Should you stay or leave medicine? [PODCAST]

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“I left my primary care practice earlier this year to focus on life coaching. Why did I leave? Because I wanted to do more and make a bigger impact. I remember how eager I was to complete medical training as I approached the light at the end of the tunnel. I thought I could finally relax and enjoy life as an attending after all the delayed gratification from becoming a doctor. All I ever wanted was to help people feel better and live a life of ease myself.

However, I was disappointed and frustrated by our broken health care system and how care coordination could impact patient outcomes negatively. Working as a PCP in the pandemic didn’t make it any easier. I saw so many patients suffer and felt helpless that I couldn’t do more. I wanted to offer healing on a deeper level by examining the root cause in order to change things for good and care for the person as a whole. But I was feeling stuck. I was afraid to leave my stable job. Medicine was all I knew. What else could I do?”

Cindy Tsai is an internal medicine physician and can be reached on Twitter @cindytsaimd.

She shares her story and discusses her KevinMD article, “Should you stay or leave medicine?”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today in the show we have Cindy Tsai. She is an internal medicine physician and a life coach, and she wrote the KevinMD article “Should you stay or leave medicine?” Welcome to the show.

Cindy Tsai: Thank you so much for having me. I’m really excited to be here.

Kevin Pho: We’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?

Cindy Tsai: Yeah, absolutely. So ever since I was young, I wanted to become a doctor and follow my dad’s footsteps, who was a surgeon. I’m the youngest of four daughters. I grew up in Taiwan in a traditional Asian household, so there were a lot of expectations, and I didn’t want to be a failure and disappoint others. So I was always interested in health and wellness, and even as a kid, I’d be drinking water instead of soda or juice. I thought medicine was the perfect way to blend all my interests, to help people be healthy and well so they could enjoy their lives. I worked really hard, trained at top schools like Hopkins and Dartmouth, and I was so focused on becoming a physician, thinking that that was going to make me happy and fulfilled.

After completing residency in internal medicine, I started working as a primary care physician, and then I realized I wasn’t that happy or fulfilled. You know, it’s such a privilege to be a part of a patient’s health journey, but I was frustrated when patients were coming in when they were really sick and in crisis, and often looking to medications as a Band-Aid. I really wish I could have done something sooner to help them before they got to that point, and also look at the whole picture and the root causes, so we could improve and change things for good.

But I was feeling so stuck myself. All these years of training, work, life looked good on the surface and on paper. Like, I did all the things, checked all the boxes, but I wasn’t happy, and that’s really scary to admit. I had been going to therapy, trying different things, and it wasn’t until I started working with a life coach that things really started to change and improve, because I learned so many tools and skills. I was able to change my mindset and perspective. I just felt so much better, because I learned how to have my own back and finally felt like I was in control of my life, and not the other way around.

And I’m just so grateful for the opportunities, the resources, and training, and all these different modalities, whether it’s mindfulness, mind-body, somatic work, that can be very effective outside of conventional medicine, that I knew I had to become a coach myself to share and help others on their journey, especially our health care providers, because our healers need healing too.

Kevin Pho: So you mentioned that you did clinical medicine and you realized that it wasn’t quite what you expected. How long did you practice before you came to that realization?

Cindy Tsai: So I was a primary care physician for about five years and transitioned to coaching full-time.

Kevin Pho: Was there anything specific about the internal medicine job itself, the environment that you were practicing in, that helped lead you to that transition to life coaching?

Cindy Tsai: Definitely. In primary care, there are a lot of things that you have to deal with, whether it’s administrative, you know, insurance, that kind of stuff, some limitations there, and with appointment times, things like that. I actually really appreciated my clinic, my support staff, and team. And I think what I realized was it was my own perspective of what I was thinking about my environment and people that led to my experience of medicine. So I think that’s the really important part, to know that, you know, your environment, other people, can be however, and you get to choose what you think about it, right, get to kind of create your own experience.

Kevin Pho: And as you transition to a full-time life coach, tell me about some of the challenges that you face in making that transition from clinical medicine to being a life coach.

