A Doctor's Doctor Counsels on the Decision to Leave Practice

Patient Care recently spoke with Michael Myers, MD, an expert in physician mental health, about the unprecedented psychic and emotional challenges faced by front line clinicians caring for patients infected with the SARS-CoV-2 virus.

In this short video, Myers comments on clinicians who have been so deeply affected by the pandemic conditions -either emotionally or materially - that they are ready to leave practice.

Dr Myers, speaking from his clinician point-of-view, explains how important it is--and will be going forward--to engage in treatment the clinician who is ready to leave a practice or shut the doors, evaluate the individual for a nascent mental health issue such as major depression, treat any mental illness with medication and counseling and, when they are feeling better, revisit the desire to leave their life work behind.

The following transcript has been edited for clarity.

Patient Care. So, sort of on the flip side of that we hear and see a fair amount of talk about physicians saying. “This is it, I'm, I'm leaving medicine. It's been ruined for me.” And some feel abandoned, some feel victimized, as I said earlier, by patients who won't follow precautions; many smaller solo practice or small group practice physicians are actually having to close their doors. I guess this all may add up to my question about PTSD in the wake of the crisis, which is not anywhere near over. But, from what you’ve said, it sounds to me as though there's going to be a group that will that is resilient, that will move on from this and maybe weren't as deeply touched. But for those who were, what do we have to look forward to for them?

Michael F. Myers, MD Professor of Clinical Psychiatry, immediate past Vice-Chair of Education and Director of Training Department of Psychiatry & Behavioral Sciences , SUNY-Downstate Medical Center, Brooklyn, NY.

Myers. Well, what I would suggest in a situation like that, and I'm, now I've got my clinician cap on, because when I was in private practice, it wasn't unusual for me at all to have a new patient come in and describe exactly sort of what you were saying; it was before the pandemic, but, in a sense, they’re sort of saying, “Should I give it all up? I feel like I need to, I want to,” etc, etc. And it became my job to help them sort that up. Because what I wanted to make sure, of course, was that they weren't perhaps, maybe slipping into what we call a clinical depression, a major depression, or some other type of illness that was contributing to the way they were feeling. So, in other words, when and if that was the case, and we successfully treated it, then their vision and their outlook was quite different. They say, “You know, now that I'm feeling better, I've got my mojo back. Yes, yes, my work is stressful, but I don't think I need, I don't think I need to leave it, or I don't think I need to retire completely. I think I need to make some changes, because so much of this, I think, got me into trouble in the first place. But I'm going to I'm going to, I'm going to have a second look at that,” that sort of thing.

I would suggest that anybody who's considering that would you know, there are physician coaches out there, they also assist with something like that. And because this is often the person's life work, and they want to make sure that if they are going to…others are very clear. They feel they feel done, you know, “I’ve given many years to this, I'm going to retire early and I’m going to become a farmer.”