Let's face it; after a while, medicine can become routine. Most women have similar complaints, and most of the remedies are the same. From time to time, we'll encounter a challenging case that really takes thought and creativity, but usually not. So how do we stay engaged? Diversify!
I've struggled with this for a while. When I was in a large hospital setting, I had a full-scope practice, was on call a lot, taught residents and medical students, fought the bureaucracy, and tried to find my niche. After 8 years, I no longer wanted to be in a large institution and set out on my own. The first 5 years of private practice were fascinating. I had to restrict dramatically my scope of practice because of the cost of malpractice insurance in New York. I no longer taught, delivered babies, or did surgery. However, I learned so much about business in those early years that I didn't really mind the monotony of the patient care in the office. Further, the intellectual blandness of the medicine practiced was more than offset by the opportunity to spend more time with my patients and really get to know them in a way that had never been possible in a busy clinic.
Nine-plus years into private practice, I have learned everything I'm going to learn about running a small business. I built it from scratch, and I did so successfully. But for the past 2 years, I've been utterly miserable. It took a while for me to figure out why I was unhappy. I had built a solid practice from the ground up. I enjoy my patients. I have a wonderful staff. But the challenge was missing.
As I considered the rut I was in, I realized that I would never make it another 20 years as a physician if something didn't change. I spoke to many friends in other fields of medicine and realized that we were all feeling the same way. It was sad to realize that my generation of doctors was feeling stifled and uninspired. As I considered my options, they were rather overwhelming. I could go back to school for an MBA or MPH; I could get training in acupuncture or integrative health; I could do a fellowship; I could expand the office to the next level with multiple locations—the list was endless. After a year of mulling over possible career changes, I realized that what I missed most was public service and teaching.