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Thriving through transitions: lessons from a hospitalist’s journey

Miguel Villagra, MD
Physician
August 10, 2023
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We all know that life is in transition, and we all go through different changes during our careers, from personal to professional growth. We all strive for a reasonable life-work balance.

Early in my career, after completing my residency training, I was discouraged by many of my mentors from pursuing a hospitalist career. The common agreement at the time was that hospital medicine was the recipe for burnout, and a fellowship offered me a path to a more sustainable career in medicine. I want to point out that the advice was a fallacy considering burnout is spread among any specialty or subspecialty in medicine.

Regardless of that advice, I persisted and became a hospitalist. I enjoyed my work and, to some extent, the schedule; however, shortly after joining my team, I realized the innumerable challenges within our practice, from a lack of EMR customization to a lack of administrative support. Despite all that, I improved my career to the extent that I was offered the position of medical director. I started my administrative journey and thought I could try to lead a change within our group. Indeed, a lot of positive changes were accomplished, from successful recruitment to a more stable and flexible schedule; however, I started to experience (what started earlier but was ignored) symptoms of burnout that, for me, manifested as increasing fatigue and irritability, emotional exhaustion, and feeling disconnected from the rest of my team. My approach at the time was to double down on my leadership journey and complete a certification as a physician executive. I was making great connections and positive change now at the organization (health care system) level. However, I continued to clearly experience conflict, from my “work accomplishments” to my “awful burnout symptoms.” This directly affected my personal and family lives, as I felt I wasn’t spending enough time with them. This is called cognitive dissonance, discomfort that arises from holding conflicting beliefs or values. In my case, I was torn between the satisfaction of my work accomplishments and the toll that burnout was taking on my personal life.

At the time, the best solution I pursued was to get to another position with more administrative time; however, the challenges grew exponentially and my quality of life (physically and mentally) declined. I wasn’t more stable or happy (as I was expecting), but I was growing more frustrated and having increasing doubts about my purpose. This is called the arrival fallacy, a phenomenon where individuals believe that reaching a certain goal or milestone will bring complete happiness and satisfaction. However, once that goal is achieved, they realize it did not bring the expected fulfillment.

I decided to take a step back and reflect on my situation. I realized that I needed to prioritize my well-being and make changes to avoid further burnout. I started by implementing self-care practices such as exercise, meditation, and spending quality time with my loved ones. I also focused on organizing my finances through budgeting to become more literate about investing. After all, I quit my directorship journey and started a new path. However, during that time, I experienced increasing self-doubt and a feeling of inadequacy and failure. This is called the impostor syndrome, a phenomenon where individuals doubt their accomplishments and fear being exposed as “frauds.” However, I pushed through those doubts and explored different career options.

I began exploring other career options within medicine that would allow me to have a better work-life balance and a more flexible schedule. I also researched telemedicine opportunities, and gradually I was able to find a better alignment between my work and personal life. During my journey, I also sought support from colleagues, friends, and mentors who had experienced burnout themselves. I also found the help of a coach invaluable in helping me navigate through this challenging time.

As I continued to make changes and prioritize my well-being, I started to notice a positive shift in my overall happiness and satisfaction. I felt more fulfilled both personally and professionally. As I continued on this new path, I also focused on setting boundaries and advocating for myself. I learned to say no to an excessive workload and delegate tasks when necessary. Additionally, I started to grow my network with physicians and non-physicians who were thriving inside and outside of medicine. I decided to become a certified coach and create a coaching program for physicians experiencing burnout or pursuing career transitions inside and outside medicine.

Here are the main lessons learned from my journey:

It took me too long to seek help (at the time, I thought this was nonexistent). My message to anyone: It’s not OK to not get any help if you are struggling. Look for a mentor or coach and build a supportive community.

I wish I had had a more structured path during these career changes. You learn from experience, and that is why I designed my Coaching program to help other health care providers.

You can bring joy and happiness into your life now. You don’t have to wait for any change to happen. Try to avoid letting your circumstances control your life. Take care of your mind and body, and strive for self-improvement every day. Remember, happiness is a choice.

There is power in building a community. Surround yourself with colleagues, friends, or anyone who shares your values and challenges and supports you at the same time.

Besides the typical medicine-related meetings, attend events outside of medicine. There are a wide variety of career paths for physicians. We have the toolkit to be successful in any new venture inside and outside of medicine with the right mindset and support.

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Focus on process improvement instead of only setting goals. Focus on the parts of the journey you can control (your thoughts, emotions, and choices); the rest is just noise. Remember, the quality of your decisions will determine the quality of your life.

I strongly believe in building sustainable routines that we can implement for long-term growth and success.

Miguel Villagra is a hospitalist.

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  • Most Popular

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