Top 10 ways to know it’s time to quit your job


Attention all doctors: The first three are mine. The rest are from miserable colleagues. All true. And common. If you’re a doctor and you recognize anything on this list, please quit your job.

10. You feel nauseated when you see your clinic logo; you alter your commute to avoid streets with your clinic’s billboard.

9. Discouraged by the general despair among staff, you try to be joyful. Then you’re reprimanded by the clinic manager for being “excessively happy.”

8. You dream of leaving medicine to work as a waitress.

7. You envy your sickest patients and/or you develop a perverse pleasure in your patients’ pain.

6. You pray you will be diagnosed with cancer so you can get some time to sleep.

5. You spend your nights trying to keep patients alive while you imagine ways to die by suicide.

4. You work 16-24-hour shifts and have not had sex with your spouse in months.

3. You’re a top-rated doctor, yet you daydream about walking into traffic, jumping through the window, or just dying in the course of a normal day.

2. You are counting down the days until retirement during patient appointments.

1. You change your computer password to “fuck [name of hospital where you work]!!!”

Are you a doc who wants to quit your job? Want to live your dream?

Join the next Live Your Dream Teleseminar—and find out how! (It’s easy!!)

Pamela Wible, M.D., is a family physician and founder of the ideal medical care movement. She was named the 2015 Women Leader in Medicine for her pioneering work. Watch her TEDx talk on ideal care. If you’re a medical student or doctor, join the next teleseminar & retreat so you can learn how to stop suffering and start practicing real medicine. Photo by GeVe.

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38 comments on “Top 10 ways to know it’s time to quit your job
  1. Daedra says:

    Wow, yeah – #7 has actually been an issue for me lately. I’m in month 2 of residency and I’ve started envying my patients… because they get to sleep and hang out in bed all day (obviously this is a gross simplification of real-life pain and problems). I occasionally with I had bilateral PE’s if only so I could not work and get bridged on coumadin for a couple days.

    It’s really sad and it’s an awful feeling, because I love patient care. I do not love the 80-hour workweek. I have no idea how people survived training when there wasn’t even that minimal protection. I can’t quit residency, of course, but I do hope that someday I will construct a life in which I have the energy to love my job again.

    • Dr. Kat Lopez, MD says:

      Guess what – YOU CAN QUIT RESIDENCY! I did! I couldn’t stand the garbage pseudo-science that passed for “standard of care” that involved pumping obese people full of pharmaceuticals. I finished out my internship and said ADIOS!- I have my “general practice” license and have partnered with a group of famous naturopathic physicians in a gorgeous wellness center where my colleagues do aromatherapy and acupuncture on me for free, I make my own hours, and I spend 1-2 hours per patient (they’re all new patients so far, as I’m just building my micropractice). I’m living my dream thanks to Pamela – I took her workshop about a year ago and realized I MUST seize the day and live my dream! No regrets! Every single patient I’ve seen says they’ve NEVER met a doctor like me, they are amazed, and in tears for being fully listened to and have all their longstanding complex issues addressed by a thoughtful, loving, unhurried physician. I am a holistic general practitioner. I am the new paradigm. I love my life.

      • Pamela Wible MD says:

        You ROCK Sister!!! You are my HERO!!

      • Julie Wolfgram says:

        Reading your words gives me chills—and hope. Thank you for following your bliss!

      • Shanhong Lu MD PhD says:

        I am so proud of you!!!
        I am an internist/integrative medicine doctor and was working myself to death 8 years ago. I saw my one penny check and I saw my patients getting sicker and way too many drugs. I started my integrative medicine practice: NOW with clean burn shape weight loss and maintenance system (vegan for 10 days), I am helping thousands and making $300K a year! working 2 days a week at Mt Shasta Integrative Medicine where I own and practice true wellness and preventive medical care.

        • dochq says:

          Dr. Lu,
          So great to hear your story. If you wouldn’t mind sharing the necessary steps to transitioning to integrative medicine from traditional practice (obgyne for me), in terms of education/training, certification and marketing. I need a springboard!! Thanks!

      • Barbara Mack MD says:

        Outstanding, Dr. Kat!!

        The holistic general practitioner IS the new paradigm!

        We doctors have fragmented our patients into systems – cardio, neuro, psych, derm, endocrine – what if all of someones symptoms are related? Who is going to look at the whole patient, look at the big picture, and be the patient’s REAL doctor?

        Answer: Dr. Kat!

      • DocHQ says:

        Dr. Lopez, you INSPIRE! How timely that I found this link sent to me by another inspiring colleague. The pink elephant follows me from room to room and I keep managing to consider it a figment of my imagination. Go figure! Thanks for sharing your story. It’s good to know that there are alternative and highly fulfilling ways to practice medicine. You’ve turned the imaginable into reality. THANK YOU!

