Rediscovering Passion

[Bougiebuster]

4 years out from training at a county program now working at a fancy community ER. Pod system, doc vs charts. Feeling isolated and miss the camaraderie of residency and the mission of a county hospital but current shop with great setup/support/pay.
Work is sucking my soul. Have little to no passion left for work and almost no empathy for patients anymore.
I imagine it's a combination of work environment, COVID, patient entitlement, the "just go to the ER" from every other specialty, ever increasing mental health patients I'm unqualified to care for on their day 4 hold, satisfaction BS, and putting out NP fires daily (BS go to ER immediately and calling consultants and knowing more than the NP answering on the other end).
Trying to get away from the work is my life mindframe that was hammered into you all medical training. Trying to find hobbies/side passions. Any help from the hive? Any suggestions?

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[RustedFox]

What do you mean when you write: "docs vs charts" ?

 

[Groove]

How many hours are you working? PPH at current gig?

If it's not a work load issue, then just find some hobbies. Also, take enough vacations. I go to the Caribbean once a year, take 2-3 ski trips and several weekender road trips to a nearby cabin with gf and our dogs each year. The decompression really helps long term.

While I do agree that the camaraderie of a busier place with dual coverage and physician overlap is fun, it can also backfire and you can easily get stuck in a group of sourpusses or crotchety old docs that expect you to work all the nights and don't want to talk to you anyway. If you have a lot of other things going for you in a single coverage shop, I don't think I'd wreck the boat for something as small as dual coverage. Also, even with dual/triple coverage, if it's pod based, a lot of times you're still stuck in your pod alone though I guess you can always walk over and talk with the other docs. I'm a little lucky in that I get to work in both environments + residents. The variety is def nice.

That being said, I think we're all chapped post COVID working in our current environments to some degree.

 

[RustedFox]

How many hours are you working? PPH at current gig?

If it's not a work load issue, then just find some hobbies. Also, take enough vacations. I go to the Caribbean once a year, take 2-3 ski trips and several weekender road trips to a nearby cabin with gf and our dogs each year. The decompression really helps long term.

While I do agree that the camaraderie of a busier place with dual coverage and physician overlap is fun, it can also backfire and you can easily get stuck in a group of sourpusses or crotchety old docs that expect you to work all the nights and don't want to talk to you anyway. If you have a lot of other things going for you in a single coverage shop, I don't think I'd wreck the boat for something as small as dual coverage. Also, even with dual/triple coverage, if it's pod based, a lot of times you're still stuck in your pod alone though I guess you can always walk over and talk with the other docs. I'm a little lucky in that I get to work in both environments + residents. The variety is def nice.

That being said, I think we're all chapped post COVID working in our current environments to some degree.

Where do you take your ski trips?

 

[Groove]

Where do you take your ski trips?

Mainly CO. Breck is my fav. I get an Epic Pass every year. I usually take a single trip with my gf and then a couple by myself. 7-14 days at a time. It’s my happy place. $$$ adds up but I still think it’s worth it for the decompress and thrills.

I like Heavenly and Tahoe area the best but it’s a longer trip and CO is a short direct flight from where I’m at. The view from top of Heavenly is incredible.

 

[Kryptocoin]

Unfortunately your issue is a common sentiment amongst your fellow ER colleagues. We are 1# for burnout. Happiness is a fleeting emotion that should not be chased else you'll forever be chasing it. Instead seek contentment and be goal-oriented. Set goals for yourself----5 yr, 10 yr, 20 yr ect--and then work towards it.

My goals so far:
5 yr: FatFire
10yr: Move abroad and chill
20yr: TBD

Having these goals makes going to work tolerable and helps deal with all the BS. Every now and then I get some innate satisfaction from saving a life at work. That feeling is infrequent. For most part, work is work and I get a paycheck that aids towards my goal.

Other ideas:
Travel: See the world while you're young and still able to
Gym: Be in shape! Lift weights, hire a trainer, eat right
Dating: Don't date or marry a crazy person.

 

[Dred Pirate]

so to preface this, I am not a physican, I am a pharmacist who works in the ED. But I get a lot of where you are coming from. I see the constant crap y'all have to deal with. I went through similar thoughts recently. I was in middle mgmt- dealing with complete a mess of office politics. Working 60 hour weeks and constantly just dealing with drama on the island that is middle -mgmt.

I had to take a step back and evaluate my life and what I was doing when my child was on their way. I changed to a staffing position, and just learned to separate work drama from life. Sometimes I feel free cold considering how many people I see pass away, or is just horrible situations, but I remind myself I am here to do a job, and not to get emotionally invested in things I can't control - and focus on the positive that is done. I now work 35 hours a week, on a glide FIRE path, and once I walk out the door, I leave it there (I know that is easier for my position that yours). I am a huge traveler, so I need that to reset (and luckily I get a ton of PDO). A couple of ski trips a year, a couple beach trips, through in a scuba trip, etc.

