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Join us as preventive medicine physician Sylvie Stacy shares insights on why physicians often feel stuck in the relentless pursuit of success and what we can do about it. We’ll delve into the impact of the rat race on physician well-being and discuss strategies for redefining success, setting boundaries, and embracing unconventional career paths to find fulfillment outside the traditional medical setting.

Sylvie Stacy is a preventive medicine physician.

She discusses the KevinMD article, “How to escape the ‘rat race’ in your medical career.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and click the CME link in the show notes to get CME for this episode. Today we welcome Sylvie Stacy. She’s a preventive medicine physician. Today’s KevinMD article is “How to escape the ‘rat race’ in your medical career.” Sylvie, welcome to the show.

Sylvie Stacy: Thank you for having me, Kevin.

Kevin Pho: So let’s start by briefly sharing your story and journey.

Sylvie Stacy: All right. So my path in medicine has been somewhat unconventional from the time that I started medical school. Even as a first year medical student, I pretty quickly realized that seeing and treating patients all day every day probably wasn’t for me. And as I made my way through the different rotations and services in my training, it seemed like no matter what the specialty area was or what the disease area was, that environment wasn’t where I thrived.

And that of course was a pretty uncomfortable realization for me, having just started medical school after thinking for years and years that I wanted to be a doctor. And most people’s ideas of what a doctor does, and where they work day in and day out, suddenly didn’t align with what I thought would make me happy.

But I ended up finding a specialty area that was of interest to me, and that was the relatively small field of preventive medicine, and that’s where I ended up doing my residency. And what appealed to me about it wasn’t just treating individuals with clinical preventive services, but also about creating a broader impact on the population and community that we’re practicing in. So I really enjoyed that aspect of it.

And that path led me to my first job out of residency, that was in correctional medicine, which is health care in jails and prisons and other carceral settings. And that’s actually been my main job for nearly a decade now, working in correctional facilities.

I’ve done both clinical and non-clinical work. On the clinical side, direct patient care of incarcerated people. And then on the non-clinical side, more of the administrative aspects that come with providing those services, like utilization management and writing policies and procedures, and even some business development for the companies that I work for.

And then alongside my primary job I’ve also taken a few clinical moonlighting jobs and some non-clinical consulting type work and side gigs. And throughout all of this have come increasingly impressed by and passionate about all of the varied ways that we can use our medical degrees. There really is so much that you can do with a medical degree. There are health care and medical services needed in so many settings, by so many different populations.

So that has become a passion of mine, just learning more about that. And then that progressed to writing about it, speaking about it, and then more recently writing a couple of books about career options for physicians.

Kevin Pho: All right. Your KevinMD article is titled “How to escape the ‘rat race’ in your medical career,” and we’re going to talk more about these unconventional pathways. But for those who didn’t get a chance to read your article, tell us what it’s about.

Sylvie Stacy: Yeah. So the experiences of my own that I just spoke about, coupled with a lot of interactions with peers and colleagues, opened my eyes to a few broader issues within our profession. And one that you and probably all of your listeners have heard and read quite a bit about in recent years is burnout of physicians.

And I know there’s been a number of articles on KevinMD about burnout and what we can do about it. It’s gotten a great deal of attention within the medical community and the broader community in the popular media. And burnout is of course a very concerning issue, I feel like it’s an important issue.

But there’s something else that I have come across a lot in my conversations with my colleagues and fellow physicians, and that is this concept of feeling like we’re in a rat race in our careers. And I think that it’s worth kind of distinguishing between what is burnout and what is feeling like you’re in a rat race, because they really are two different things.

So professional burnout is more of a psychological syndrome that emerges after a really prolonged response to chronic stressors on the job. And it leads to depersonalization, a lack of empathy, cynicism toward both our patients and our colleagues, and just a reduced sense of personal accomplishment, that can really wear away at you over time.

But then the term rat race is more of a colloquial term that describes this struggle to get ahead, either financially or professionally. And it leads to this constant, stressful, kind of aggressive pursuit of whatever our goals are related to status or professional power or wealth. And that just leads us to feeling trapped in this sort of relentless cycle with little satisfaction, or little light at the end of the tunnel.

So I was surprised when I started writing about this topic of professional satisfaction, just how often I heard physicians use the term rat race. Because I had heard so much about burnout, but not so much about this mindset of feeling like we’re on this constant cycle or struggle toward meeting our professional goals.

