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How to Marie Kondo your medical practice

Lynn Marie Morski, MD, JD
Physician
June 24, 2019
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Back in medical school when you chose a residency, you probably thought you had to do most everything that came with your chosen specialty.

Then in residency, they for sure made you do every last part of your specialty (and more!).

Now you’re out of training, and you’re a practicing physician. And what you may not have realized is that at this point — something glorious happens.

You get to choose what you want to do with your medical degree and training.

You may have just reacted violently to that last statement as the voice in your head screamed: “Not at my job! I have to do everything, and I get no say in it!”

Well, short of being in a contract you can’t get out of, you have every say in it.

You, my dear physician friends, can quit whatever parts of your medical practice don’t work for you.

Let’s examine further what I mean by this. Say you are a burned-out family medicine doctor, and the highlight of your day is seeing pediatric patients, but the low point of your day is doing procedures.

Or you’re a urologist who loves to do vasectomies, but prostatectomies are the bane of your medical existence.

I was there before I even left training. During my sports medicine fellowship, the low point of my week was having to stand on the sidelines of football games for hours.

Yes, I’m fully aware that what I just described as my nightmare is probably a dream job for someone else. And guess what  —  so is that thing that’s your nightmare!

You see, even those of us within the same specialty can be very different. So while you may love doing yearly GYN exams, your co-worker may loathe them  —  but she may love doing the procedures you dread!

So if you’re suffering from burnout, take a look at where the friction is truly coming from in your medical life, because there are a ton of little quits you can make to better tailor your current practice to your needs, or to find a way of using your medical degree that works better for you altogether.

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This, my friends, is where you follow good ol’ Marie Kondo’s advice:

If it doesn’t spark joy, get rid of it!

Now I’m not naive to think that those of you working for the big medical systems of the world can waltz in and declare that you’re no longer doing certain things within your scope of practice. However, I do recommend getting bold and starting to ask around.

Maybe you chat with the docs in your practice and see if there can be some agreements made. One doc does all the procedures, and another takes all the school physicals. Yes, it requires a chat with the scheduling staff, but unless your practice is huge, it’s probably doable.

If you work at something like Kaiser where the schedulers may not even be in your office that may make it more difficult. However, don’t yet write it off as impossible. It’s always worth asking your higher-ups because while you may think it’s their job to drive you crazy. They’re actually going to suffer if you leave. So any supervisor worth their salt should at least hear you out and try to make accommodations where possible.

I’ll give you an example. A friend of mine is a highly skilled facial plastic surgeon, and he was burning out. He was expected to do the full range of cases within his scope, but his heart and passion lie within doing total nasal reconstructions. Despite working for a big government institution, he went and asked if he could do just those cases.

And guess what  —  they said yes.

I’m guessing they knew he was a valuable asset and that it was better to have to dole out cases differently than to lose a well-trained and respected surgeon. And I’m betting they also realized the other important factor here that may be the elephant in the room of all of this:

If you really dislike doing part of your job, it’s significantly harder to be fantastic at it.

Now I didn’t say impossible, but let’s all be honest with ourselves. You know how much extra energy and focus you have when your heart is in something versus when it’s not. So if you’re the one on the table getting a knee replacement, do you want it done by someone who’d much rather be doing a rotator cuff repair? I know I wouldn’t.

And this extends beyond procedures or types of cases into your schedule: Does working full-time do it for you? Or would you be less burned out if you could go to part-time? Is the commute what’s draining the life out of you? Try telemedicine.

I decided at the end of my fellowship I was never going to wear a pager again and never work another night or weekend. Guess what —  along came a job with the VA doing compensation and pension exams that required none of the things that were on my dealbreaker list.

One last reminder, for those of you who have read this far and have figured out what does and doesn’t spark joy and within your current job can’t make any alterations:

I want to remind you of what I said above — you have options. If the people you work for aren’t willing to work for you, start looking elsewhere. If clinical medicine period isn’t working, start looking at nonclinical options.

Because we all have worked too hard for too long and invested too much time and energy getting to where we are to spend the rest of our lives suffering.

Konmari that practice, that job, or that career! Find what sparks joy and trust that the doctor you get to be when you’re working in your most joyous state is exactly the doctor your patients want, need, and deserve.

And it’s what you deserve, too.

Lynn Marie Morski is a family physician, attorney, and founder, Quitting by Design. 

Image credit: Shutterstock.com

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