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  • monotony

    I have now been an attending for 3yrs in a non-procedural IM subspecialty- starting to feel like the daily clinic grind is getting repetitive/not challenging anymore with limited income potential in the setting of being dependent only on E&M coding and telephone/telehealth coding.

    Thinking where to transition to- director role with more admin time? pharma? private practice? another fellowship?

    Anyone felt the same after a few yrs of being an attending? Hard to imagine doing the same for the next 20 yrs until FI.

  • #2
    People forget that medicine is a job just like every other job out there. Administration comes with its own headaches, but some people do enjoy it. Doing another fellowship would probably be about the worst thing you could do. I'd recommend finding some hobbies outside of medicine.

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    • #3
      Originally posted by Financemd8155 View Post
      I have now been an attending for 3yrs in a non-procedural IM subspecialty- starting to feel like the daily clinic grind is getting repetitive/not challenging anymore with limited income potential in the setting of being dependent only on E&M coding and telephone/telehealth coding.

      Thinking where to transition to- director role with more admin time? pharma? private practice? another fellowship?

      Anyone felt the same after a few yrs of being an attending? Hard to imagine doing the same for the next 20 yrs until FI.
      I've been an attending for 19 years. I am not dismissing your feelings, but here is some food for thought: I very much dislike when my day is "challenging"....

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      • #4
        Work/life balance. They don’t call it work for no reason. Any job will evolve to repetition. The next
        move you make will become old too.
        Good luck.

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        • #5
          Continue for another 20 years and you will spend most of your day , talking about grandkids , politics and life. I hear more gossip than the local hairdressor and still get to do a little medicine in between.

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          • #6
            That's the job. Probably something that should be emphasized to premeds more. Not the type of job that's constantly new, fresh or "growing." I feel the same but I'm fine with it. PP and fellowship is just more the same. Admin, teaching, research may scratch that itch.

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            • #7
              Congratulations!

              You're competent.

              Imagine if it was still challenging after the decade you've been learning how to do this stuff.
              Helping those who wear the white coat get a fair shake on Wall Street since 2011

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              • #8
                Originally posted by G View Post

                I've been an attending for 19 years. I am not dismissing your feelings, but here is some food for thought: I very much dislike when my day is "challenging"....
                Agree! I don't much care for "challenging patients." I can assume surgeons don't enjoy "challenging cases" etc

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                • #9
                  I remember hitting this time early in my career and feeling some discontentment. Many of us are nerds at heart and love to learn and be challenged. The truth is that the majority of our jobs becomes repetitive once you are doing this for a while. I'm outpatient primary care; there are a handful of things that make up the majority of my day, so they become automatic.

                  I'd suggest doing some reading on the achievement treadmill or TPP's writing/podcasts on the arrival fallacy. I really identified with these things in my post-training career.

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                  • #10
                    When I was a resident I did a rotation with a FM doc, and he mentioned for him the job really became enjoyable when he was experienced enough not to have to worry about the medicine so much and could just interact normally with patients.That's turned out to be true in my career as well. It could be different in a subspecialty I suppose.

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                    • #11
                      Boring is ok. Save & enjoy life outside the hospital.

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                      • #12
                        You been on a nice vacation recently?

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                        • #13
                          I just like hearing about my patients lives. It's almost never boring because humans are fascinating! I'm glad the medicine feels easy.

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                          • #14
                            if it makes you feel any better i'm an ER doc at a major urban quaternary trauma/stroke/burn center and i find my work to be fairly unexciting most of the time

                            at this point as others have said i mostly enjoy interacting with patients at this point. the delta between being a new attending trying to get dx/tx/dispo right and now focusing more on individualized plans is pretty rewarding -- sometimes a hypoxic pt w/ metastatic cancer needs to go home!

                            mostly what i do when i supervise is just first make sure the residents haven't missed the boat (they usually don't) and then shoot the breeze w/ people for 5-10 min.

                            major resus is still pretty fun, but like WCI said above it should also feel pretty routine.

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                            • #15
                              Originally posted by Financemd8155 View Post
                              I have now been an attending for 3yrs in a non-procedural IM subspecialty- starting to feel like the daily clinic grind is getting repetitive/not challenging anymore with limited income potential in the setting of being dependent only on E&M coding and telephone/telehealth coding.

                              Thinking where to transition to- director role with more admin time? pharma? private practice? another fellowship?

                              Anyone felt the same after a few yrs of being an attending? Hard to imagine doing the same for the next 20 yrs until FI.
                              Are you reading? There is an avalanche of research published every week.

                              Not long ago, I had to learn the indications/exclusions/adverse effects of the new "cardiology drugs;" SGLT2i and GLP1 agonists.

                              Then it was finerenone indications/caveats from FIDELIO-DKD and FIGARO-DKD.

                              Last weekend, I read the CLICK trial, and now I'm looking for my next CKD4 pt with difficult HTN so I can use chlorthalidone 12.5 mg po qd. I avoided it in that setting in the past because expert consensus advised loop diuretics instead.

                              I read as much as I can and I can't keep up with everything. Each new guideline statement is a tome.

                              If you're bored with medicine, I suspect you aren't trying very hard to improve/keep up, and it's very unlikely that admin work will hold your interest. If it's your compensation that bores you, that is a different problem.
                              Last edited by CM; 05-13-2022, 08:29 PM.
                              Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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