  2. Young Doc says:

    Wow – #10 (“first” on the list) is one (of many) that I can definitely relate to. Glad I’m not the only one, I always felt kind of weird for thinking/feeling that way. I actually noted this phenomenon primarily *after* I had left the horrid facility and stuck out on my own as a direct-care practitioner (and yes – I’m MUCH happier now). But for the longest time, I would feel really tense, uneasy, emotionally bitter (and yes, even a tad bit nauseous) whenever I had to drive by my old hospital (it’s along a major street in town – kind of hard to avoid.) Now it’s not so bad – I kind of force myself to not think of any of my history at the place when I drive by. (So really, that’s just denial or suppression or something, not true resolution…) I can still feel kind of tense when I drive by there with my husband in the car because he has a (well-intentioned) habit of mimicking my (bitter) voice as we drive by and saying “fuckers! … fuckers! …” (I don’t think I ever said that out loud when driving by there, but it’s a pretty accurate representation of what I was thinking / feeling!) He means this as an expression of solidarity, but it tends to bring out some of the bitterness in my that I’ve been working so hard to suppress!

    • Pamela Wible MD says:

      Very, very, very common. I think my husband and I had the same solidarity song when I unlatched my shackles. They’re just paper chains, by the way. Your employer knows that their enslaved doc employees are their only real competition. So the tactic is to control with fear and intimidation. Of course, the average patient just thinks docs are rich, greedy, and self-serving as they do not “get” that they’re docs are idealistic humanitarians who now have PTSD and depression—even suicidal thoughts. This is not health care. Never in my wildest dreams did I expect that I would be subjected to such inhumane working environments as a healer.

      Like you, I am happier than ever in my own clinic—designed by my patients. :))

      • Shanhong Lu MD PhD says:

        Love, are you making it financially ? and do you make love truly to your mate everyday ??? Can you go away for a retreat without having to go into debt??? and lose income???

        I have my own practice since I started 1998…. I spent time with them and I poured out the best solution for their sicknesses from stress and toxic environment…. then I was broke and divorced 8 years ago too….

        • Pamela Wible MD says:

          Everything is FANTASTIC! I have the practice of my dreams created by my patients. I am truly their servant and nobody turned away for lack of money, yet I can exceed my full-time big-box clinic slave salary. No gimmicks. No tricks. Just my humanity and a willingness to serve the people.

          A sick job will make you sick. No doubt.

    • Dan Robinson says:

      How come that word, which can mean something very nice to most of us, has become one to express anger and hostility? I hope it used to mean similar to “make love”, which should actually mean “create love, by doing nice things for others”. If they happen to be nice for oneself also, where’s the problem in that?


  3. BabyCatcher Michelle says:

    I’m deeply saddened today to read Robin Williams committed suicide. I’ve always admired his work and when I was young “Mork and Mindy” was one of my favorite shows (I just dated myself, right?!?) I really hate that suicide is so pervasive in our culture. And although I wouldn’t say I’m suicidal, my job dissatisfaction is deep rooted and sometimes veers towards deep depression, cured only by the lusty cry or soulful gaze of a sweet babe.

    What resonated with me:

    #4. Working long hours KILLS the intimacy of a relationship, it seems all time together becomes goal focused (bills, chores, etc.)

    #9. Trying to be supportive and getting criticized for having all the junior providers come to me for support/advice instead of the manager or owner. Well…duh. Who would you want to talk to? The person who sticks around and listens and laughs or the patronizing office manager and/or absent owner???

    #8. Calculating just how much those Wal-Mart greeters make, and if I lived off mac and cheese if I could still pay off my student loans…and then feeling depressed that a Wal-Mart greeter is my new goal in life and how fucking over educated I am for that, but then thinking that’s about what I have the energy for.


    BUT…the flip side of that is I’m very excited about getting clear on what I want, and moving forward. Yay!

    • Shanhong Lu MD PhD says:

      so you are an GYN? ready to help women balance their hormones and drop toxic fat belly? and make $300K a year…. not just now, but even after you retire?

      and the best? no overhead and no time clock… you are in control… your own life!!!

  4. Cynthia Bettinger says:

    I would add: having chest pain on the way to work.
    Losing your hair. Being unable to sleep at night. Severe irritable bowel symptoms.
    Yep, have had them all.

  5. praseena says:

    yep, almost covers all on my list and add chest palpitations, nausea and wanting to get some sick leave myself.

