Perhaps you are standing in the same place I once stood: From the outside, everything looks great, but on the inside, you’re running on fumes.

In my mid-40s, I was on the verge of becoming a full professor. Our dream house was under construction. My retirement plan was on track so I could stop working before 60. Our kids were grown and thriving, launching their own lives. On paper, life was perfect.

Inside, I wanted to disappear.

My work life had quietly started to crumble. Colleagues were leaving. Patients weren’t getting the care they needed. The institution I worked for was slow to respond, and the result was predictable: more work for those of us who stayed. I was going in before sunrise and leaving well after sunset, clinging to the only strategy I had ever known: Work harder.

For a while, that’s exactly what I did. Say yes to everything, carry more, be “resilient.” Eventually, it broke me. I was exhausted but couldn’t sleep. I stopped exercising. I lived on hospital food. Even the smallest decisions like what to make for dinner or which movie to watch felt overwhelming. I was so depleted by decision fatigue at work that I had no margin left for my own life.

There was no dramatic “aha” moment. No single sentinel event. I just became tired of being tired and started wondering, quietly at first, if there might be another way.

Being stuck and miserable is hard. Change is also hard. I had to choose my hard. I chose change.

Understanding the true nature of physician burnout

Burnout is not just feeling tired or having a rough month. It’s a chronic, occupational condition characterized by:

• Emotional exhaustion: Feeling drained, used up, and unable to recover between shifts.
• Depersonalization: Becoming cynical or detached from patients and colleagues, sometimes feeling like you’re just “going through the motions.”
• Diminished sense of accomplishment: No matter how hard you work, it never feels like enough.

If any of that resonates, you’re not alone. Research suggests that more than half of physicians experience at least one dimension of burnout at some point in their career. Burnout doesn’t mean you’re weak or inadequate; it’s often a predictable response to chronic overload, moral injury, and misalignment between your values and your work environment.

When I look back now, I can see all three dimensions clearly in my own story. I was emotionally exhausted. I snapped at people I cared about and felt like I had nothing left to give. I started to depersonalize. Patients became “tasks,” not people, and I hated that version of myself. I felt like a failure. Despite the promotions, the titles, and the nice CV, I felt like I was losing at the thing that mattered most: being the kind of doctor and human I wanted to be.

At the time, I thought the only options were to keep grinding or to leave medicine entirely. What I did not realize was that there was a third path.

How coaching entered the picture (and why I was skeptical)

Eventually, I reached a point where something had to give. I took some time off and decreased my FTE for a few months. It was terrifying on every level: financially, professionally, and personally. I had built my entire identity around being a “hard worker” and a “team player.” Stepping back felt like failure.

During that time, I decided, with a lot of skepticism, to hire a coach.

To be honest, coaching sounded a bit “made up” to me. I wasn’t looking for a motivational pep talk. I wanted practical help. I wanted a way out that didn’t require walking away from a profession I had poured decades of my life into.

But slowly, things started to shift. Coaching didn’t fix the health care system. It didn’t magically change my institution or make the EMR disappear. What it did do was help me change how I navigated all of it.

Coaching helped me see what I truly wanted instead of only doing what I thought I should do; notice what was actually going well and practice gratitude, even when work felt heavy; identify my strengths beyond “I take good care of patients”; and recognize that there isn’t just one way to use my medical training.

I began exploring other paths: medical writing, utilization management, nonclinical work. In that exploration, I learned something surprising about myself: I actually like seeing patients. I just don’t like seeing patients full-time in a way that erases the rest of my life.

Today, I still practice clinically, but I’ve redesigned my career. I have a supported teaching appointment in the medical school. I serve as a division director. I started my own business. I work less clinically but am actually more “productive” in ways that matter to me. I see my family, exercise, and even have space to explore new hobbies.

I am, ironically, “busier” than I was when I was burned out, but my life is far more sustainable, joyful, and aligned. Coaching didn’t just pull me out of burnout; the skills I learned have sustained me. My story is only one example of how coaching can help you stay in medicine without sacrificing yourself.

