Overcoming Your Roadblocks: A Physician's Guide to Navigating Change When it’s Time to Move On

An earlier version of this article appeared on this website in December, 2023.

If you’re feeling stuck in your practice, torn between your current role and the pull toward something different, you’re not alone. In the old paradigm, physicians assumed they’d join a practice after training and remain there until retirement. Especially in private practice, moving locations, switching roles, or stepping away from clinical work altogether was rare and even stigmatized.

But the landscape has changed. Across every sector, more physicians are re-evaluating what fulfillment means—and realizing that staying true to your values may require reimagining your role, whether within your current system or beyond it.

It’s a deeply personal realization, and one that can feel both unsettling and energizing. And it’s becoming increasingly common.

In fact, a recent Mayo clinic survey reported that one in five physicians plan to leave their practices within the next two years, and one in three expect to reduce work hours. A second study found that amongst academics, one in three felt a moderate or greater intention to leave. And a 2023-2024 AMA survey of nearly 18,000 physicians from more than 100 health care systems reported similar finding across all physicians. What’s more, the number may be closer to 40 percent in some specialties, including Anesthesiology, Radiology, and Vascular and General Surgery. Burnout, excessive EHR requirements, and lack of support from their organizations were primary issues cited in these studies.

All of this is to say that if you're considering a change, you’re not alone. But that doesn’t make the decision easy. Physicians are often motivated by loyalty and compassion. But we are also creatures of habit, and veering off the well-worn path can feel daunting.

You’re someone who’s used to thinking independently and making critical decisions, but it’s likely that your roadmap was clearly defined from the start: college, medical school, residency, maybe fellowship. As long as you followed this straight and narrow track, and nothing unexpected knocked you off course, you would make it down the road. Waiting for you at the end of the trail would be a satisfying profession, a place of respect in your community, and a happy home life to balance it all out.

Over the past decade, that promise has faded for many physicians. Burnout due to lack of autonomy, higher patient demands, a sicker and older population, falling reimbursements, the unrelenting pace of EHR tasks: all have contributed. So have our increasingly disconnected healthcare systems. It’s not surprising that more and more doctors are reflecting on what they want from their careers, and what might need to shift.

Moving on is sometimes the best and healthiest choice. But change doesn’t always mean leaving your organization or giving up your practice altogether. Sometimes transformation begins by renegotiating how you work: seeking new roles, advocating for flexibility, or crafting a job description that better aligns with your strengths and goals.

Still, thinking about change of any type can feel like stepping into the unknown. The hardest part is often getting started. It may even feel as if your feet are stuck in quicksand. That’s normal. But once you begin, you’ll discover that your momentum will build and possibilities will unfold as you continue to move forward.

In this article, I’ll give you seven actionable steps that can help you move forward when you’re feeling stuck.

1. Self-Reflection

Before deciding what’s next, take time to reflect on what matters most, both professionally and personally. You don’t need to know the final destination yet, but clarity around your values, interests, and strengths is essential.

Journaling for a few minutes each day can help. Ask yourself:

❓What are my defining values? How do I want to manifest those values in my daily life?

❓What aspects of my current role energize me—or drain me?

❓What skills do I love using? And what would I be happy to give up?

❓How do I want to feel at the end of each day?

❓What would I regret not doing, both personally and professionally?

❓How will any change I make impact my loved ones, either positively or negatively?

Making time for self-reflection will lay the foundation for building a more aligned, satisfying professional life, whether that’s in a new place or a new role within your current setting.

  2. Recognize Your Triggers and Limiting Beliefs:

When you’re contemplating change, it’s natural for doubts to arise: “I can’t start over,” “I’m too far along,” “What would my colleagues/ family/friends think of me?” or “I’m lucky to have a job—why rock the boat?”

Instead of pushing these thoughts aside, examine them:

❓What stories am I telling myself?

❓What are these beliefs protecting me from?

❓Are they actually true—or just familiar?

❓What would it take to feel more confident in exploring a new path?

