AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
When should a doctor stop seeing patients? What are the alternative careers for doctors? Why do physicians leave practice? What other jobs can you get with an MD?
Our guest is Debra Atkisson, MD, senior vice president of clinical services at Blended Health and a professional certified coach. In this episode, Dr. Atkisson talks about navigating the transition out of medical practice. AMA Chief Experience Officer Todd Unger hosts.
- Watch AMA Update for health care news for physicians, residents and medical students.
- Not a physician? Join the Patients Action Network.
- Wondering "when should a doctor retire"? Access retirement resources for doctors leaving medical practice.
- Thinking about when to stop practicing medicine and what comes next? Learn more about transitioning out of active medical practice (CME credit available).
- AMA Ed Hub™ login.
- Struggling at work and wondering "should I quit my job"? Get insights and motivating life advice from Master Your Storm by Dr. Debra Atkisson.
- AMA Senior Physician Section (SPS).
- Member groups and AMA section list.
- The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most—patients. We will meet this challenge together. Join us.
- Learn more about our AMA advocacy priorities, including:
- Reforming Medicare payment
- Fighting scope creep
- Fixing prior authorization
- Reducing physician burnout
- Making technology work for physicians
Speaker
- Debra Atkisson, MD, senior vice president of clinical services, Blended Health
Transcript
Dr. Atkisson: I think what we have to realize is we don't leave behind being a physician when we stop an active clinical practice. We have those skills that we can take and that we can continue to service medicine in a different way.
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about what physicians need to know about transitioning out of medical practice. Our guest today is Dr. Debra Atkisson, senior vice president of clinical services at Blended Health and a professional certified coach in Weatherford, Texas. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Atkisson, it's a pleasure to have you with us today.
Dr. Atkisson: It's a pleasure to be here today to talk about such an important topic. I'm grateful to AMA for having me here.
Unger: Well, usually, we're talking about what it's like to be in practice, so this is a bit of a twist. Why don't we just start with an overview of your career journey in medicine?
Dr. Atkisson: Certainly. Well, I attended the Texas Tech University School of Medicine. And while there, I thought I was going to do family medicine but quickly fell in love with the specialty of psychiatry and decided to pursue child psychiatry, which I did at the Karl Menninger School of Psychiatry in Topeka, Kansas. After that, I relocated back to my state of Texas. I've practiced in the DFW Metroplex since the early '90s doing a variety of things, including a long private practice as well as working at a medical school. And currently, I work in a medically adjacent career as a senior vice president of clinical services for Blended Health, which services the Connections Wellness Group in the Metroplex, as well as being a professional certified coach.
Unger: Well, that's quite a career. And let's head into the thoughts about transitioning out of medical practice. What, for you personally, is driving that decision?
Dr. Atkisson: Well, there are a number of things. I think that we all have to think about four primary factors that we need to contemplate before we even decide if we're ready to transition out of active clinical practice. The first part of those is looking at what I call our self-factors, which involve our health and wellness, our family, other matters along those lines. The second are the emotional things that we need to think about. The third thing that we really need to think about is what will we be transitioning into as far as when we leave active clinical practice. Because all of us as physicians usually just don't come to an abrupt halt.
And then I think the other thing that we must think about is the family factors and the goals that we have for ourselves and our families. So when I think about these different factors, I think you do need to spend a significant amount of time looking at each one. And it also includes your energy levels. One thing about physicians is we tend to think of our energy as being completely unlimited, and there comes a time in life when we realize that is a finite resource, like time and money, and we need to think about it in that way.
Unger: Now, I'm curious because those buckets of things that you said in your analysis make a lot of sense. Where do you think most people get kind of tripped up as they analyze each of those?
Dr. Atkisson: Clearly, I think it's the emotional reaction. It's the second phase of what you have to contemplate, and this is the thing I have found it the hardest. I've talked to a large number of physicians who have contemplated retirement and helped some of them walk through the process. And it's the fact that our identity is that of a physician. I think what we have to realize is we don't leave behind being a physician when we stop an active clinical practice. We have those skills that we can take and that we can continue to service medicine in a different way, as well as our communities at large.
Unger: I think that makes a lot of sense, the identity part. Obviously, the first thing I learned about physicians when I started working here was just the calling, just how attached folks are to just the idea of saving people and treating patients. There has to be some kind of feeling, too, tied to leaving patients behind. Is that something you often see as part of that emotional calculation?
Dr. Atkisson: That is a big part of the emotional calculation. I will say for me personally, that was the hardest part. I had patients that I had taken care of for almost 30 years, and I had watched them grow up, so to speak. I walked through life with them. So it's a very, very important part of our identity as being caretakers and caregivers. I think, though, that if we do things appropriately, we will realize there are other people who are ready to step into our shoes if we appropriately mentor them, we make a good choice for our succession plan, and I know that I did that for my patients and I'm very glad that I did.