But important to stay healthly, eat healthy, etc. Night shift, rotating shifts can wreck havok on your health- I am sure you know that from residency, but as you get older (I am in my 40's) it is just that much harder to keep on top of it if you don't make a constant effort.

Hobbies are great - I love woodworking, but to each their own.


PS- agree with @Kryptocoin don't marry a crazy person, I made that mistake once, corrected it, luckily no lasting consequences....

 

[TheComebacKid]

I work at a county/level 1 shop with all the things you described. I can tell you, morale is not high here either. Grass is always greener. There are some benefits though. Some days taking care of the patients is a nightmare, dealing with the EMR, social issues, charge nurses chewing me out etc drives me up the wall. But I enjoy teaching the residents, and sometimes having a good shift with a resident keeps me a little more level headed. The counter is true, working with a resident who isn't motivated/interested makes things even worse.

Another other plug for working with residents: while the cognitive burden of supervising trainees can be a lot, I don't deal with the BS consultant conversations, nurses nagging me to go talk to the patient because they want more pain medications, etc. My documentation is also more of just a brief MDM (3-4 sentences), some critical care billing, and calling it a day. Not saying this is an option for you in the community, but down the road, if you think you would like this set up better, something to consider.

This might be a little too touchy-feely, but I try to find one "good" patient encounter per shift. This usually involves maybe spending a few extra minutes connecting with a patient/family member, maybe asking them something about their life/career, cracking a joke. I'm cringing a bit writing it out, but I've found it to be useful and make me not hate my job as much. There are plenty of opportunities for ONE encounter like this amidst many terrible ones.

Contrary to WCI advice, I think it's okay to splurge within reason. Buy some nice clothes, take some nice trips. While money doesn't buy happiness, it buys you an escape and the opportunity to do other things you enjoy outside of work.

Try to find a way to work less clinically. If you can do admin stuff, consulting, legal work etc... If you find 100% of your self worth through clinical work, you will be unsatisfied, since the system for all intents and purposes doesn't give you much worth. You have to find it from other ways.

 

[Janders]

This might be a little too touchy-feely, but I try to find one "good" patient encounter per shift. This usually involves maybe spending a few extra minutes connecting with a patient/family member, maybe asking them something about their life/career, cracking a joke. I'm cringing a bit writing it out, but I've found it to be useful and make me not hate my job as much. There are plenty of opportunities for ONE encounter like this amidst many terrible ones.

^This is good advice. The worst thing about our job? The people. The best thing about our job? The people. You got into medicine because, on some level, you like helping people. We don’t have time to have 30 minute conversations with every patient, but carve out a little bit of time to connect to a couple a shift. It helps.

 

[CoolDoc1729]

^This is good advice. The worst thing about our job? The people. The best thing about our job? The people. You got into medicine because, on some level, you like helping people. We don’t have time to have 30 minute conversations with every patient, but carve out a little bit of time to connect to a couple a shift. It helps.

💯. I was having a crummy shift Sunday. Walked into 12 up to be seen for my single coverage night , 2 nosebleeds and 2 i&d among them, I was totally aggravated … and then I had the most pleasant chat with a 90 year old who had been waiting several hours for xray reports and it turned it allllll the way to a fairly nice day. It’s amazing when that happens. I love the (alert) 90 year olds .. not a drop of entitlement generally and they value seeing a Doctor more than most younger people ..

 

[thegenius]

4 years out from training at a county program now working at a fancy community ER. Pod system, doc vs charts. Feeling isolated and miss the camaraderie of residency and the mission of a county hospital but current shop with great setup/support/pay.
Work is sucking my soul. Have little to no passion left for work and almost no empathy for patients anymore.
I imagine it's a combination of work environment, COVID, patient entitlement, the "just go to the ER" from every other specialty, ever increasing mental health patients I'm unqualified to care for on their day 4 hold, satisfaction BS, and putting out NP fires daily (BS go to ER immediately and calling consultants and knowing more than the NP answering on the other end).
Trying to get away from the work is my life mindframe that was hammered into you all medical training. Trying to find hobbies/side passions. Any help from the hive? Any suggestions?

My suspicion going back to academics, since you miss it, won't really change your sentiment.

You know how there are some people that are bothered by things that others are not?
I hate gnats. When I'm hiking and there is a swarm of gnats that seemingly follow you everywhere, I can't stand it.
My wife doesn't even notice them. She isn't bothered by them. I am. I don't get it.

