Dear medicine,

We need to take a break. I’ve finally realized that this relationship isn’t healthy for me—in fact, it’s borderline abusive. For a long time, I didn’t realize I was in an abusive relationship. We’re taught that it’s OK when patients curse at us, threaten us, and even sometimes physically assault us. Unfortunately, for many of us, medicine checks many of the boxes of abusive relationships.

Not realizing we’re in an abusive relationship — Check.

Normalizing unhealthy behaviors — You mean patients aren’t supposed to treat us disrespectfully?

Poor self-esteem — I believe “burnout” is the medical term for this.

Belief we can change our partner — We often think we can change the system initially.

Fear of leaving — Many people have said they wanted out of medicine but didn’t know what else they would do.

Financial dependence — We get comfortable with higher incomes and start racking up an expensive lifestyle that doesn’t allow us to take a pay cut.

Lack of support from friends and family — It’s hard for people who aren’t in medicine to truly understand what we go through on a daily basis.

I realize that not everyone has this type of relationship with medicine, and I’m thankful for that. Yet, this is how many of us feel across the nation. This is supposed to be where we can make a difference. It’s not supposed to be the place we go to become demoralized and lose our passion for helping others. HCAHPS and RVUs seem to be all that matters to our employers, and they are always telling us how we need to do better. It seems the mental health and satisfaction of health care providers take a backseat to just about everything else these days. Employers are constantly adding to our job responsibilities, oftentimes without any increase in compensation, which adds to the feelings of burnout that are ravaging health care today.

I spent my first 10 years in medicine as a hospitalist, which was initially enjoyable. But COVID really put a damper on enjoying the hospital lifestyle. Patients lost so much faith in clinicians during that time. Patients no longer trusted us when it came to treatments and vaccines. They would call and demand zinc and vitamin D, convinced vitamins would cure COVID. Many people weren’t able to get the care they needed during that time, as hospitals were stretched to the breaking point in many regions. We were keeping patients in the ER sometimes for days at a time, trying to get them to a higher level of care. At home, I was trying to keep my head above water with a 2-year-old son and newborn twin girls.

My hospital employer started cutting our hours if things were slow, which certainly adds to one’s stress level as you watch your income shrink. Then they outsourced our group to a staffing company, which resulted in over a 90 percent turnover in our very large group. If things were slow, I would get shipped to other hospitals where I had to learn a whole new list of patients in the middle of my workweek. It’s stressful not knowing where you’re going to be working from one day to the next. It was here that I realized I couldn’t keep dealing with this uncertainty on a daily basis. I started looking for other job opportunities in order to have more of a home life. I wound up spending the next 2 years in the wasteland that is known as primary care.

I had spent 12 years trying to make a difference, trying to help others. Yet, it became apparent during that time that I was just a number to my employers. None of them cared about me or my family. This burnout had impacted my home life in a major way. It caused marriage problems. It affected my relationship with my children; I was often exhausted both physically and emotionally when I got home and wasn’t the father I should have been. I usually had a short fuse by the time I got home and was quick to fly off the handle. I felt like work was getting the best of me, and my family just got the leftovers… which wasn’t pretty.

I needed to make a drastic change. Switching clinics or jobs didn’t seem like it would be enough. I decided to take a break from medicine and reevaluate if I really want to continue down this path. My goal is to be a better husband and father. I don’t want to miss school events and other important events due to work. It would be nice to actually stay home when I’m sick and not just don a mask and limp through a workday. I haven’t had sick days from any of my employers over the past 12 years.

My wife and I decided to take our three kids and spend a year traveling the world while we try to figure out what’s next. We would get to experience the world with our children in a way that few people do. The prospect of leaving medicine behind fills me with joy, which is something I haven’t felt in quite some time. I don’t know if I’ll ever go back to practicing clinical medicine, but if I do, my focus will be finding quality of life rather than salary. I don’t know what the future holds, but for the first time in a very long time, I’m actually hopeful about tomorrow.

My goal is to give hope to others out there who may be struggling with burnout and loss of purpose. I realize most people assume they could never do something like packing up and traveling the world for a year, yet that is just a limiting belief.

David Olson is a physician assistant.