❓If there are meaningful limitations that are holding me back, how can I close the gaps?

Acknowledging and challenging these beliefs is a key step toward moving forward.

 3. Seek Guidance

 Talk to mentors, colleagues, or others who’ve made career shifts, whether big or small. You may be surprised by how many have reimagined their roles without leaving their organizations. Others may have made audacious shifts and found greater fulfillment. And some may have dealt with regrets and learned from their mistakes. The point is not to recreate anyone’s story, but rather to understand that your own possibilities may be more expansive than you realize.

Tapping into others’ experiences can offer both perspective and inspiration. Just be thoughtful about whom you confide in—especially if your plans are still unfolding.

 4. Set Achievable Goals

Break your career change into smaller, manageable goals. This not only makes the process less intimidating but also gives you a way to envision the road ahead.

Rather than winging it and hoping for the best, create a timeline with defined milestones. These might include:

✅Gaining specific qualifications or licensure

✅Attending relevant conferences,

✅Researching places you might want to live

✅Identifying internal opportunities that might better align with your goals

✅Exploring part-time or leadership roles within your system

✅Updating your CV or LinkedIn profile

✅Reaching out to potential employers or colleagues in your desired field.

Use the SMART framework—Specific, Measurable, Achievable, Relevant, and Time-bound—to track your progress and stay motivated.

 5. Reframe Setbacks as Lessons

 Rejection can sting. And not every door will open right away. Setbacks are part of any meaningful journey. Instead of seeing them as failures, view them as data.

What did you learn? What might you do differently next time? What can you take with you to the next opportunity?

Stay rooted in your “why,” and let that guide your next move.

 6. Get Comfortable with the Unknown

 Uncertainty is normal. It’s uncomfortable, especially if you’ve grown accustomed to defined pathways. But the unknown becomes less intimidating when you ground yourself in research and preparation.

If you’re exploring a nonclinical role, learn the landscape. If you’re considering a new position, understand the expectations, workflows, and culture. And if your skills need to be refreshed, find out what you need to do to make that happen, then make a plan to get it done.

The more you know, the more confident you’ll feel taking the next step.

 7. Keep an Open Mind

You don’t need to have everything figured out right now. Stay open to possibilities while keeping your perspective grounded. Often unexpected new opportunities will present themselves while you are putting in the work.

Seek input from those you trust, but recognize that you’re the one who knows yourself best. Give yourself the space to grow into what’s next.

Final Thoughts

Redefining your path as a physician takes courage, clarity, and commitment. You’ve honed these skills over the past decades of training and professional practice. Now, it’s about using them to design the life that you want to live. Whether you're stepping into a new career, transitioning into a different role within your current system, or simply giving yourself permission to explore, start by addressing the internal roadblocks that stand in your way.

Be willing to ask bold questions and take thoughtful action. Most of all, trust in your ability to create a more fulfilling and sustainable future.

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If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Creating Boundaries and Reclaiming Values: My Podcast Appearance on Dr. Bill Lombardi’s Journey to Better

I recently had the great privilege to be invited back to trail-blazing cardiologist Dr. Bill Lombardi's Journey to Better podcast. This is truly one of the best physician-focused podcasts out there.

Bill is a fantastic and thought-provoking interviewer! We discussed a wide range of issues facing physicians today, including

⚕️The importance of setting boundaries

⚕️How to integrate the experience of the arts into medical practice

⚕️The crucial role of effective and engaged leadership

⚕️Why defining your personal values can help you to make better decisions for yourself and your practice

⚕️How coaching can work for physicians dealing with challenges of transitions, time management, and leadership opportunities.

You can find our conversation wherever you get your podcasts, including Spotify and Apple Podcasts, or take a listen below. And if you want to listen to my first podcast appearance on the show, you can find it here.

My second podcast appearance on The Journey to Better with Dr. Bill Lombardi

Rediscovering Your Why: A Road Map for Physicians

An earlier version of this article appeared on this website in November 2023.

