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We sit down with anesthesiologist Kolleen Dougherty as she reflects on her experience of career burnout after two decades at a Level 1 hospital. Kolleen shares the internal struggles that kept her in a job that no longer brought her joy and how fear, loyalty, and the “sunk cost fallacy” contributed to her staying longer than she should have. She opens up about her journey to making the difficult decision to leave and the relief that followed.

Kolleen Dougherty is an anesthesiologist.

She discusses the KevinMD article, “Why this doctor stayed stuck in a job for years and how she finally broke free.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Kolleen Dougherty. She’s an anesthesia and critical care physician. Today’s KevinMD article is “Why This Doctor Stayed Stuck in a Job for Years and How She Finally Broke Free.” Kolleen, welcome to the show.

Kolleen Dougherty: Thank you so much, Kevin, for having me. I’m really excited to be here.

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

Kolleen Dougherty: Sure. So, I was born and raised in New Jersey, and ever since I was a little girl, I knew I wanted to be a physician. I then journeyed down to Atlanta, Georgia, to Emory University, where I went to college, and came back up north to Columbia College of Physicians and Surgeons in New York City, where I received my medical degree and stayed for my internship. Then I did my anesthesia and ICU training in Boston, both at Massachusetts General Hospital for my fellowship and at Brigham and Women’s for my anesthesia residency. Thanks to my husband, who always vacationed in Maine, we decided to move up to Maine, and I’ve been here ever since.

Kevin Pho: All right, wonderful. Let’s talk about your KevinMD article, “Why This Doctor Stayed Stuck in a Job for Years, and How She Finally Broke Free.” So, before talking about the article, what led you to write it in the first place?

Kolleen Dougherty: Well, I left my clinical job, which I was at for over 24 years, a little over a year ago now. In that intervening time, the past year, I’ve had a lot of time to catch up on my sleep, which has been magnificent—I can’t oversell that. But also, I’ve had a lot of time to think about why I stayed in my job a lot longer than I knew I should have. Leaving was one of the best decisions I ever made; I consider it right up there with deciding where to do my training, marrying my wonderful husband, and having my kids. It’s one of the best decisions, but I realized I should have made that decision probably about two to three years earlier than I did. So I really started wondering, why did I stay? Why didn’t I leave when I felt like I should have? It boiled down to what I consider three major reasons.

One was the psychological trap popularized by Richard Thaler: the sunk cost fallacy, which affects all of us in different ways. For me, I think the biggest example is staying in a job I knew I should have left, but it could be why you keep reading a book even when you don’t like it, or you go to a movie, pay for your ticket, and stay to the end even though you don’t enjoy it. That was one big reason—I felt like I had dedicated 24 years of my life to this practice, creating great relationships and building my professional reputation. I thought, “Wow, it’ll take me another 24 years to get to the same place elsewhere. I’m finally higher on the seniority list and can pick better vacation times. Why leave?” It was all those sunk cost fallacies that kept me there.

Kolleen Dougherty: Another major reason was fear—the fear of the unknown, fear of change. There’s that expression, “The devil you know is better than the devil you don’t.” I felt maybe this was as good as it would get, so I stayed because I was afraid. The third reason was loyalty. I had spent 24 years with these partners and colleagues, who in many ways became my second family. We spent holidays together, celebrated milestones, and supported each other through life events. I felt guilty about leaving them behind. So, for these reasons, I stayed longer than I should have. I wrote the article to shed light on this and hopefully give people who might be pondering the same decision some things to think about.

Kevin Pho: You mentioned earlier that you always dreamed of being a physician. Tell us what your job was like and some of the pressures that led you away from clinical medicine.

Kolleen Dougherty: When I started with my group, I was the 24th physician. Over two decades, our group grew to 80 physicians. That collegial camaraderie we shared initially was hard to maintain with so many people. I felt like just a number in a system, and I faced the same pressures affecting medicine now: productivity demands, the treadmill feeling, and not having enough time with patients. I felt it was time to step back and reevaluate the next stage of my career. The schedule was also tough. With 80 people, you’d think switching calls would be easy, but subspecialization and credentialing made it hard to balance work with other priorities in my life. So, for these reasons, I felt I needed to move on.

Kevin Pho: Were there other clinical options—other jobs or part-time work—before you decided to leave clinical medicine entirely?

Kolleen Dougherty: Honestly, there were some opportunities to scale back, but I felt the hospital system and group environment had changed so much that I wanted to start over.