  6. Kim says:

    As a nurse, I can relate to several of these especially 6, 8, and 10!! I listened to the song “mad world” over and over prior to quitting “the system”–it seemed like my theme song at the time. Ironically, it was a homicidal/suicidal patient (according to his threats directed to me, the doctor, and the general practice/system) that was my wake up call to get out. I had severe anxiety and panic attacks for the three years after leaving but am better now and am happy as a solo practitioner helping those who really want to be helped.

    • Pamela Wible MD says:

      Smart move Kim. My question: Why do we put up with this crap for SO long? Can’t be a victim and a healer at the same time. Choose one.

      • Lorin says:

        The real reason that some of us “healthcare workers” put up with so much is because we want to eat food and put bread on the table for our children. As a nurse that has been a genuine concern of mine, THEN my own experience and what to do about it.
        It is easier to stand up for what you believe when the basics are covered.

        • Pamela Wible MD says:

          Yes. It can be scary (and risky) to stand up for what one believes in. When folks started the bus boycott in Montgomery, Alabama, they risked personal assault and loss of income, loss of food on the table. It ain’t easy to stand up for what’s right and boycott what is wrong with health care either.

          Mother Pollard was part of the African-American community in Montgomery, Alabama, during the start of the historic 1950s bus boycotts. Despite her advanced years, she refused to take the bus and was adamant that she would walk to see change happen, making the statement, “My feets is tired, but my soul is rested.”

  7. tad hominem says:

    sad, sad and sadder. what has happened to your profession. being somewhat in charge of your own future is the way to go.

  8. Dr. No says:

    I walked away from a misfit residency. For the longest time when folks knew I was leaving, I felt like I was wearing a scarlet letter and no one wanted to have anything to do with me, but their fear eclipsed my own, and was somehow very sad to see. I had to broach the subject myself to let people know I was okay with my decision, head held high, and it brought relief to them. Somehow it was odd being the positive one–when everyone was afraid I was going to drive off a bridge. The depression lifted. I began to love medicine again, to learn without being trapped in the memorize-an-algorithm or you are a terrible person, or you are too slow and the sky is falling. I see the lingering fear and dilated pupils when I join them for recertification classes. They are in a hurry, restless, bored, panicked, and not enjoying the pearls of the EMT who has been practicing for 40 years, and knows a bit about saving lives, not just teaching to the test. I on the other hand loved it all.

  9. Future Doctor says:

    Oh my goodness!!! Is this what I have to look forward to as a doctor lol?
    But seriously, it is refreshing to see this because often times people go into medicine thinking that it will be peaches and cream. While I am still in my infancy stage of the process, I know that medicine is where I want to be. I know that I want to focus more on taking care of my patients and less on the red tape that comes along with healthcare. Thank you guys for posting this because I don’t want to walk in naive thinking that being a doctor is going to spare me of all my troubles 🙂

    • SteveofCaley says:

      Be cautious. Professional nursing has been almost destroyed by the Machine into a clock-work factory-line job. Do not be swayed by the “romance” of medicine.
      Watch Pinocchio’s Pleasure Island. Many of the people running healthcare just want to turn you into jack-asses.

  10. James of Santa Rosa, CA says:

    Dr. Wible

    You need to be careful what you post on the internet.

    Saying stuff like “Voluntary Simplicity” and “an Investigative Reporter in a Doctors body” has a pheromone-like quality to this reader. You knock my socks off!

    Sign me up for your fan club.

  11. Marv Brilliant A.A. says:

    Some of these comments bring to mind someone’s worst nightmare. There is too much red tape and politics in the health system. I am not a physician, but I can sympathize with the turmoil that medical students must endure; however the tough training can lead to better doctors.

    Regarding insurance, the Obama plan will affect a medical practice in the worse way possible! There must be a better health system for this country. The U.S. Government is not the right fix for health care, just adding to the turmoil for more students and doctors.

  12. Dale Howard says:

    My question: How many patients committed suicide because their doctor fell into one or more of the top ten and they passed along the negative energy unwittingly?

  13. Shanhong Lu MD PhD says:

    we need to provide them tools today… otherwise many are killing themselves and dying from stress and committing suicide.

  14. Pamela Wible MD says:

    Leaving an abusive job is like leaving an abusive marriage. E-mail I just got from a doc trying to extricate herself from the abuse:

    “Had a 1.5 hour meeting with administration today where I was told that I was making a ‘terrible mistake’ and would never survive in private practice–‘you will be so unhappy.’ I told them that I was unhappy now, and if I’m unhappy in private practice, at least I would be able to do what I want. He told me I would have to increase my volume substantially and it would never be financially worth it. ‘You are going to want nice things. All doctors do.’ Well, frankly, Mr. F*ckhead Suit, the only nice thing I want is my soul back. Everything else is irrelevant to me right now.”