If you ever find yourself questioning whether you’ve chosen the right job, the right specialty, or even the right profession, it may help to know that you’re in good company.

Most physicians go through cycles of doubt, revisiting old decisions when things aren’t going well. Times of stress, exhaustion, or disconnection often trigger these seasons of questioning. This type of critical reflection isn’t a sign of failure. Instead, it’s an opportunity for growth and realignment. And with time and support, it often opens a door to greater clarity and purpose.

Of course, dissatisfaction today doesn’t always mean that you need to make a drastic change tomorrow. Perhaps it’s a signal that it’s time to take a break. It may even be a reminder to keep pushing through. Avoiding unease is not always the best choice. Discomfort can be a sign of growth, and sometimes short-term pain and sacrifices are necessary to get you where you want to go.

But if this seems like a theme song that just won’t stop playing, then it might be time to rediscover your why.

Why Your Why Matters

Often when you feel unfulfilled or frustrated at work or in your personal life, it’s because you are not living a life that feels authentic to you.

❓ Perhaps you are trying to live up to someone else’s ideal

❓Maybe your life has moved in a different direction since you first chose your current path

❓It could be the job itself that has changed or not lived up to your expectations

❓Perhaps you simply need to rediscover the reason that you chose to become a physician so many years ago

"Finding your why" is the process of discovering and understanding the deeper purpose or meaning behind your actions, goals, and choices. It's about identifying the core values and beliefs that drive you and give your life a sense of meaning and fulfillment.

This concept is often associated with personal development and leadership, and it's a key element in the philosophy of Simon Sinek, an author who has been hugely influential in the business world. Sinek argues that successful individuals and organizations are those who are able to articulate and align their actions with a clear sense of purpose or "why." In fact, one of Sinek’s most popular books is called Find Your Why.

The idea is that when you have a clear understanding of why you do what you do, it can serve as a powerful motivator and guide for decision-making. It can help you stay focused, overcome challenges, and find a greater sense of satisfaction at work and in your personal life as well.

As Sinek puts it

⭐ Your why is your driving force

⭐ Your how is the actions that you take to bring your why to life

⭐ Your what is the manifestation of your why—the actual work that you do

Once you understand your why, everything else starts to make sense. Your decisions will become clearer and your actions more purposeful and meaningful.

Coming Home to Your Why

Knowing your why is so integral to being a physician that it’s surprising this concept is not routinely taught in medical schools. Discovering your why is not a “one and done”, check-it-off-the-list sort of thing, but it’s logical and easy to understand.

Finding your why involves introspection and reflection. It means clarifying your own unique values, passions, and the impact you want to make on the world. It’s about you, and not somebody else’s version of you. It means going beyond your surface-level goals and digging deeper into the fundamental reasons that drive your choices and actions today.

If those goals and values are different than they were when you started the journey, that’s normal and healthy. Keep excavating until you discover your own truth.

Unearthing Your Why, One Page at a Time

To help you find your why, get a piece of paper or a journal and start writing. You could do this on your computer or your tablet, but writing by hand tends to engage the brain more fully than typing on a keyboard. If paper isn’t your thing, a writable tablet like the Remarkable is a great alternative. Most importantly, choose a method and a time that works for you.

Over the next few weeks, consider taking a few minutes every morning or evening to discover the patterns and thoughts that arise. Here are some questions to get you started. You don’t need to take on all of them. Just pick and choose what is calling to you.

🔍 What do I find fulfilling about my current job?

🔍 What do I not like about my current job?

🔍 What values do I seek to honor in my work and in my life?

🔍 What other goals and aspirations, professional and personal, do I have?

🔍 What are my strengths, my natural talents, my soft skills?

🔍 What strengths and talents would I like to develop further?

🔍 What are the common ideas and threads that run through my life over the years?

🔍 What makes me happy at work, at home, and in my private life?

🔍 What do people thank me for?

🔍 What do I enjoy teaching?

🔍 What do I enjoy learning?

