A Medical Economics Web Exclusive

Why I left medicine, and why I came back

After five years as a stock broker, this doctor returned as a hospitalist.

By Charles F. Schiffer, MD
Internist, Schenectady, NY

Medicine is a lot like riding a bicycle. Once you master the basics, you can always return—with a little extra effort—no matter how long you've been away. I know, I've done it.

There were several reasons I left medicine in 1995. After practicing nephrology for almost 20 years, I needed a change. I had accomplished all the goals I'd set for myself in practice, including the development of a thriving dialysis center. Caring for patients with end stage renal disease—and their deaths—also took its emotional toll on me. And it certainly didn't help when a close colleague had a cardiac arrest while jogging, at the ripe old age of 43.

As part of my search for a new occupation, I enrolled in an executive MBA program at a local university. Fortunately, most of my fellow students were closer to my age than the 20-somethings in typical graduate programs.

During my studies, I became friendly with two men who worked for a regional brokerage company, and I took their advice to search for a position in the investment industry. Upon completing my master's degree in 1995, I resigned from my nephrology practice and joined a national brokerage firm.

Life in the investment world was fun and particularly rewarding in the late 1990s. No matter what company I chose to follow, chances were the stock would only go up. Then in 2000, we all learned that stocks could also go down. Luckily, most of my clients were my former medical colleagues, who tended to be sophisticated investors, and understood the market's spasms.

Nevertheless, I gradually became disenchanted with the business community, and my interest in the job waned. By then, I'd grown accustomed to answering my co-workers' requests for medical advice. At times I even talked to their doctors for them, to help them understand their medical conditions or treatment options. Once again, I found that medicine was becoming the focus of my life. I became fascinated with the new medical discoveries, and with what the future of medicine might bring.

Then in 2000, our state's Office of Professional Medical Conduct asked me to review medical records, which helped prod my return to medicine. Fortunately, I had maintained my license during my sojourn in the financial world, and had attended CME update conferences at least once a year.

Eventually I found a job opportunity at a local community hospital for a "hospitalist," a specialty that hardly existed when I'd left medicine in 1995. Although I hadn't been actively involved in acute care during my foray in the investment world, I had kept up my knowledge through conferences, talks with colleagues, and reading medical journals. I also enrolled in an advanced life support course to update that aspect of medical care. Recommendations from my former colleagues also helped.

This job has turned out to be a perfect position at this stage of my life. As part of a group of hospitalists, I now see acute care patients and work at only one location. (In my former medical career, I'd covered five hospitals, two dialysis units, and my office practice). I now enjoy academic discussions, interesting patients, and congenial colleagues who have welcomed me with enthusiasm. Some have asked for financial advice in this time of market turmoil!

Fortunately for those who return to medicine after a break, the basic concepts remain fairly constant. The names of medicines may change but the treatment goals are the same. What is, and has always been the complicated art of medicine, is establishing the diagnosis. Once that is made, the treatment plan generally falls into place.

Although I didn't plan on returning to medicine when I left, I was able to do it rather easily thanks to a few crucial decisions I'd made. If you're thinking of leaving practice, here are some suggestions that will make it easier to return:

First, never let your license lapse. That may seem obvious, but I know some physicians who forgot to renew their credentials, and found the process of reapplying outrageous.

Second, continue your CME activities, whether with formal courses or simply by attending the medical grand rounds of your local teaching hospital. It's also important to keep up with medical journals, to stay abreast of recent trends.

Third, maintain contact with your former colleagues. Not only can they help with recommendations, but they may also be aware of job opportunities in your region.

As much as I needed my time off from medicine, I'm happy to return to my chosen profession. It brings a purpose to my life and I still find it extremely rewarding to help patients. After all, that's why we became doctors in the first place.

Charles Schiffer. Why I left medicine, and why I came back.

Medical Economics

May 23, 2003;80.