Kevin Pho: You mentioned three factors that kept you at your job longer than you should have. How did you navigate those feelings? Was there a final event that made you decide to leave?

Kolleen Dougherty: I did a lot of self-reflection and joined some coaching programs. For example, Empowering Women Physicians, a group run by Sunny Smith, a family medicine physician in San Diego, was helpful. It was a lot of internal thought work about the direction I wanted for my life. I have four children, three in college, and one still in high school who will hopefully start college next year. I felt now was a good time to consider the next chapter of my life. I wanted to explore new opportunities in clinical medicine and outside of medicine.

Kevin Pho: Now that you’ve made your decision, any regrets?

Kolleen Dougherty: No, no regrets whatsoever. I’m not going to lie; the first few months were challenging—waking up and wondering, “What do I do today?” As an anesthesiologist, I had a strict schedule, often starting work at 6:30 a.m. There’s a sense of accomplishment in having taken care of patients by 10 a.m., while the rest of the world is just starting their day. It was challenging to navigate the next steps, but it was also a needed time to sit back, start enjoying life, and think about what I want to accomplish next.

Kevin Pho: Reflecting on this journey, is there anything you would have done differently?

Kolleen Dougherty: I think it would have helped to figure out why I stayed sooner and whether those reasons were truly valid or just limiting beliefs. Our primitive brain tries to keep us safe and avoid risk, but staying was partly based on fear and limiting beliefs. Now that I’ve moved forward, I see so many opportunities I didn’t know existed. I’ve reconnected with past friends from medical school, residency, and fellowship, and with residents I trained in anesthesia, ICU, and even surgical and ED settings. I helped train hundreds of residents over the last 24 years, and reconnecting with them has been exciting and eye-opening.

Kevin Pho: What reactions have you received from colleagues and others you’ve reconnected with?

Kolleen Dougherty: Some say they wish they could do what I did. I’m fortunate to be able to walk away from my job financially; not everyone has that option. I worked full-time for 24 years, and my husband also works, so we could afford for me to take this time. I know not everyone has that financial stability, which is a big reason people stay in their jobs. Many people want to find something different but aren’t sure how to start, especially if they’re financially dependent on their current job. I think taking time for self-reflection is crucial, though, and it was essential to my journey.

Kevin Pho: What advice would you give to those who wish they could do what you did? You mentioned reflection—can you expand on what that involves?

Kolleen Dougherty: Great question. For me, reflection meant thinking about values and the legacy I want to leave. It’s easy to go through day-to-day life focused on the immediate, without thinking long-term. That’s what I did for 24 years. I’m proud of the work I did and the patients I cared for, but it’s easy to get into a routine. Suddenly, years pass, and you haven’t achieved other things you want to. It’s important to think about what you want to accomplish, as we don’t know how long we have. Waiting for change isn’t always the best plan, and things may not improve in a timeframe that works for you. Taking ownership of your goals and values is important.

Kevin Pho: Do you think you might return to clinical medicine?

Kolleen Dougherty: As much as I’ve enjoyed the past year off, Kevin, I do miss taking care of patients. I miss helping people at vulnerable moments. Some think anesthesiologists don’t want to interact with patients, but we often meet them at one of the most stressful times in their lives. I miss that connection. I do plan to return, but not to a full-time role with all the on-call demands. I’m exploring per diem and locum opportunities to balance my schedule and family life, while also getting that patient care connection. But I’m not interested in hospital politics or meetings about generating revenue in anesthesia—that’s not my priority.

Kevin Pho: We’re talking to Kolleen Dougherty, an anesthesia and critical care physician. Today’s KevinMD article is “Why This Doctor Stayed Stuck in a Job for Years and How She Finally Broke Free.” Kolleen, let’s end with some of your take-home messages for the KevinMD audience.

Kolleen Dougherty: One of the biggest take-homes is that change is hard. Our brains want to keep us safe, so they often come up with reasons not to leave. Look deeply into those reasons—are they true reasons to stay or just barriers you can work around? Another point is that indecision is a decision. For a long time, I questioned whether to leave but didn’t answer it. Putting it off felt easier, but that was essentially a decision to stay. If you want to leave, figure out why and take steps toward the life you want.

Kevin Pho: Kolleen, thank you so much for sharing your story, time, and insight. Thanks again for coming on the show.

Kolleen Dougherty: Thanks for having me, Kevin. I really appreciate it.