My hero and mentor recently wrote “5 Ways to Get Out of Clinical Medicine”. His article inspired me to write “5 Ways to Stay in Clinical Medicine & Be Happy”. Even though I am a radiology resident and frequently seen by the society and other doctors as "not a real doctor," I think of myself as very much practicing clinical medicine every day. Not only do I do procedures involving educating an partnering with my patients, but also I frequently call up patients to share findings with them, answering their questions, and recommending follow up with their clinicians with appropriate imaging modalities when warranted. I recently learned in a very humbling and scary fashion, how challenging clinical medicine is. I missed a critical fracture in a multiply injured patient who was a high-speed car struck pedestrian. Even though I caught my "miss" immediately and I recommended the appropriate management immediately for all the other critical findings I reported, I was shaken by the fact that I could have harmed this patient. I came to realize that bearing the weight of a fellow human being’s life or death is simply too heavy for any human like myself, fallible, imperfect, distractible, and fatigueable. Now compound the fact that a “fast” clinician may see 60 patients daily, yet an average radiology resident will see the images of at least 60 patients daily. The impact of practicing clinical medicine on the practioner is multiplied simply by the number of cases/lives he or she touches. I thought about leaving the clinical practice of radiology. I would love to be a yoga instructor. I don’t need to make more than 50k a year to have a happy life and save for my retirement, and as it is, I can easily work 20 hrs/week and make 50k annually. There are so many things I could do and would do extremely well and make a living from, from blogging, tutoring, writing books. I’ve always made more money hourly doing something else other than medicine. The easier way out is certainly tempting. But I decided, like how I initially chose medicine in my teens and 20s, to take the path of great resistance and greater rewards (albeit not financially speaking.) Fully recognizing the stress, burden and sacrifices associated with practicing clinical medicine is not worth a million or even 5 million and more, I also know that the true rewards of clinical medicine is also priceless. So for those of us who are overwhelmed, overworked, underpaid, squeezed and taxed in all directions, let’s look at some ways we could be happy doctors rather than leaving our once-upon-a-time “dream career” all together. 1. Give yourself the permission to work less. Why are you on a treadmill, running and running trying to keep up? I also abhor the endless, mindless, tedious paperwork associated with getting insurance pre-auth and workman’s’ comp. When you are so overworked, seeing 60 patients daily, back to back with hardly any food or bathroom breaks, no one is going to be a happy doctor. But if you see 30 patients and work 8 hours daily with a 1 hour lunch break, you’ll be happier. To get from stressed and overworked to relaxed and happy, one just needs to cut his/her paycheck. You ask, how can I cut my paycheck in half? Sit down with a cup of your favorite beverage and track your monthly expenses for 2 months. Find out where your money goes. I bet there’s fat to be cut out. Ask yourself, “Is my happiness and well-being worth half of my paycheck?” My answer is, of course, your health in mind and body is the greatest asset you have to generate wealth! If you have been successful with all the fear and stress you have, imagine how much more successful you’d be if you are filled with love and positive energy instead. For instance, I increased my sleep hours by 50%, from 4 to 6 hours daily, and I found myself writing 3-5 articles in the same amount of time that I used to take for just 1 article! 2. Reduce clinical hours and increase academic/educational hours. Many of us go into medicine because we enjoy the role of a teacher and life long learner. If the goal was to obtain the most amount of money for the least amount of work, medicine is probably the worst choice of professions to accomplish such. So reduce your clinical hours to half, increase patient/student teaching hours. You may think that the latter is fine and dandy but don’t put food on the table or pay the bills. Then first, go back to step I and cut out the fat in your expenses, allowing yourself to work less for money and more for passion. In this age of YouTube and blogging, you’d be surprised you could in fact make money educating others. #3 Replicate yourself. We all don’t enjoy repeating ourselves, to our children, our parents, or our patients. So replicate your voice, your knowledge, your recommendations in a video or a publication. Refer those who need your teaching and expertise to the educational materials you produced to perfection. Save yourself time (time is money), make money, and free yourself to do more good for your loved ones, yourself, and the society. #4 Outsource tedious work. Hire someone from oversea for 4 bucks/hour to do your grunt work. Writing a research paper, PhDs abroad are available at $10-15/hr to do the literature search for you and/or even draft the entire paper for you! You can outsource as much as you’d like, only you know how much your time is worth. If you ask me, your time, should be priceless. #5 Practice medicine in a different country. I’ve heard that medical system is not so messed up in Canada, Europe, or Australia. Consider that. You may make less. But I’ve also heard that radiologists in Australia makes only slightly less than their miserable US private practice counterparts. It’s worth exploring to say the least. We spend 1/3 of our lives and 1/2 million dollars to obtain the privilege of practicing clinical medicine. Before trying to get out of it, perhaps we can figure out ways to be happy staying in clinical medicine. Source
