Perspective
Mid-Career Crisis
A family physician retreats and recharts her professional path.
By Kristin Haugan, M.D.
I left my practice. It was my first practice, my only practice, the one I believed was going to take me to retirement, so deciding to leave was not easy. But it was something I had to do. I had worked in the same family medicine clinic in the Twin Cities since I completed my residency in 1994. For a number of years, I was content. The practice was stable, I worked three-quarter time, clinic only. The other doctors and physician assistants were supportive and collegial. I enjoyed seeing patients, their families, and their friends. As time passed, I grew more comfortable being me, being real, with these people. I realized that the practice of medicine is a sacred art.
So what happened?
The work environment changed. As all physicians are well-aware, in recent years, we have been asked to do more busywork: prescription refills, insurance-mandated prescription substitutions, other paperwork. Because of financial pressures, our clinic had to let office staff go. That meant having less support for getting that work done. Morale flagged. Doctors and physician assistants left. Then the electronic medical record came along. Time was required to document, order, code, and charge for visits. I found my attention divided between the patient in front of me and the computer between us. As I had less time to spend with my patients, I began to feel myself disintegrate.
I changed as well. Daily meditation practice was making me more aware of myself and the realities around me. I began to see my role in supporting the pharmaceutical industry and large health systems. It seemed I was a gear in an industrial machine designed for growth and profit.
It was time for a change, but it took a while before I was ready to jump.
A year went by as I soldiered on. As my partners left, I became more isolated. I didn’t share my negative feelings at work. I thought I needed to be a good partner and a positive presence for my staff and patients: strong, reliable, getting the work done and not whining about how difficult it had become. If I couldn’t be positive, I thought it best to be silent. But I was experiencing the emotional and physical pain that results from feeling “stuck.” I was irritable and tearful at home with my family. My upper back and legs ached, and I developed a frozen shoulder. This was a telling analogy for the inertia I was experiencing.
One day, I realized I had labeled myself as the victim in my own life story. I knew I didn’t want to continue in that role. So I decided to drag myself out of the hole I’d dug for myself. I began to search for a new perspective, new friends, and a new way to think about healing others. I wanted to connect again with the sacredness of my work.
Finally, last February, I stepped away from my practice. I needed a break, and I knew that leaving would give me the space I needed for searching. Arriving at the decision to do so was very hard. I felt I was abandoning my partners, my patients, and the office staff. I was leaving behind that large piece of ego bound up with being my patients’ doctor. I wasn’t sure I would return to medicine.
I began my break at St. John’s Abbey, where I stayed alone for three days, walking, journaling, and meditating in silence. I listened for my inner voice, wanting to follow my heart. I began to heal my achy body with regular exercise including outdoor walks. I began to eat a vegan diet. I attended conferences and retreats. One was Rachel Naomi Remen’s Finding Meaning in Medicine, which was a wonderful way to connect with other doctors and nurses who were also hurting and looking to rediscover the heart of medicine. There, I learned that loneliness was a common theme; but none of us felt we were alone when we left. I participated in a Parker Palmer Circle of Trust retreat, which was two days devoted to listening to others, reflecting, and listening for my inner voice.
I discovered that the Minnesota Holistic Medical Association offered a great way to connect with local physicians and other providers who are interested in practicing the healing arts. We meet quarterly, always beginning by introducing ourselves and talking about what is currently exciting us in our work. I also met one on one with other physicians, healers, former teachers, and old friends who had previously inspired me or about whom I was curious. We’d meet for a couple of hours over coffee. Through them, I discovered fresh new ways of working and being. It truly was fun.
Since then, I’ve initiated a physician group that follows the model developed by Rachel Naomi Remen. We try to meet monthly in each others’ homes for the purpose of listening and fellowship. We each bring a story to share about a chosen topic. Storytelling is a powerful way to listen and be inspired, to be heard, and to touch each others’ hearts.
I would not have been able to do this on my own. I’m grateful to my partners, who stepped in to care for my patients when I left. I’m grateful for my husband, who encouraged me to make this decision, trusted me to find my way to healing myself, and provided me an emotional refuge. I’m grateful to my physician supervisor, who was empathic and open-minded. She cared about me and supported my decision.
Reaching out to others to create a network of support has been crucial to my development and to getting unstuck. So has solitude. I needed both the space to step back and reflect on the big picture and enough silence to hear my inner voice. We need a balance of community and alone time to be whole. I believe healing ourselves is important to helping others. My challenge now is to merge who I am with what I do while keeping my feet on the earth to support my family. Being aware of my inner voice will help me avoid getting stuck again.
I’m back in medicine now. I recently started working at an independent integrated holistic clinic. I work with a traditional Chinese medicine doctor and a physician who practices allopathic medicine and homeopathy. Here, I have longer appointments and a population of patients seeking a different approach to healing. I am board-certified in integrative holistic medicine and look forward to developing my own style of practice. I am inspired to help people heal themselves. MM
Kristin Haugan is a family physician at Total Health Clinic in Fridley.