Cindy Tsai: So I would say that the journey has been really fun in many ways, just diving into entrepreneurship. And I think in the beginning, definitely many differences, from having a structured day being a physician, right? Like in a clinic, this number of hours, these patients, to an entrepreneur, where there’s a lot of freedom and flexibility. But I feel like it’s been such a great learning journey, just being able to meet and reach and help so many more people and to make a bigger impact. So I know I’m really lucky and just grateful for this opportunity.

Kevin Pho: So let’s transition to the KevinMD article that you wrote. It’s titled “Should you stay or leave medicine?” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Cindy Tsai: Sure. So my article was really inspired by my own healing journey, and I wanted to offer some different perspectives and ideas to hopefully help people who are feeling stuck to see that there are other options out there. And even though the title talks about staying or leaving medicine, I want people to know that I’m not trying to convince you one way or the other, right? Like, there’s no judgment either way. You can have a fulfilling career in medicine or outside of medicine. And my intention, and the most important thing, is for you to learn how to connect with yourself and really listen to what’s most important to you, and live your life from that place of truth, so you can really enjoy the life that you’re meant to live.

Kevin Pho: Now, for those physicians who may think that medicine isn’t quite right for them, or not quite what they expected, go through some of the questions that you asked yourself to really help clarify what your future path would be.

Cindy Tsai: Yeah, I think it was really important to really get to the why, in terms of why did you pursue medicine in the first place, what’s important to you, your values and priorities. And I think what was scary to me was, you know, I had gone through my life thinking that medicine was what I was meant to do, and just that being a doctor would be very fulfilling in many ways. And then when reality didn’t match up with that, that’s really scary, right? I think there was definitely a lot of judgment in the beginning of myself, just being like, “You know, what are you doing? Like, so many people would love to be in this position, and just leave too.” And so I think that contrast was very challenging in the beginning, and that’s why I knew I needed to get help and have someone else there with me. And a coach really offered that for me, to help me clarify and understand what’s important to me.

Kevin Pho: When you talk about the reactions from your colleagues and family when you left clinical medicine to be a life coach, what were some examples of some of their responses?

Cindy Tsai: A lot of them were just really confused and just didn’t understand why I was leaving such a stable job and an environment to pursue something that seemed very risky and just uncertain. But I think that when they saw how excited I was to pursue coaching, they saw that this was really in line with what I really wanted, and they were in support as well.

And I think that’s the thing: In the beginning, when I was not totally sure of the transition, I was mindful about who I was sharing this with. And I think that’s something to remember, that, you know, it’s almost like in the beginning, it’s like a baby, right? You have to kind of really be careful and protected. And then I think as you continue to become more firm in who you are and really being open about it, then it almost doesn’t matter as much what other people are saying, right? Because you know who you are so strongly that they appreciate and respect that about you.

Kevin Pho: Tell me about how you started your coaching practice. How did you grow that? How did you find clients, and how did you manage that? Because there are a lot of physicians who are interested in what you’re doing, and they’re just, like you said, scared about straying from that linear path and steady income into something that’s relatively unknown, not only from a job standpoint but even from an economic standpoint. How did you grow your coaching practice from basically nothing?

Cindy Tsai: Yeah, well, I think that there are so many great resources out there that, you know, we’re really fortunate to be an entrepreneur in this moment in time, right? And I think for me, it’s really figuring out, trying different things out. You know, I wish I could say, again, kind of like medicine, right, have it be very linear, like, “OK, do X, and then, you know, this will happen, and that,” and then, you know. But you really do have to try different things so that you can figure out what feels good to you. And I think that’s the most important, right? Like when you’re really in your element and being authentic, people respond to that.

So, you know, for me, I see networking, word of mouth, referrals being very helpful, and also doing speaking presentations, webinars, and also writing articles like the one I shared on KevinMD, and Doximity, and things like that. So, you know, that’s been just different ways of sharing my message, and of course there’s social media and other things.

