The Advice That Every New Medical Grad Needs to Hear? Get Out Now (while you still can)!


Author’s Note:  This is a satirical tongue-in-cheek article  that tries to highlight physician burnout. More physicians are making the transition to physician executive as the practice of medicine has become increasingly frustrating. If you are a physician executive reading this, please note that I have neither owned, nor have ever slept on a yoga mat. 

Get out, get out while you can! It won’t be easy, it requires a lot of practice and preparation. Which is why I am talking to you now, this is something that you need to start planning soon, before it’s too late. . . like it is for me.  

The key to happiness in clinical medicine is to not practice it, but rather to tell other doctors how to practice it.

So I am imparting to you this wisdom of the hairless; the key to happiness in clinical medicine is to not practice it, but rather to tell other doctors how to practice it. To accomplish this you must get through your training and then begin the process of positioning yourself as “non-essential staff”, or as we call it in the parlance, Physician Executive Leadership. (The term “non-essential”  is a general term referring to those who don’t need to come in on a snow-day. As you will soon learn,  most of those people are actually more “essential” than  you are!). 

Earnings? Don’t be so short-sighted. What you give up in earnings will be repaid  in nights, weekends, and holidays of blissful nothingness. As “non-essential” staff you will not find yourself up at 4:30 am on a freezing and moonless night to dig your car out from the snowbank it got stuck in on your way home from work just a few hours earlier. (See figure 1).


It may seem like I have something against Physician Leadership in hospitals, but that could not be further from the the truth. My physician executive colleagues meet with me quite often, some would say suspiciously often. They share with me important information like how to improve my revenue and satisfaction metrics.  They created a committee for physician burnout and were kind enough to supply me with a free yoga mat. It came in handy last week when I had to sleep in the hospital.   They even say things like “Bye, have a nice weekend, we really value you!” every Friday at 4:30 pm.

Clearly, these guys have figured things out, which is what I want for you. All it takes is a few hours online and a few weekend courses and you too can have your executive MBA.

Why am I not I doing this? Well, really it’s too late for me. I could probably make the time,  but between maintaining 4 boards, 2 kids, 1 marriage, and an acre of untended yard, I don’t have the juice for more continuing education. I’m already on the career treadmill, the speed is too high for me to do anything but keep running.  Eventually I won’t be able to keep up, and I’ll be flung off into the abyss, the oblivion, or whatever it is they call locum tenens these days.

I’ve done locums for a bit a few years ago. The docs I was subbing for were always SO excited to see me. Like a dog with a bursting bladder who’s master just came home. I must have that same look on my face when my locums guys comes in; I can finally go out and pee!

Oh, and I’m sure you’re wondering who’s going to take care of patients if you don’t go into clinical practice. Don’t worry, nurses will. Oh you didn’t hear? They’re all becoming doctors now. Look up the search history of any computer in the hospital and the most googled term is probably “online nurse practitioner course”. You should probably be aware of this, because as a physician executive you will be conducting numerous nurse practitioner interviews as you phase out your expensive physician workforce. So remember not to ask that degree holder from Arizona State University if they’ll miss the warm weather, that’s a beginner move, really.

I hope that this information has been useful to you, and you take this advice to heart. As for me I’ve got to get back to it, my treadmill awaits!

Deep Ramachandran, M.D. is a Pulmonary, Critical Care, Sleep Medicine physician, and CHEST Journal Social Media Editor. He blogs at Caduceusblog and the CHEST Thought Leaders Blog. He is on twitter @Caduceusblogger.