Dear Early Career Physician,

Most days I feel so lucky I have to pinch myself to make sure it’s real. It sounds quaint, but it is truly a privilege to be a physician. Folks tell you their secrets and literally trust you with their lives. You watch them grow and thrive: they learn to self-manage their chronic conditions, they find peace in loss, they share their hurt and then their gratitude. I have a job where I can learn every day; I learn both about the science and art of medicine and about myself. I am often useful and usually can bring some joy to my patients. 

Other days I want to crawl into bed, pull up the covers, and cry. Because I cannot bring joy to everyone, some folks are unable to reflect and change, and sometimes I am not trusted no matter what I say or do.

No, I am not bipolar. I am a general internal medicine physician with more than 25 years of practice, and life is like that. Interesting and complicated.

The way to stay sane is to know your own values and live them authentically. (If you don’t know how to find your values, and you don’t want to ask AI, Brené Brown is a good resource.) If you don’t feel grounded or you cannot bounce back from the bad days, it’s usually because you’ve lost the big picture or you are carrying out the plot in someone else’s storyline.

Have a physician friend group in which you can safely share your worst patient care experiences and biggest errors. Give more support than you get. Schedule get-togethers religiously. Never worry alone. 

Know when to say yes: to things that resonate with your beliefs and passions, to things that challenge you to be more. Get involved. ACP has so many ways to do that.

Better than knowing when to say yes: know when to say no. We all have only 24 hours in a day. Saying no to one thing means you are saying yes to something else. That something else may be self-care. You cannot doctor with compassion if you skip self-care.

Spend more time looking outside than within. Listen more than you talk. 

Hire help. This is the best advice and the best decision I ever made. I don’t think it’s possible to raise a family, create long-lasting family bonds, and have a fulfilling career in medicine if you don’t have help. I hired a series of teenagers to clean the kitchen and make dinner three evenings a week for five years when my kids were little. Don’t do stuff you can farm out unless it brings you joy.

Thank your team, particularly your nurses and your medical assistants. They have likely earned your thanks, and you will feel better when you share gratitude.

Finally, find a way to remind yourself about the good days and your purpose. I treasure gifts and letters from patients. I also literally write my values on a sticky note and attach it to my computer screen. 

With gratitude,

Julie Mitchell, MD, MS
Primary Care Preceptor
Froedtert & Medical College of Wisconsin
Menomonee Falls, Wisconsin

Medical School: University of Wisconsin–Madison, Madison, WI
Internal Medicine Primary Care Residency: University of Pittsburgh, Pittsburgh, PA
Fellowship: Women’s Health, University of Wisconsin–Madison, Madison, WI
Master Of Science: Population Health, University of Wisconsin–Madison, Madison, WI