Unger: Well, that brings us to the next question, which are once you have made your way through that analysis and you're ready to make the transition, what are really the key steps that are involved there afterwards?
Dr. Atkisson: So there's three major steps. If you've done this process as I mentioned, the contemplative phase of the process where you've really thought through all of these things—and by the way, that's not something you do quickly. That takes a little bit of time to do, so I suggest to people, you really start thinking about it at least a year before you plan to retire. Because you're going to need to think it through, and then you're going to do the roadmap of how you're going to get there. And so once you have actually done those things, step one is that you're ready to let go of your active role.
At this phase, it's very important that you say, all right, I know there's going to be other things I have to deal with, but I can step back, follow the plan that I've established. And part of that plan is, of course, a good communication plan with your family, your colleagues, taking care of your financial matters and making sure that everything is in place. So as you let go of the active role, you've set a date when you're going to be fully complete with your active practice and you begin to phase out. I think that's the stage one. Stage two, that emotional reaction I talked about. It's going to happen again. It happened when you thought about it. And then once you actually begin to do it, you'll have a stronger reaction.
And the last stage is visualizing your new identity. Get excited. This is a time when there is a new chapter for you. There are other things you can do that will be a major contributor, and be glad about it.
Unger: I like that, especially having something to look forward to in terms of the next phase of life. I'm sure that this process can be really overwhelming. Could you share a few pieces of advice that you have to help physicians navigate the steps that you just walked us through?
Dr. Atkisson: I think there's three primary things everybody needs to do, because this will really help you with the process. When you've set that timeline and date of transition, be sure you have two plans in place—your own personal financial plan, as well as the plan for the patient transition. That must be nailed down, it must be ready to go and you should have communicated it to all the appropriate parties.
The second part, your emotional reaction. Many physicians, most physicians are actually fairly emotionally healthy and they're used to compartmentalizing and dealing with their own feelings. Realize that now is the time that you don't do that. Seek out a trusted peer—your spouse, a significant other, a colleague, a coach, a therapist, whoever you need to talk with—to work through that because that's going to help you and let that not be a roadblock. And the last thing is you visualize your new identity. Really think about how you're going to continue to serve others in a different way. It's going to really help you as you step forward and be excited about the process.
Unger: Now, part of what that next adventure might hold is staying involved in medicine somehow, even though you're transitioning out of clinical practice. Is that something that you recommend or at a high level, what are the areas of opportunity that you see out there?
Dr. Atkisson: There are many opportunities for physicians that they're not aware of I think, always, because we think of ourselves as giving that patient care, which is what we are trained to do and it's very important, and it's what we've done all of these years. But the other ways that we can really serve others is using our experience and our knowledge that we have in roles such as part time work educating or mentoring at a medical school, becoming a coach to medical students, residents, young attendings, using that skill with other people. I found that that's a translatable skill to working with many other professionals and educators.
Also, other ways that we can serve is by volunteering in our local medical missions that are most of our communities. The other things that are really important that we need to think about is those skills that we have do translate to organizations outside of medicine. I know people who sit on boards of faith communities and other organizations, and their ability to strategically think through matters is extremely helpful for those agencies. So there's so many opportunities for us to work in medically adjacent careers.
Unger: I know there's a lot more we could say about that in this entire process. Are there any resources out there that you'd recommend physicians check out to learn more?
Dr. Atkisson: There are a number of resources, and I have to tell you, as a lifelong AMA member, I was amazed when I went to the AMA resource page and how many resources there are. AMA also has—I did a clinical education on this and you can get free CME by going to the link that I know you all will provide, where I talk about this in more depth in about a one hour discussion, including a panel of four physicians who have successfully done this process. I think that would be helpful to anyone looking at this process as well.
I also think coaching can be quite beneficial. I wrote a book that was entitled Master Your Storm and it's on amazon.com, and it has the whole process of coaching questions you can go through as you tease these things out. If you have Kindle Unlimited, you can download it for free. And I encourage also, one other place I'd like for people to look for those who think of speaking or writing or blogging, there are pitfalls. I know that you are well aware of all of those. There is a website where there are a lot of free blogs you can look at. It's media-public-relations.com. I suggest that people look at that as well.
Unger: All right. Well, we will include links to some of those resources in the description of this episode. Dr. Atkisson, thank you so much for joining us today and helping physicians navigate this process.
Dr. Atkisson: Thank you for giving me an opportunity to talk with you. I appreciate your time and AMA for doing this.
Unger: Well, thank you. If you found this discussion valuable can support more programming like it by becoming an AMA member at ama-assn.org/joinnow. That wraps up today's episode. We'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
Subscribe to AMA Update
Get videos with expert opinions from the AMA on the most important health care topics affecting physicians, residents, medical students and patients—delivered to your inbox.
