffered from an Arrival Fallacy.  This is the idea that once we accomplish a goal, that it will be the thing that makes us experience the long-term satisfaction and fulfillment we are looking for.  That when we make it, that is when we will be happy.

There is No “There” There

Unfortunately, Gertrude Stein had it right when she said “There is no ‘there’ there.”  When you think that the next big accomplishment, purchase, or moment in life is going to be the one that finally makes you happy… it may fix things for a short-period of time, but it will lead to that long-term happiness you are looking to find.

This is when I realized that the most important boundary of all turned out to be a boundary around my mindset.  Not in a limiting way, but in a way where I limited the broken soundtracks that were running on repeat in my life.  Things like the arrival fallacy that told me if I kept working harder and accomplishing, I’d be happy.

I needed to replace these broken narratives, paradigms, and perspectives with ones that actually served me.  This is something we teach our physician clients in coaching – there are not true or false thoughts.  There are only thoughts that serve us, and thoughts that do not.  Thoughts that move us closer to Self Determination or thoughts that move us closer to burnout.  

For example, I could keep telling myself that I was a victim of a broken healthcare system. Or I could release that and become the hero of my story, but in order to do this I needed to learn how to set boundaries around my mindset, my money, and my time. 

Mindset, Money, and Time

This is exactly what we do in physician coaching.  We help physicians realize what is holding them back, and then help them set boundaries.  This may sound strange, but think about it.  

Literally everything is about setting a boundary. You are setting boundaries whenever you:

• Spend less than you earn so that you can create financial independence.
• Decide to only answer emails when you are at the hospital so that you can be present at home.
• You negotiate your way to a better contract by getting your non-compete removed (which is a boundary in itself).
• Put in a buy-out clause for your group so that if they get purchased by private equity before you are a partner, you get paid.
• Decide that you aren’t going to let someone else’s words or actions dictate how you feel.
• When you decide that you aren’t going to complete the unnecessary online module, chart at home, or see more patients without getting compensated for your time.

These are just some of the examples of boundaries that Self Determined Physicians place in their life. They all fall into The 3 Pillars of Mindset, Money, and Time.  And only when you have mastered all of three of these elements can you find the work-life balance you need to create your dream job in medicine.

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