I’m Dr. Pamela Wible. I run a suicide helpline for doctors. I hear from a lot of physicians with distorted thinking patterns that limit our ability to reach our full potential as healers on this planet. Recognize any?
1. “I’m stuck in assembly line medicine.”
A common complaint across all specialties. I want to assure you, whether you are a GP, primary care doc, or specialist—this is a myth! I helped a child psychiatrist discover that this was not true. Even though she had had a challenging fellowship and then ended up in a very big hospital, where she was told, “There’s absolutely no way as a child psychiatrist that you can work outside of the system.” When she decided that she was going to go out on her own, she was pleasantly surprised to discover that she wasn’t stuck. Not only was she not stuck, she could thrive. And she has a thriving full practice—with a waiting list. Never put up a website. Doesn’t even take credit cards. BONUS: The CEO and top-tier managers at the hospital system—the administrators that were hassling her so much about how she was gonna fail—they actually bring their kids to see her. How about that!
2. “I’m not smart enough.”
Med students and physicians are in the top 1% of intelligence, compassion, and resilience on the planet. You’ve been valedictorian, president of all these clubs. The smartest one in the room. You’ve lost your confidence during training. When overworked, lacking emotional support from peers (amid intense competition) with accelerated perfectionism kicking in, you may feel like you are not smart enough to be a good doctor. If you made it into med school, you are very smart. You just need a safe educational and work culture that supports you.
3. “I have no power.”
You’ve got a mortgage to pay, you’ve got administrators down your throat. Family, spouse, kids. You have a lot of obligations. You start to think that your life is not your own, but you do have power. I felt the same way. My contract was up, I was the only breadwinner. I finally decided, “I don’t have to put up with this shit.” I took my career into my own hands—opened my own practice. This was back in 2005. never been happier. I cut out the middlemen, and I literally got my power back by removing all the people in my business life that were sucking my power from me. They’re like little parasites and you’re supporting them with the revenue you’re generating per minute. Sometimes upwards of 85% is going to them. Why not cut them out of the formula? Which is what I did. My overhead went from 74%, to about 10%. I was suddenly making as much as I was earning at my full-time job, working part-time on my own and having the time of my life. Remove disempowering people and organizations from your life and you will rediscover your power.
4. “I’m burned out.”
You are not burned out. You have been abused, manipulated, and you have experienced human rights violations in your medical education and training. We are so conditioned to blame the victim because if I tell you, “You’re burned out. It is your problem.” The reason why this gets under my skin, is that people start to think that they’re defective when they hear the word, burnout. That defective feeling leads to additional negative patterns of thinking in which you feel like you don’t belong. You’ll never make it as a physician. You don’t even belong on Earth. You’re not even helping your family. You might as well kill yourself. Blaming victims sets some on a path to ultimate self-destruction— suicide. Let’s use proper terminology. Stop the lies. Stop calling yourself burned out—when you’ve been abused, manipulated, and have literally survived years of human rights violations.
5. “I must overwork and overextend myself.”
Workaholism, alcoholism, self-medicating are the top coping strategies that we, as medical professionals, use to deal with unrealistic work demands. We subscribe to an impossible work ethic. We glorify overwork and start to believe, “In order to get everything done to meet expectations and deadlines, I have to overwork.” Your belief enables the lie to continue. Put yourself first. Take your life back. Don’t participate in self-destructive work habits. Stop believing in magic workaround gimmicks that only enable you to stay trapped in a toxic work environment, just reshuffling deck chairs. If you continue to overcompensate, overdo, overextend yourself—you can never win. Crazy thing is many doctors’ solution for overwork is to (surprise)—work harder! “I’m exhausted. I’m tired. My office isn’t working. I’ll get another phone line. I’ll get two more receptionists. I’ll add three more patients per day.” Your solution to overwork, if it’s overwork, is probably not going to work. Overworking will only lead to self-destruction. Step back. Say no. Set boundaries, Liberate yourself. You can be free.
6. “I can’t get confidential mental health help.”
Yes you can. There are so many off-the-grid options. Though you may always be at some risk with your mental health records inside an EHR, many psychologists and counselors do not use an electronic record. They keep paper charts, and they’re 100% confidential. You have many off-the-grid options that you may not be aware of so check out these 13 tips for 100% confidential mental health care.
