EP322: Who Am I Without the White Coat? Leaving Clinical Medicine Without Losing Yourself

Transcript
YouTube English auto-captions.

========================================================================

Hey guys, welcome to another edition of Bootstrap MD. My name is Dr. Michael Ming. I am a physician entrepreneur for 20 plus years.

You are at the podcast for physician entrepreneurs and healthcare entrepreneurs. And going to talk about different subject that occasionally we bring up now again, but I've been seeing it more often. And this is something that a lot of doctors are thinking about, but very few are saying out loud. What if I don't want to do this anymore?

Now, I'm not talking about having a bad week or a rough shift at the hospital. I'm talking about that persistent quiet voice that asks, "What if I left patient care entirely? What if I walked away from clinical medicine?" Now, if you had this thought, you're not alone. And more importantly, you're not broken.

The numbers tell a story that matches what I'm seeing when I'm working with doctors in my coaching programs. Physician burnout rates are in an all-time high. More doctors are working part-time or leaving medicine entirely within the first few years of practice. I see it on Facebook groups, on the online forums with doctors.

They're exploring nonclinical careers and it's growing exponentially. Now, this isn't a weakness epidemic. This is a mismatch epidemic. And here's what I want you to hear about right up front.

Thinking about leaving clinical medicine doesn't make you ungrateful for your training. It doesn't mean you've wasted your MD or DL. It doesn't mean you're abandoning medicine or your patience. What it means is that you are who you are and what the current system demands from you is misaligned.

And when that misalignment gets big enough, it's not just okay to consider other paths. It's actually the most honest thing that you can do. Today I want to talk about this stuff, real talk, what it really looks like to consider or make the transition away from patient care, the emotional journey, the practical realities and the paths that might actually be waiting for you on the other side.

So here's the thing that makes leaving clinical medicine different from leaving any other job. You're not just leaving a profession. You're questioning an identity that's been woven into you since the day you got your acceptance letter in medical school. So, think about it.

From day one of medical school, you weren't taught here's what doctors do. You were taught here's what doctors are. The white coat ceremony, the hypocratic oath. The entire culture of medicine tells you that being a physician isn't a job.

It's who you are. And I think that's beautiful in a lot of ways until it isn't. Because when you start thinking about leaving patient care, you're not just evaluating a career decision. You're staring down an identity crisis.

If I'm not seeing patients, am I still a doctor? If I'm not a doctor, who am I? And I tell you this as I work with physician entrepreneurs all the time. They're smart, capable doctors who build successful businesses.

Or maybe they're exploring nonclinical opportunities and they still introduce themselves at gatherings, at parties by saying, "I'm a doctor, but carries a ton of weight." It's apologetic. It's defensive. Like, you need to justify why you're not in scrubs or in a white coat. So, again, I'm going to talk real about this.

Let's name the big emotions that come with considering this transition. As someone who left medicine for a significant period of time, if I didn't address it, if we don't name these emotions, they kind of run the show from the shadows. What's the emotions? First, there's grief.

You spent four years in medical school, maybe 3 to seven years in residency, maybe you did even more years in the fellowship. That's a decade more of your life. It's called sunk cost. And the sunk cost is real.

When you think about leaving, there's grief over those years. The relationships you didn't build, the experiences you missed, the version of yourself you set aside to become a doctor. Next emotion is fear. What if I can't make it work financially?

What if I'm not good at anything else? What if I leave and realize I made a huge mistake? What if I lose my identity entirely and I don't know who I am anymore? Third, there's guilt.

Now, this one's massive. There are people who would kill for the opportunity you have. You have colleagues who are drowning and are staying in the trenches. You have patients who need doctors.

How can you leave? This guilt is compounded by the fact that medicine, let's face it, there's a martyr culture. We celebrate sacrifice. We glorify the doctors who works 80our weeks every other call and never complains.

When you say, "I don't want to sacrifice anymore." It feels like you're betraying some sacred covenant. But here's what I want to offer you. a different framework entirely. You're not quote just a doctor.

You're a problem solver. You're a critical thinker. You are someone who can take complex information, synthesize it under pressure, and make high stakes decisions. You are a leader.

You are a communicator. The initials behind your name is a credential. Your MD, DO, DPM. Yes, it's also a proof of your capacity.

Is a signal to the world that you can handle hard things. And when you leave clinical medicine, you don't lose that. Your MD becomes a superpower that runs in the background. It opens doors.

It gives you credibility. It shapes how you approach problems. But it doesn't have to be the entire operating system of your identity. And I've seen this play out in real time.