🔍 What keeps me up at night?

🔍 What moves me to take action?

🔍 What is my ideal day?

After sitting with your reflections for a few weeks, try distilling what you’ve discovered into a single, powerful sentence—a personal mission statement that captures the heart of your why. You might start by asking: What do I want to contribute? What kind of impact do I hope to have?

There’s no need for it to be perfect—or permanent. This isn’t about meeting anyone else’s expectations. It’s about articulating something that feels true to you. Your statement may evolve as you allow it room to breathe, but by simply starting, you’ll begin to align your goals with a deeper sense of purpose.

When you know your why, it can shift everything, bringing your actions into alignment with your values and your deeper self. In this way, your own North Star begins to emerge: steady, clear, and sustaining.

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 P.S. If you want to learn more about defining your values, click here to sign up for my free Values Workbook.

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Strategies for Success for New Physicians in Outpatient Care

If you’re just getting started in practice, or starting over in a new job, it’s important to set yourself up for success right from the start.  This is true whether your career path is in academics or the private sector. 

Starting out on the right foot is not as difficult or mysterious as it might seem, but it can make all the difference to both your professional trajectory and your personal fulfillment.

In this article, we’ll focus on five key areas that will help you provide the best care while managing the demands of a growing practice. Developing these strategies early on can improve both patient outcomes and your own well-being.

1. Master Time Management and Efficiency

Let’s be honest. Managing a busy outpatient schedule without sacrificing the quality of care can seem daunting. Physicians often find themselves juggling patient visits, charting, and administrative duties without a definite plan. This can easily lead to inefficiencies.

If your position includes hospital work, supervising, or teaching responsibilities, these added challenges can snowball very quickly. But taking shortcuts only leads to more complications and frustration for both you and your patients.

Your strategy for success: Developing effective time management skills is crucial. Prioritizing tasks, utilizing electronic health record (EHR) templates, and implementing workflows that streamline documentation can save you valuable time.  

Task-batching and time blocking are crucial skills that will serve you well. Try to limit the amount of time you spend returning to unfinished tasks by getting them completed as soon as possible.  

Think about putting in a few hours up front to set up your chart management systems, including smart phrases and, where feasible, appropriate AI integration. Don’t be afraid to create a workflow to delegate simple tasks when it’s appropriate. When you organize your day efficiently, you will not only reduce after-hours work, but you’ll also improve patient care and satisfaction.

2. Cultivate Work-Life Balance

It’s become normal and sometimes even expected that your working day will bleed into your personal time. In the current environment, this often morphs from a slow drip to a frank hemorrhage.  This lack of control not only impacts you and your family, but ultimately can have a negative impact on your patient care.

Maintaining clear boundaries between your professional world and your personal life is essential to avoid burnout. The importance of your own well-being cannot be overstated. When you’re burned out, you’re more likely to make mistakes that impact your patients’ lives

Your strategy for success: Consider setting aside specific times for charting and answering messages, so you can limit after-hours communication. This is a technique known as task batching. By grouping a chunk of similar tasks together, you’ll achieve greater focus and get more done.

Don’t overlook your own well-being.  Scheduling time for self-care activities such as exercise or relaxation can help you recharge and maintain a sustainable work-life balance.

If there is a hobby or activity that you’ve been yearning to try, simply get started. Don’t expect perfection or even competency. Just do it for the joy of trying something new.

3. Build Strong Patient Communication and Relationships

Building strong relationships with your patients is key to delivering effective care. When patients trust you, you will deliver your care more efficiently, and you’re likely to see fewer after-hours messages and questions.

Your patients want to feel seen, heard, and cared for. However, developing this rapport can be challenging when time is limited, and managing patient expectations or difficult conversations can often feel overwhelming, especially for new physicians.

Your strategy for success: First, keep your charts current. When you go into the office visit armed with accurate and up-to-date information, your patients will feel more confident that they are in good hands.

Setting expectations early is important when managing difficult situations, especially when dealing with complex diagnoses or treatment plans. But having the data at hand and a plan in place is not always enough.