And so this article that I wrote is about how we can avoid this mindset of feeling like we’re in a rat race in our careers. So I talk about a few different ways that you can approach your career and your professional work to try to avoid it, or to try to nip it in the bud if it’s taking place.

So some of those are making sure that you continuously are addressing what you feel is success to yourself. What feels like success now might not feel like success five years from now, so it’s worth kind of redefining for yourself what you mean by success in your professional life.

And then there’s setting boundaries for yourself in your work and in your relationships. There’s finding a supportive community, advocating for change. A lot of these are similar to ways that you would address symptoms of burnout as well.

But then one that I talk more deeply about is combating the rat race mentality by considering an aspect of unconventionality to your career. Whether that is changing your job entirely and getting new employment or partnership in a practice in a less conventional setting, or with a less conventional patient population that you haven’t worked with, or doing something on the side that’s less conventional in nature.

And by unconventional I mean not your typical full-time employment at an academic or community hospital, or a traditional private practice that does primary care, or a conventional specialty practice, but something a little out of the ordinary.

For me it’s been working in prisons and jails. It’s been being the medical director of a methadone clinic, with methadone being one of the most highly regulated drugs that is available for us to treat our patients. And that aspect of having to deal with all of the regulation, with that discrete patient population of those who are struggling with addictions, has been just a great mix of something new and different for me that keeps me passionate and interested in progressing my career, rather than feeling like I’m spinning my wheels day in and day out.

So I talk quite a bit about these different types of unconventional aspects that you can put on your career, whether it’s making a full transition or just adding something as a moonlighting opportunity or a side gig.

Kevin Pho: So give us an example scenario or story of a physician that you feel is trapped in that rat race mentality. What exactly would that look like, for those who may be outside of the medical field listening to this?

Sylvie Stacy: Yeah, most of the situations that I’ve come across, they’re physicians who have gone through the traditional path of going to medical school, pursuing one of the main specialties that we’re exposed to in medical school, like surgery or internal medicine or family medicine. And then right out of residency getting a full-time job, either employed through a health care system or as a partner in a practice, in which they’re seeing a full panel of patients day in and day out.

And they’re dealing with some of the common stressors that physicians have in medicine, like denials from insurance companies, and maybe technology issues with their EHR, and sometimes in the larger organizations dealing with the bureaucracy and administration who maybe does not have a medical background.

So they’re in these positions where there are high expectations to see a lot of patients very quickly, and also follow the rules of the organization, and maybe do so without all of the resources and without all of the support staff that they would hope to have. That tends to be a typical scenario of someone who ends up feeling like they’re in the rat race mindset.

Kevin Pho: So you mentioned that one of the ways to get out of that rat race mindset is to maybe do something outside of what they do clinically, like you, as correctional medicine or being the medical director of a methadone clinic. How can a physician make that transition? Because a lot of doctors, and kind of outside of my world, because I talk to a lot of physicians who have that similar mindset that you do, but for the majority of physicians, doing what they do clinically is the only thing they know how to do, and they’ve gone through medical school and residency only doing that one thing. How can they find those other passions, or how can they find those other unconventional pathways to escape that rat race?

Sylvie Stacy: Yeah, I think that one of the main things that keeps physicians in their current position and leads them toward having symptoms of burnout is that they don’t realize that they are fully equipped to do so much else with their medical degree and with their skill set and with their experience. I think we have the tendency to feel like what we’ve always been doing is the only thing that we’re prepared to do moving forward.

And many physicians, even though they may be interested in a change of job, or they may be interested in earning some supplemental income on the side, they feel like, well, I don’t have the skills to do that, I don’t have the skills to, say, transition to working in the pharmaceutical industry, or I don’t have any experience doing utilization management so I could never get a job doing chart reviews.

But I think all of that really is a misconception. I think in general physicians have a way broader skill set than we are willing to admit to. And even though you may have had your whole career so far in one specific setting just doing clinical work, that has certainly included a lot of tasks and responsibilities that help equip you for some other type of work, whether it’s clinical or non-clinical.

So I think the big first step is to consider your experience more broadly. Like, really sit down with your CV and your resume and flesh out what your broad set of skills actually are, because I promise you it’s more than just patient care in your specific medical specialty. You have a broad set of skills and the credentials to go with them.