    • Dr M says:

      In my area of Western PA, the insurers are happy to see me as a solo. The key here is to see where you’re going and where you are now. Being a solo works fine for me, perhaps not financially, but I know what the next 3-6 months will be.

      I’d have to say 70% of the docs in my area are now employed. I fear for them, not only because they may loose their identity, but I also suspect that the job stability is an illusion.

      I am happier over the last 10 years of self-ownership professionally than I ever was working for an HMO staff model (6 years), or the hospital owned group (8 years).

      Unlike Pam, I do turn pts away from my doors when they are “potentially” abusive to me (drug requests, inappropriate follow ups or lack thereof), but not often.

      I don’t fear the day…

      Regards, all.

      Dr M in western PA

      • Pamela Wible MD says:

        Oh, I turn abusive patients away Dr. M. Why would I leave an abusive employer and keep taking abuse from patients??? We may have a different definition of abuse though. 🙂

  15. Geoff says:

    As a patient, I want to thank all of you for busting your gluteals, (minimus, medius, and maximus) to endure med school and its mental and emotional exertion (not to mention abuse) so that you could be a healer in this wounded world. Hearing that the abuse you all suffered to become authorized healers is awful enough, but as it continues in big-box medicine should be, in my opinion, a punishable crime. The fact that you all became vulnerable for this moment by posting your comments is a hopeful sign of life on your part. I wish to send you all a virtual hug, high-five, fist-bump, or whatever physical gesture works for you to indicate I admire your courage and strength and that I wish you all healing of heart and a place to practice your craft that supports your humanity.

  16. Pamela Wible MD says:

    E-mail from a doc:

    I took a hospital employed job 3 years ago when my attempt to escape the world of assembly line medicine exploded in front of me. I had left a position as a program director with a very well known integrated health system to take a boutique job in the NE. It seemed almost too good to be true… And it was. 10 days after I arrived… And after the practice was dumped by one insurer and my first check bounced the practice manager confessed that I had joined what I later learned was essentially a criminal conspiracy. Within a week I had resigned without notice and spent 4 hours being interviewed by a special investigator for Medicaid fraud in the state AG’s office.

    And then the reality of unemployment hit. As I learned of my former employers violent tendencies I became more and more panicked. I experienced full blown anxiety attacks nearly daily. My wife felt so exposed. We blacked out our windows. I bought a pump 12 gauge shotgun that I kept loaded with 00 buckshot, round in chamber, on safety, next to the bed. We only felt safe in the darkness of movies and we saw a lot over the 3 months it took to find the hospital employed job. It was pure hell.

    And then the new job started. And it got more interesting

    ….ok Pam I’m getting anxious just going this far

  17. Karen Hutchinson says:

    I am a doc that landed in med school by “accident”. I was completing my PhD in physics from a highly prestigious university in Northern California when the job offers at that time that were almost exclusively from the Department of Defense. The alternative would have been to become a faculty member, which meant spending time chasing grant money for research projects, etc…A very high pressure job. I didn’t want to work for the DOD so my best friend, who was a first year med student suggested medicine. I had never given it a thought in my life. I only applied to UCLA and was accepted with a full scholarship. I figured I’d give it a try. We all know that’s impossible. You have to really want it. I literally hated every second of med school but liked internship and residency. I never felt burnt out but I do remember being exhausted. This was long before the restricted hours residents have now and I routinely worked 110-115 hours/week but it was satisfying.
    Then the wake up call. I started work at a very large HMO in San Diego. Before the EMR I enjoyed my job but once the damn EMR came along I hated it. I was now supposed to see 22-25 ppd. The EMR required me to go faster, but I couldn’t. I needed to spend time with my patients and was always behind by over an hour. I did my charting at the end of the day as well as returned phone calls, emails and reviewed lab results. After 20 years at that job I was terminated for being too slow despite never having a single complaint. My patients loved me for listening to them. That was 2 years ago. I haven’t returned to work. I still have PTSD from the constant pressure and from feeling like a failure as a doctor. The EMR has enabled medical corporations an enormous amount of money because documentation of diagnoses is far more elaborate. The “incentive bonuses” and the Press Ganey scores are what we were supposed to strive for. I’ve been following Pamela for a while and love everything she stands for. I wish I had her self confidence and support. I’ve thought of opening my own “ideal clinic” but the wounds inflicted by working under such a high pressure environment have killed my soul. I’d rather work at Starbucks. Has anyone else felt this way, but still forged ahead with their own clinic? I’m 57 years old and don’t know if I am too old to do this. I no longer have the enthusiasm I used to. I need a mentor to help me make a decision.

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