Of equal importance, your communication style matters. Listening actively, showing empathy, and offering clear explanations can improve the experience for your patient and inspire greater confidence in your care.

4. Sharpen Your Clinical Decision-Making Skills

As a physician, making sound clinical decisions quickly and confidently is part of the job. Dealing with the more complex cases can be challenging, especially when you’re still building your clinical experience.

In training, you’re continuously learning, but it’s important to remember that you’re never done. To be a doctor is to be a perpetual student. For optimal patient care as well as your own professional fulfillment, it’s critical to stay up to date.

Your strategy for success:  Staying current with evidence-based guidelines and refining your decision-making process will help you feel more confident when faced with uncertainty. Using decision support tools, collaborating with colleagues, having an excellent referral network, and continually educating yourself on new developments will ensure that you make informed decisions efficiently and wisely.

In addition to maintaining your CME requirements, consider subscribing to a service like JournalWatch, which sends out regular emails summarizing important research from multiple medical journals. Stay curious and engaged.

5. Cultivate Emotional Resilience and Stress Management

Outpatient care can be emotionally demanding, and it’s common for physicians to experience stress or compassion fatigue. To be clear, the role of healthcare systems cannot be overstated. If your situation seems toxic, it might be reasonable to look for other opportunities that are a better fit.  But often there are constructive and sustainable ways to improve the status quo.

Burnout continues to impact nearly half of all physicians. Those in outpatient care are disproportionately affected. Burnout and compassion fatigue are not your fault, but if you find yourself falling into a funk, it’s important to seek help.

More and more healthcare systems are offering coaching and other resources. When possible, take full advantage of those opportunities, or find your own. To ensure long-term success, it’s essential to build resilience and develop ways to manage the pressures of the profession. 

Your strategy for success: Incorporating stress-reducing strategies into your daily routine—such as good nutrition, mindfulness meditation, and regular physical activity—can help you manage the emotional demands of the job.

Building a support system of colleagues, friends, and family can also provide an outlet for discussing challenges and staying emotionally balanced.

Take advantage of coaching and other services that might be offered through your institution or professional groups. Or seek out a coach that specializes in physician burnout and related issues. If you are experiencing depression or other mental health challenges, contact a mental health professional. You deserve to feel well, happy, and invigorated.

Conclusion

Starting and maintaining your career in outpatient care comes with its own set of challenges, but by focusing on these five key strategies, you can build a strong foundation for success.

Mastering time management, improving patient communication, and developing emotional resilience will not only enhance your professional satisfaction but also improve the quality of care you provide.

By investing in your personal growth and well-being, you can thrive as a physician while maintaining a balanced and rewarding lifestyle.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.

How to Manage Interruptions and Limit Attention Residue: A Guide for Physicians

It’s not just your imagination. It’s more challenging than ever to maintain your mental focus at work.

💉 EHR alerts

💉 Phone notifications

💉 Interruptions from staff

💉 Attention sapping apps

💉 Email

All of these and more conspire to make focus more difficult than ever before.

These constant interruptions and the lingering effects of shifting attention, known as attention residue, can severely hamper not only your effectiveness and productivity, but also your own well-being.

Resolving the current state of disorder in healthcare will require systemic change, including a fundamental shift in the functionality of many EHRs.

But protecting your headspace is a critical skill that can help you stay above the fray.

In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily life and practice.

Understanding Attention Residue

Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task.

The little breadcrumbs that remain can jumble up your thoughts and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to switch over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.

Realistically, interruptions are a part of life in most medical settings. Apart from a few innovative healthcare systems, the current state of affairs creates the perfect setup for attention residue.

Each interruption requires a mental reset, which can take a considerable amount of time and effort. Ultimately this leads not only to decreased productivity and lost focus, but also to increased stress.

This isn’t just theoretical. Research looking at Emergency Department physicians and nurses has found that interruptions from a broad range of sources can seriously degrade the ability to remain focused and aware. What’s more, the disruptions in this study occurred on average about 11 times every hour.