You know, I work with doctors who struggle with their identity after leaving patient care. But then they found a path where their MD enhanced their work without defining it. They went into nonclinical careers, expert witnesses. They joined boards of healthcare companies.

They used their credibility in ways where they were the only doctor in the room and went into a field and they were respected. They were embraced. They were appreciated. The transition isn't about abandoning medicine.

It's about expanding your definition of what it means to be a physician. So, let's talk about something critical. The difference between running from something and running towards something. Now, if you're only running from burnout from a toxic work environment, from insurance hassles and documentation requirements, you might leave medicine and still be miserable because you haven't figured out what you actually want.

So the physicians I see who successfully transition to nonclinical work, they're not just escaping. They're running towards something. A specific autonomy, flexibility, impact at a different scale, intellectual challenges, time with family, the ability to build something. So let me ask you, if you could design your ideal day, what would it look like?

Not your ideal vacation, your ideal working day. Would you be working from home or at an office? Would you be collaborating with a team or you working independently? Would you be teaching, writing, building, advising?

Would you have patient interaction at all or would you prefer to be completely removed from clinical care? And these questions aren't rhetorical. I want you to actually pause and think about them because the answer tells you what path makes sense. So, I've seen doctors in my own community, in my own students, physicians who've moved effortlessly into medical education into creating content at becoming an influencer.

What do they improve? They improve their schedule flexibility, their ability to teach at scale. It was a creative outlet for them. I've seen physicians who moved into healthcare industries, healthcare startups.

They felt intellectually challenged. They felt that they are part of building something new. there was significant financial upside. They were involved with the team.

So, the common thread of these two examples isn't the specific path. It's that each of the physicians got clear on what they were moving towards, not what they were leaving behind. And here's what I can tell you about going towards something. It's usually about reclaiming something you've lost along the way.

autonomy, creativity, time, energy, the ability to be a parent, a spouse, a whole person, not just a doctor who occasionally shows up to their own life. So, I want to give you practical advice, practical steps. What are the actual options if you decide to step away from patient care? There's a few major buckets that you can decide to go on.

That's not the end. It's not the entire options that you can have. Not just because you need to pick one today, but because I want you to see that there's a whole ecosystem out there that you may or may not be aware of. You do have options.

So, bucket one, going into the healthcare and biotech industry and this is where a lot of physicians land because it still feels connected to medicine. You can go into medical affairs, drug safety, clinical development, medical sites, liaison roles. You're working with pharma companies, project startups, medical device companies. So, why does it work?

You're still using your clinical knowledge. You're often working on things that will help patients at scale. The pay uses are pretty good and the work life balance is typically better than clinical practice. So, who does this fit for?

These are physicians who like the science of medicine, but maybe they're burnt out from the day-to-day patient care grind. Another bucket you could go to administrative and informatics. These are the chief medical officer roles, utilization management, quality improvement, clinical informatics, payer roles. These are the physicians who move into the operational side of healthcare.

And why does it work? Is physicians get to shape systems and policy instead of just working within them. You often have more influence and autonomy. This fits best for physicians who are interested in the how does healthcare actually work questions and who want to get involved in leadership.

Bucket three, education, content, and consulting. This is one of my favorites. going into medical education, coaching other doctors, creating courses, medical writing, speaking, consulting. This is where I often live and it's a rapidly growing space.

So why does it work is you get to teach at scale. You control your schedule and if you build it, this income potential is significant. You're helping other doctors which you could feel is very meaningful for you. Who does it fit for?

Doctors who love to teach, who are natural communicators, who are comfortable with some uncertainty and they have entrepreneurial risk. The other bucket that I love, entrepreneurship and investing. This is starting your own company, health tech ventures, becoming a creator, entrepreneur, real estate, investing, venture funds. This is often the highest risk, but has the highest potential reward path.

Why does it work? Complete autonomy, unlimited upside. You're building something that's entirely yours. It's fit for physicians.

We've got a high tolerance of risk. We have some financial runaway. We get energized by building and problem solving in ambiguous environments. Now, here's what I want you to notice about all these different buckets.

None of these paths require you to completely abandon your clinical skills or your MD or DO or DPM. In fact, it's often what opens doors those initials behind your names and gives you credibility. So, the question is, can I leave medicine? That's not the question.

The question is which version of using my medical training actually aligns with the life I want to build. So let's talk about the practical stuff because this is where a lot of physicians get stuck. They want to explore nonclinical work but they're terrified of the financial risk. First know your numbers.

How much money do you need to cover your life for 6 months, 12 months? What are your fixed expenses? What is your debt situation? Do you have student loans?