7. “I’ll go broke.”
Don’t believe that in order to pay off debt, maintain your medical license, you have to stay in assembly-line medicine or your big-box job. Many docs find when they get a small space (even go 100% virtual), get rid of all of the administrative middlemen, and just provide health care on their own terms with low overhead—they can double their income and work fewer hours. I started my clinic for less than $3,000!
8. “It’s the system.”
We spend so much time vilifying and demonizing insurance and pharmaceutical companies, clinic managers, hospital CEOs—that we remain victimized and don’t take our own lives back. Once you realize that you have the power to practice medicine on your own terms, you end up way more successful and financially secure. You sometimes realize, along the way, that you are the problem. Your psychology has likely been the biggest obstacle to your success.
9. “Nobody cares.”
So many people who want to share your vision—support your dreams. They just need the invitation. So much of the time we isolate and we don’t communicate. We tell ourselves nobody cares. When we share our vision, we get brave enough to invite others to join us, we discover that there’s power in collaboration. More people care than we recognize. Real-life examples of the power of community: 1) I just sent a $10,000.00 check to a new doctor who inspires me in North Carolina. She’s opening up a clinic in her farmhouse this July when she finishes residency. There are so many people that want to help you. 2) Another doc got a $100,000.00 check from a philanthropist in upstate New York to open her clinic. People will jump out of the woodwork to help you. You have to believe in yourself first and realize that people care.
10. “Nothing will ever get better.”
I’m here to tell you, you are not terrible. You have not screwed it all up. It doesn’t matter if you’ve lost your license, made unethical or illegal mistakes, or missteps. It can and will get better. You just need help in strategic planning. You need to be willing to embrace change, instead of resisting it. And when you do that, through acts of courage and bravery, usually that start by telling yourself the truth. Not participating in the lies that we tell ourselves, you begin to personally and professionally experience what it’s like to have things get better, not worse. You absolutely can create for yourself, what you want your practice to look like. We are totally living in a time when huge disruption and innovation in medical practice delivery is happening—right now. Don’t miss out. Ask for help. You are not alone. Your community cares. Your loved ones care. I care. You can call me 24/7. You are a brilliant, capable, amazing person Stop selling your soul. You went into medicine with high hopes and dreams and you can absolutely be the doctor you described in your personal statement when you entered this profession.
Kudos to you for working to empower physicians to “punch-out” of institutional employment and to have the confidence to value themselves in a new medical marketpłace. I am hopeful that more discerning patients will recognize the fallacy behind “population based systems” managed by “insurance” schemes who’s business objective is to collect maximally from large populations of “covered lives” and pay-out minimally to care providers, profiting from the expanded margin at EVERYONE else’s expense.
Who would value a physician who doesn’t value himself?
Love your comment. Yes to more discerning patients and courageous physicians who have the confidence to value themselves! Once patients experience unrushed office visits and the quality care they have gone without in the assembly line practices, they “get it.” Because this broken model has been in place so long, patients often don’t even know what they are missing.
Physician suicides – Why?
Our predecessor cheated and lied about a buck turning MDs all into terminators and patients into victims.
See my prior post to find out the med-sci
For a buck — big bucks for the winners and we are the loser. The Complex is driven by profits and has no care as to who it terminates or consumes — it fed with people for profits. MDs will consume their colleagues for the Complex.
The problem is precise, MDs messed up. The solution is also precise, MDs must acknowledge the mess, repent, pay reparations and do good and godly.
Many of these lies are particularly true in acedemic medicine. Being underfunded, depts can’t afford to give their physicians time off the schedule to do research or prepare lectures and write papers. So it is done on family time, vacation time etc. This leads to burn out and poor patient care Ironically many private practice institutions give more time off the schedule than academic institutions.
Unfortunately in the ivory tower many lose common sense and compassion and a real connection to what patients and communities really want (and the way staff physicians—especially residents—are treated is just so damn sad).
Great article! Just what I needed. But I’m at the other end. I have owned my own practice and sold my soul. Struggled to find staff with good work ethic and struggled dealing with the needy / entitled patients you describe and me trying to over deliver and over accommodate to stay relevant…
Oh I’d love to talk to you. Got some great fixes for that!!