Strategies to Regain Mental Focus

Ideally, our healthcare system leaders will realize the importance of creating pathways that will minimize interruptions. This process is underway in a number of medical systems. But even under the best of circumstances, interruptions are going to happen. Here are a few ways that you can limit the mental drain.

Prioritize and Plan

This can be a difficult step for physicians, since we don’t always have control over the way the day might go. But simply outlining your top priorities can help by giving you a focus and a “north star” for the day,

Start your day by outlining your top priorities. Whenever possible, highlight high-impact tasks when your mental energy is at its peak. For many people, that is the first thing in the morning.

Use tools like the Eisenhower Matrix (also known as the Time-Priority Matrix) to distinguish between urgent and important tasks, and mitigate those less important time-wasters.

Time Blocking

Whenever possible, consider setting aside specific time blocks for different types of tasks. For example, set aside uninterrupted time to study for your boards, or for administrative work. If you have some control over your schedule at work, scheduling similar patient visits may be helpful, so that your mental flow is less likely to be interrupted.

Communicate your schedule and your plan to create these focused blocks of time to your team (or your family) to minimize unnecessary interruptions. Getting buy-in from your schedulers and administrative staff can help to make time blocking work for you.

Mindfulness and Meditation

Consider incorporating mindfulness practices into your daily routine. Techniques such as deep breathing, meditation, or yoga can help improve focus and reduce stress.

Meditation in particular has been found to be helpful in improving attention, focus, and memory and reducing stress. Just like medication or physical therapy, it’s important to be consistent. In one study, it took 8 weeks of regular practice before the impact of meditation was clear.

Taking a mindful pause before and after each patient, study, or procedure is a great way to mentally reset. In many cases, even this very  brief break can improve your efficiency.

Meditation might sound intimidating, but it’s really quite simple. This article shows you how you can easily get started. Don’t just think of meditation as something that you can investigate when you have the time. There is good evidence that engaging in a regular meditation practice can enhance your attention and mental efficiency.

Limit Multitasking

Multitasking used to be considered a superpower. But now we know that when people multitask, they often make more mistakes. And because of inefficiency, it may actually take longer to get tasks done than if each one was done separately. That’s especially likely if both tasks require mental energy, rather than rote memory.  

By focusing on one task at a time, you may improve the quality of your work, reduce the cognitive load, and actually save time.

If you have tasks that are time-consuming and not realistically amenable to completion in one sitting, break them down into smaller, more manageable steps. That way you can think of each step as a separate and achievable task. It can be helpful to write each of these sub-tasks out and check it off the list when it’s completed.

As you knock out these smaller to-dos, you’ll feel a sense of accomplishment. That can reduce the attention residue that builds up when you stress about unfinished work.

Set Boundaries

It’s not surprising that research has found that interruptions increase the likelihood of errors, which may put your patients at risk.

What’s more, these unwanted intrusions also impact your own mental well-being, provoking measurably high levels of anxiety and annoyance.

Ideally, set clear boundaries with colleagues, staff, and patients regarding when you are available for interruptions.

When practical, limit social and nonessential chatter when you’re focused on something that requires deep thought or careful consideration. Reading studies, creating notes, reviewing charts, and developing treatment plans all fall into this category.

Use simple visual cues, like a closed door or a "Do Not Disturb Unless Urgent" sign. Distractions can’t all be eliminated, but taking these and other attention-preserving actions will likely build awareness and respect for your focused time.

It can also be helpful to set expectations with patients and staff that non-urgent in-box messages will only be addressed during or after certain hours of the day.

Conclusion

Maintaining mental focus requires practical, intentional strategies and consistent effort. By experimenting with some or all of the steps I’ve listed above, you will enhance your ability to concentrate, manage interruptions, and reduce attention residue.

Developing these practices will not only improve your productivity but also contribute to better patient care and support your own vital well-being.

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If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.