How does income driven repayment factor into this? Now, looking at these numbers isn't fun, but it's essential because the moment you know you're one way, the decision gets less scary. You can say, "Okay, I got 6 or 9 months of expenses saved. That gives me six or nine months to experiment without patient care." Second, you don't have to quit cold turkey.

In fact, I argue that you shouldn't. The smartest physicians I know transition to non-clinical work. We didn't wake up one day and redesign. They tested the waters first.

So, here's what it look like. Let's say you decide to take a side gig. Let's say you do medical writing, chart review. Maybe you're doing some tele medicine on the side.

Maybe you're just doing some nonclinical work, but that generates income. You could join a committee or an advisory board that get you exposure to administrative or industry side, gets you prominence, gets you to let other people know who you are without leaving your job. You could start a small project on the side. Maybe you just start up a website, a blog, a course, a coaching practice.

See if you like it before you bet the farm on it. The goal is to build yourself evidence, experience, not just financial evidence, but emotional evidence. Do I actually like this kind of work? Do I feel more energized or less?

Does this feel like I'm running towards something or just running away? Now, we have to address the elephant in the room when I have my medical license. So, here my take. You got to keep it.

At least for a while. You spent all these years trying to get it. You don't have to be practicing full-time to maintain your license. You can do locoms work a few shifts a month.

You can do volunteer work. You can stay on staff somewhere. Even if you're barely picking up shifts. So, why does it matter?

Because it preserves optionality. If you leave clinical medicine and then realize 18 months later that you miss it or need to go back, you might have some hurdles to try to reenter. So, maintaining your license keeps that door open. It also keeps you connected to the clinical world, which can actually be an asset in nonclinical roles.

The best medical affair directors, the best physician consultants, the best healthcare entrepreneurs, they're often the ones who are still clinically active, even if it's just minimal. Let's give you some action steps. I want to give you some concrete action steps you could take in the next 30 to 90 days. So, step one, I want you to journal on these three questions.

Take out a pen and paper, take out your iPhone, and start typing. And I want you to reflect on these questions. If I weren't a doctor, what would my ideal day look like? Number two, what parts of medicine do I genuinely love versus what parts do I dread?

Number three, what am I afraid people will think if I step away from patient care? You got to be honest with yourself. Write it down. You can't make a good decision if you're not clear on what you actually want and what's holding you back.

Step two, talk to two to three physicians who left patient care. Not physicians who are just miserable. physicians who've actually made the transition and are thriving. Ask them about their emotional journey.

Ask them about their practical steps. Ask them what they would have known before they left. Now, if you don't know anybody personally, join some of the online communities. Go to events.

We're having a event coming this January called Dr. Podfest where you can meet other physicians who are podcasters or looking to get into podcasting. So, you can go to drpodfest.com. We'd love to have you on there.

Get to meet them, connect with them, send them emails. Most people who've made this transition are happy to share their story. Now, step three, calculate your financial runway. I want you to sit down sometime, maybe this weekend, and figure out how much do I need per month to cover my life?

How much do I have saved? What's my real number? Once you have that number, the fear gets smaller. It's not what if I can't make it.

It's I have x amount of months to figure this out. Step four, try one small nonclinical project. You don't need to quit your job. Just start something small.

Write an article. Take on a chart review contract. Offer to teach a session at a conference. Build some evidence that there's life outside the exam room.

So, here's what I want you to leave with today. Considering or choosing a non-clinical life is not a betrayal of medicine. It's not a failure. It's not a wasting your MD, DOD, DPM.

It's an evolution of how you serve. You became a doctor because you wanted to help people, solve problems, and make a difference. Those motivations don't disappear when you step away from patient care. They just find new expressions.

Maybe you help people by building better healthcare technology. Maybe you help people by coaching burnout physicians. Maybe you help people by teaching the next generation of doctors. by creating content that educates patients at a scale level.

Your MD isn't just a license to see patients. It's a credential that proves you can think critically, handle complexity, and show up under pressure. That's valuable everywhere. So, if you've been sitting with this question, should I leave patient care?

I want you to reframe it. The question isn't, should I leave medicine? The question is, what version of being a physician actually aligns with the life I want to build? And that's a question worth exploring.

If you've made the transition to nonclinical work or if you're in the middle of considering it, I'd love to hear your story. Send me a message. You can reach me at bootstrapmd.com. I'd love to do follow medicine because I love to feature physicians who have fully left the bedside and what their lives look like now.

Until then, this Dr. Mike Wuing. Remember, as a physician entrepreneur, you're going to have your ups and downs. Do something a little each day to get you closer to your goals and keep moving forward.