The power of coaching for physicians

At its core, coaching is a structured, confidential conversation focused on your goals and your well-being. A coach doesn’t tell you what to do. Instead, they listen deeply; ask strategic, often uncomfortable questions; challenge assumptions that may be keeping you stuck; help you clarify what you actually want; and support you in taking realistic, incremental steps.

For physicians, coaching can be particularly powerful because we are trained to push through discomfort, socialized to prioritize others’ needs above our own, accustomed to working within rigid systems and hierarchies, and not taught how to design careers (we’re taught how to realize short-term gains).

Coaching helps you reclaim a sense of agency in a system that often makes you feel powerless. It doesn’t erase systemic problems like staffing shortages, administrative burden, and payment models, but it does equip you with tools to set boundaries, communicate more effectively, navigate difficult dynamics with leadership and colleagues, and make intentional career decisions rather than reactive ones.

In my own journey, coaching shifted me from “I’m stuck and miserable” to “I have choices.” That mindset shift alone was life-changing.

Choosing the right coaching path

Not all coaching is the same, and not every physician needs the same kind of support. Here are some of the main coaching paths that can help you stay in medicine while making it sustainable.

1. Burnout coaching

Best for: Physicians who want to recalibrate within their current role or practice setting.

Burnout coaching focuses on identifying the specific drivers of your exhaustion (volume, EMR, culture, misalignment of values, etc.) and developing strategies to protect your energy:

• Setting boundaries around work hours and communication.
• Saying “no” (or “not now”) without guilt.
• Delegating tasks where possible.
• Reconnecting with what you actually like about medicine (and what you don’t).

When I was in the thick of burnout, I assumed the only solution was to leave my job or medicine altogether. Burnout coaching helped me see that I could start with small but meaningful adjustments: adjusting my FTE, reshaping my clinic template, changing how I approached my day, and being more intentional with my time and attention.

2. Career coaching versus nonclinical career courses

Best for: Physicians who suspect they may need a different role, whether inside or outside traditional clinical practice.

Some physicians discover that they still love medicine but not the job they’re currently in. Others realize it’s time to transition to something nonclinical. There are two complementary approaches here:

• Career coaching: Helps you clarify what you value most in your work, what kinds of roles align with your strengths, and what you want your life outside of work to look like. It supports you through exploring possibilities, crafting a realistic transition plan, and tackling the fears and identity questions that come with changing direction.
• Nonclinical career courses: Provide structured education about possible new paths, such as pharmaceutical or biotech roles; utilization management; medical writing and editing; informatics and digital health; and administration, quality, and operations. Often self-paced and informational, they broaden your view of what’s possible.

Many physicians benefit from combining both: using courses to learn about new fields and coaching to translate that knowledge into a personalized step-by-step plan.

3. Leadership coaching

Best for: Academic physicians, division chiefs, medical directors, and anyone stepping into formal or informal leadership roles.

Many of us step into leadership roles with little to no formal training. We go from “good clinician” to “department chair” or “medical director” almost overnight, often without leadership skills, mentorship on navigating politics and culture, or tools for leading teams in a sustainable way.

Leadership coaching can help you develop core leadership skills (communication, conflict management, strategic thinking); align your leadership style with your values; manage the stress that comes with being “in the middle” between frontline clinicians and institutional leadership; and recognize that your well-being is a leadership competency (burned-out leaders cannot sustainably support their teams).

I didn’t initially see myself as a “leader.” Coaching helped me recognize that I had been leading all along at the bedside, in committee work, and in informal mentoring. Today, leadership is a core, energizing part of my hybrid career rather than a drain.

4. Sustainable practice coaching

Best for: Physicians who genuinely love patient care but don’t want it to keep hurting.

Sustainable practice coaching focuses on designing a hybrid career that balances clinical work with other fulfilling roles like teaching, research, administration, writing, consulting, or entrepreneurship.

Key elements include clarifying how much clinical work is actually sustainable for you and what mix of activities (clinical and nonclinical) feels energizing; redesigning your schedule and responsibilities to match your capacity; improving workflow efficiency so that clinical days are less draining; and building complementary roles that use your strengths in different ways.

Coaching helped me see that I didn’t have to choose between “all clinical, all the time” and “leave medicine.” I could create a portfolio career that includes clinical practice, teaching, leadership, and my own business, on terms that protect my health and my family.

