I'm not sure where the best place to post this is, but this looked as good a place as any and while anonymity is probably not necessary, it is comforting.
Every now and then, I have fantasies about leaving clinical medicine. My sticking point is that I don't really know what I'd do instead. And to be honest, I don't inherently dislike what I do, there are just parts of it that are difficult and frustrating and leave me burnt out far too often.
My department is understaffed and access is terrible. This is not for the lack of trying to recruit new docs. We're trying like crazy and we're a good place to work, there just aren't enough of us to go around. Consequently, I am in a situation where I can't even get established patients in for follow up any sooner than three months. This leads to a lot of frustrated patients and a lot of managing things over the phone that would be better managed face to face. Of course, we don't get paid for managing things over the phone and the whole reimbursement scheme is set up to favor the things that aren't actually what the department really needs, which is frustrating. So I can't see enough patients. I can't see them frequently enough. When I can see them, they often can't afford what I'm recommending whether it be a certain medication or course of therapy. Oftentimes, they have insurance that does cover these services, but the co-pays are prohibitive. I don't see it getting better. And I honestly think I work at a really good place and that it wouldn't be better anywhere else. While some of our policies are frustrating, I know that my employer needs to respond to the same systemic pressures and do what it needs to do in order to survive.
So I fantasize about leaving clinical medicine. I just don't know what I would do instead provide me a similar income (I still have loans) and be any more satisfying. But lately, I've been wondering about working at some sort of health policy level analyzing and devising remedies for the systemic pressures that are giving rise to my escapist fantasies. There must be people who do this. Who are they? What is their training? Are there jobs available doing this? How does one find out about them? And do they pay a more or less equivalent salary to what I am making now as an attending in a non-procedurally oriented outpatient specialty?