My solution: when I go for walks or hikes, I try to find trails that generally don't have swarms of gnats. I still hike, but I'm careful where I go.

 

[DrDrummer]

I can relate to this very much. I think the most common etiology of this is working too much. We come out of residency trained to grind, so keep doing it and never look up. Empathy/compassion/patience is a finite quantity that either refreshes on its own as a function of time away from injury (like a video game character's health bar) or which must be refilled actively by doing revitalizing activities which are unique to the individual. I have found that trying to actively get outside every day in the sun doing something active is very helpful. I literally track this on a whiteboard and use apps to game-ify physical activity (e.g. Strava, Zwift, Peloton, whatever) to help track/motivate myself. Playing music, or cooking or otherwise interacting with people outside of work does this for me too. My friends from residency have also set up recurring trips / reunions that everyone looks forward to and plans for which are incredible sources of recharging -- if you haven't had one of those, consider trying to set it up, you might find that a lot of others are in the same place and it would be therapeutic to talk about it over a beer on a beautiful beach somewhere.

Just in case this is glossed over in the earlier advice: Evaluate how much you are working, cut back as much as your group will let you (you can always pick up extra shifts if you find you are bored) and re-assess. You won't miss the difference in your paycheck and you may find that it changes everything. I was averaging ~ 200 hrs/month in 2021 and wanted to blow up my life and leave my current work setting to return to academia or go to NZ or something. I changed the amount I was working and feel way happier. Correlation might not equal causation but I think there's enough experience on this forum to suggest it's worth a shot.

 

[emergentmd]

We are ER docs. You can not let anything at work affect you in a good/bad way too drastically. Learn/find a way to have all aspects, good or bad, at work affect you 1 deviation from the mean. Its a job, its a good paying job, that allows you to do things outside of work that 99% of the world are not able to do.

Find things that are great about the job and continue to do it. Things that you hate, just deal with it and move on. I trained at one of the busiest county in the US and that place is a recipe for burn out.

Things I liked about EM hospital work and always do

1. Go to the starbucks downstairs and make a trip before my shift. Middle, and end.
2. Go to doc lounge and grace a snack, talk to collegues
3. Have fun talking to the staff
4. Take repeated 2-5 min break and surf the internet

Things I didn't like
1. Drug seekers - Ehhhh... 2 min eval then DC
2. Admin and metrics - Ehhh.. figure out to game the system and be in the middle of everything
3. Charting EMR - Ehhh. Figure out to game it. There is always a way
4. Overnight shifts - Pay someone or hire a nocturist to do your night shifts
5. Pain in the A$$$ staff - Barely talk to them

Game your job (and almost anything in life) to make it enjoyable, there is always a way.

 

[emergentmd]

I was averaging ~ 200 hrs/month in 2021

OK, no way to game the job if you are working 50 hrs a week.

 

[Birdstrike]

Work is sucking my soul.

The good new is, you can make this better. The extent to which it gets better, is the extent to which you're honest with yourself about your chosen career. The extent to which it gets better, is the extent to which you reduce the percentage of time you must spend in an ED, to pay your bills.

 

[B52forU]

This opening post rings home.

I am only close to 3 years out after residency and I am crispy beyond what I could have imagined. The last two years have been tough, not just physically but more mentally. Working for a CMG and going through the staffing (lack therof)/inequalities/stress/managing family life has been hard to say the least. Talking with colleagues who have chosen to reduce hours (not a possibility due to CMG staffing) has improved their lifestyle and mental outlook but is not a reality that can be feasibly attained for myself. I can honestly say that I do not feel that my care for my patients has been affected but my projected longevity in this career path is severely contracted compared to what I initially felt was projected. ^ what birdstrike posted above is spot on, you need to be honest and REALISTIC about the chosen career and what it currently is and projected to be in the near to long term future. I've been looking actively at ways to diversify my income away from clinical hours as a pit doc and the earlier you realize what you yourself can tolerate and how to react to this is for the best. The burnout is real and given the negative spiral of our specialty (multifactorial), it is only likely to get worse.

 

[Tenk]

I went from 135 hours a month to 99 hours a month. It has been a game changer.

 

[EctopicFetus]

As said find something you enjoy outside of clinical medicine. For me a side gig, residents, real estate and doing admin work helps. I work 100 clinical hours a month on average. I was doing 160 in a moderately busy high acuity entitled patient place.
now I’m in a busier place but work less enjoy work more and the pay is better.

the real key for me is vacations. I always need something on the calendar to look forward to. It helps a ton. Recently took up scuba as well. Hit the gym, enjoy your friends/family and work less. It’s tough cause good jobs are few and shrinking.

 

[Bougiebuster]

Alot of really good suggestions. Thanks yall, this forum has been a friend for years.