The world looks different when you’re eighteen and when you’re thirty – in some cases because your perspective has evolved, other times because the world has changed. Men and women drawn to careers in medicine while in high school or college are finding that when they emerge on the other side, things aren’t quite what they expected.
Typically, this is portrayed as the (well-worn) “Narrative of Disillusionment” – i.e. idealistic youth drawn to help people discover the practice of medicine is more rushed/bureaucratic/corporate/burdensome than they were expecting, and now are searching for new opportunities. While there’s a measure of truth to this arc, I’m not sure how different it is from any other career choice, which tend to be attractive in the abstract (A prosecutor! A screenwriter! A journalist!), perhaps less so when you’re actually doing it.
While there’s no doubt that practicing physicians face many (well-documented) challenges, many also continue to love what they do, and find the opportunity to help others — even with all the paperwork — still accessible, and still rewarding.
My hunch is that many of the physicians who leave medicine do so not because the negative externalities have become so bad, but rather because the range of potentially appealing alternatives has become so good.
A recent NPR blog focused on Bay area physicians leaving medicine to become entrepreneurs has sparked considerable dialog on social media (see here for my recent discussion of physicians-turned-entrepreneurs). My sense is that many physicians are attracted to entrepreneurship not to escape medicine, but to deliver on their perception of medicine’s promise. Frontline providers, as Aenor Sawyer of UCSF’s Center for Digital Health Innovation frequently emphasizes, offer vital insights into where the existing system may not be working, and where innovation is sorely needed.