But I would say that for people who are considering, you know, kind of charting their own path, just know that there’s no one way to do it. You know, the one that feels good to you is going to be perfect for you. And I think sometimes the process is just learning how to listen and kind of sort through, like, “Is this my fear and anxiety? Is this what I really want?” And just, like, learning how to really figure out what works for you. So it’s a process, and I think, you know, having fun every step of the way and just also being open to what is.

Kevin Pho: If you were to take this journey all over again, is there anything that you would have done differently?

Cindy Tsai: That’s a good question. I think, you know, I have wondered if I would still pursue medicine, in terms of going through all the medical training, if ultimately, you know, I’m kind of shifting paths. But I do think that having gone through medical training and being a physician has helped me in so many ways and helped me in my coaching, because, you know, you learn how to really listen and hold faith for someone. So, you know, I think that I’m just grateful that I’m here right now, and just excited to see everything that’s going to be coming.

Kevin Pho: We’re talking to Cindy Tsai. She’s an internal medicine physician and a life coach, and she wrote the KevinMD article “Should you stay or leave medicine?” Cindy, for those other physicians who may be listening to this podcast and are thinking of creating their own life coaching business, what kind of advice do you have?

Cindy Tsai: So I want everyone to know and remember that you’re enough, worthy, and amazing right now. You know, even if you’re just starting, you’re amazing, right, for taking that step and remembering that you’re doing great. Take time to acknowledge yourself and celebrate every win, big or small, especially at the beginning stages of a business. There are so many days where it’s easy to be deflated, right, when people don’t respond, when people don’t, you know, whatever, all these things. Because with our human brain and negativity bias, it has a tendency to focus on the negative, right, and everything that’s not working. And even though life is not about being positive and happy all the time, through just awareness, mindfulness, coaching, you know, you can really retrain your brain and build habits so that you’ll feel better more often than not, and really learn to be kind to yourself.

Be open to what is, because I think when you’re really attached to a certain outcome, it leads to suffering, disappointment, and struggle, all these things, right? It’s not to say you shouldn’t have goals, because it is important to have direction so you can live your best life. But just know that if it doesn’t work out exactly, it doesn’t mean that, you know, something has gone wrong, right? There are some lessons there, and you’re not a bad person. It’s not like it’s never going to work. So just try not to be so hard on yourself.

And last but not least, I would say just have fun. You know, I think especially when you’re really creating your own business, being an entrepreneur, anything is possible, and you get to choose how you live your life. So just do what feels good to you and be present so you can enjoy every moment.

Kevin Pho: What kind of resources do you recommend for those who are interested in creating a life coaching?

Cindy Tsai: So I think there are some really great books out there about mindset, in terms of being an entrepreneur and really accessing that state of abundance and sufficiency, because, you know, when you’re building a business, there’s so much uncertainty and unknown, right? So you really want to be open and really stay in that state. Because a lot of times it’s easy to feel like, “Oh, everything’s not working. I don’t have enough.” And then you get into that, like, rumination and shame spiral, which is never productive. So I would say it’s really important to work on your own mindset and perspective, work with a coach, you know, just really tapping into that growth mindset.

And I think there are so many different resources out there, from, you know, books to online courses and things like that, and depending on where you are in your business, there’s something out there, which is the amazing thing right now, right? You know, in the beginning, it’s about really getting clear on your messaging. You know, I love the StoryBrand framework. And then, you know, as you kind of grow and scale, it’s making sure you have the processes in place, right, to really grow your business, and, you know, building a team, really being a leader and a visionary, and continuing to share your message. But knowing that every step of the way, you always get to choose. And I think that’s the beauty of it. Like, the business will probably take many different iterations, and your messaging, your niche may change, and that’s OK. Just have fun along the way.

Kevin Pho: And my final question: What’s your take-home message you want to leave with the KevinMD audience?

Cindy Tsai: Remember that you are enough right now, and you’re doing great. You know, really take time to acknowledge yourself, celebrate every win, and really believe in yourself and be your own best friend.

Kevin Pho: Thank you, Cindy. Thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

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