And then once you have acknowledged that, I think the second most important step is to really get out there and explore what the different opportunities are. Another thing that holds back physicians from doing something unconventional with their career is just general lack of awareness of the different jobs that are available, and organizations that are hiring physicians, and the type of compensation that you can expect from those.

So really just exploring your options, looking at job descriptions, talking to colleagues that work in unconventional settings and hearing about their experience, all that can be really helpful. And that was a lot of my motivation for writing my recent book, which is all about unconventional clinical career options for physicians. I wanted to have more of a one-stop shop where physicians can see kind of an apples to apples comparison of all of these different routes that we can take our careers.

Kevin Pho: So you work in correctional medicine and you’re the medical director, as you said, of a methadone clinic. What are some other examples of common unconventional pathways that you see physicians pursuing?

Sylvie Stacy: Yeah, so a methadone clinic is just one example of an organization that is required to have a medical director, with others being a hospice agency, or a long-term care facility, a plasma donation center, certain types of therapy and counseling organizations need to have a medical director. So there are a lot of these opportunities for very part-time work in which you’re overseeing the services and clinical work of a team of clinicians.

And I think that can be a really rewarding way to use our body of knowledge as a physician, in a way that is not too stressful. It often doesn’t take up a lot of time, so it can be done on the side of a regular job, and they tend to be compensated pretty well. And it’s really an interesting way to use what you’ve learned in your direct patient care practice and apply it to something a little bit different, in which you may have a little bit of a less direct involvement. So medical directorships are a great one.

There are also more and more settings in which patients need to be seen outside of traditional hospitals and outpatient practices. So correctional facilities are just one example that I’ve already mentioned, but then there are home visit programs in which physicians go directly to patients’ homes. We’re seeing more and more mobile medical clinics, in which medical vans are able to go out and see patients in communities that may be more remote, or in which it’s harder for patients to seek care in a regular health care delivery setting.

And not just patient care settings, but other aspects that can make a practice unconventional might be the specific clinical niche that a practice is focused on, or the payment model that it uses. So there are a lot of subscription-based medical services or concierge type practices that are doing away with the regular insurance reimbursement in order to try to make things more efficient and allow their physicians to focus more on patient care.

So sometimes just seeking out a job in which the business model itself is a little bit different than what you’re used to, that can be that aspect of unconventionality to get you out of that rat race mindset.

Kevin Pho: Now, how can one go about finding opportunities perhaps outside of something that they’ve been doing all their lives?

Sylvie Stacy: So as I said, first learning about what the different opportunities are is key, because then you can sort of match those up with what might be a good fit for your own personality and your own career goals.

And then once you’ve done that, I think the two biggest ways are networking and publicly posted jobs. In the past I feel like physicians were always taught, networking is the only way you’re going to find a good job, network, network, network. And although that is still really important, there are so many jobs that are publicly listed on the internet, on job boards, these days, that even just perusing those you’re likely to come across something that is of interest to you.

So I think LinkedIn is a great resource, both for networking and for looking for job postings. And then the big job aggregators that are online, like indeed.com, are great resources as well.

So just setting aside some time once a week to do a search for the types of jobs that are of interest to you, you’re bound to come across something at some point. That even if that particular job isn’t the right fit for you, just reading through a job posting will help make you aware of the types of positions that physicians are being hired for, so that you can keep an eye out for something else, or that you can go out and talk to your colleagues and network about.

Kevin Pho: We’re talking to Sylvie Stacy. She’s a preventive medicine physician. Today’s KevinMD article is “How to escape the ‘rat race’ in your medical career.” Sylvie, we’ll end with some of your take-home messages to the KevinMD audience.

Sylvie Stacy: So I guess I’d first like to acknowledge that being a doctor is inherently stressful, and the demands of patient care combined with all of the administrative and bureaucratic and other challenges that come with it, they can make our profession really taxing.

But I would encourage everyone to really recognize that there’s so much that you can do with your medical degree and the training and certification that you’ve gotten out of that. So don’t feel locked into having a traditional path, without realizing the full breadth of opportunities that can really align with what your interests and your aspirations are.

So I want to encourage everyone who’s listening to step beyond whatever you’ve been taught the traditional boundaries of a path in medicine are, and find other ways to use your degree, to pique your interest, and learn about how you can help patients either indirectly or directly with all of your credentials.

Kevin Pho: Sylvie, thank you so much for coming on the show and sharing your perspective and insight.

Sylvie Stacy: Thank you for having me.