Strategies for sustainable medicine (beyond coaching)

Coaching is powerful, but it works best when it’s paired with practical changes. In my own journey and in my work with physicians, these strategies consistently help:

• Set boundaries around work hours and communication: Protect specific times for rest and family. Reduce after-hours charting as much as possible. Experiment with “no-clinic” days or half-days for focused work.
• Delegate and build teamwork: Use scribes, medical assistants, and collaborative workflows where available. Ask, “Am I the only person who can do this task?” If not, consider who else can help.
• Tame the technology: The EMR and email can easily expand to fill all available time. Try batching messages, using templates and smart phrases, and setting specific times to check email rather than grazing all day.
• Explore hybrid roles: Look for opportunities to mix patient care with other interests (teaching, QI projects, research, informatics, writing, or administrative work). Your value to your organization and to yourself is not limited to RVUs.
• Cultivate gratitude and self-awareness: This is not about “toxic positivity.” It’s about seeing the full picture. Coaching helped me notice the parts of my life that were already rich: my family, my relationships, my strengths. That perspective didn’t erase the problems, but it gave me more resilience to face them.

Steps to design your own sustainable path

If you’re reading this and thinking, “That sounds great, but I don’t know where to start,” here’s a simple framework you can use.

Reflect on the sources of your distress. Is it volume? Lack of autonomy? Misaligned values? Moral injury? Toxic culture? Naming the problem is the first step toward addressing it. For me, the combination of unsustainable workload and feeling powerless was at the core.

Clarify what you want more of (and less of). Instead of just asking, “What do I need to escape?” try asking: What parts of my work give me energy? What parts absolutely drain me? How do I want my life to feel outside of work?

Learn about coaching options. Explore one-on-one and group coaching. Consider whether burnout, career, leadership, or sustainable practice coaching best matches your current needs. If it feels strange or “indulgent,” know that I felt that way too. It turned out to be one of the best professional investments I’ve ever made.

Explore educational resources. If you’re curious about nonclinical or hybrid roles, consider courses, webinars, or workshops that outline different paths. This can help you move from “I’m stuck” to “I have a menu of options.”

Build peer support. Connect with colleagues who are also trying to design sustainable practices. It’s easier not to slip back into old patterns when you’re not doing this work alone. In my case, talking openly with a few trusted colleagues was incredibly validating.

Take incremental action. You don’t have to blow up your life to start healing. Consider reducing your FTE, even slightly; blocking one half-day a week with no clinic; saying no to one additional committee or task; or exploring one new role or project on a small scale. Experiment, adjust, and iterate. Sustainability is a process, not a single decision.

Bringing it all together

Coaching empowered me to stay in medicine, on my own terms.

I went from wanting to disappear, dragging myself to work before sunrise and leaving after sunset, and questioning my worth and my options, to practicing in a way that aligns with my values and capacity, holding a supported teaching role, serving as a division director, running my own business, being present with my family, moving my body, and rediscovering hobbies I had long abandoned.

I’m still in medicine. I still care deeply about patients and about our profession. The difference is that I’m no longer sacrificing myself to stay.

If any part of my story sounds familiar, I want you to know this: You are not alone. You are not broken. There are more options than “stay and suffer” or “leave altogether.” With evidence-based coaching, practical strategies, and a willingness to rethink what a physician career can look like, you can design a sustainable path that honors both your commitment to patients and your commitment to yourself.

If you’d like, I can help you think through what your first small step might be, whether that’s exploring coaching, adjusting your schedule, or simply naming what’s not working. You don’t have to figure this out alone.

Ben Reinking is a board-certified pediatric cardiologist, medical educator, and certified physician development coach, as well as the owner of The Developing Doctor. He can also be reached on Instagram.

He’s not just any coach—he’s a practicing physician who truly understands the realities of modern medicine. He knows firsthand the internal battles you’re facing, from short-staffing and limited resources to production metrics, constant billing pressures, and the ways your altruism can be taken advantage of. Ben is here to help you reignite the passion that first led you to medicine and provide you with the strategies needed to regain control.