Medicine’s Great Resignation.
In 2021, an article published in Mayo Clinic Proceedings: Innovation, Quality & Outcomes found that one in five doctors planned to leave their practice within two years.1 An AMA commentary referred to it as “medicine’s great resignation.” One in five is a pretty ominous figure and speaks to the instability and trajectory of our current healthcare system. It’s not a secret that patients are largely unhappy with the quality of their care and many providers are overburdened, constrained and often either unsatisfied or outright miserable. Maybe someone is winning with our current model, but it’s surely not the patients nor the doctors.
In October 2021, I was one of the doctors who left.
I was a senior dermatologist in a large healthcare system. My reasons for leaving were not unique or heroic; hasty patient encounters, overwhelming volume, an overflowing inbox and a feeling of missing-the-bigger-picture left me feeling unsatisfied and unsettled. A well-timed introduction to the world of podcasts at the onset of the COVID pandemic spurred my curiosity about how medicine could be practiced. Through these podcasts, I felt childishly connected to a body of doctors who already paved the way to a new paradigm of medical practice called “functional” medicine. When I decided to leave managed care to pursue functional medicine, I felt moments of exhilaration, like I was a part of a grassroots uprising of fed-up physicians, happy to shed the cloth of Rockefeller medicine and emerge from under the thumb of big pharma to stand liberated and free. Of course, the reality was not so dramatic. One day was my last day, and then I wasn’t there. But in my heart it was a glorious leap of faith, because I had made a commitment to practicing in a holistic way and there was no looking back.
I purchased a building in Historic downtown Lincoln, CA that was previously a salon and spent the next few months turning it into my clinic, Body and Sol Medical Phototherapy Clinic. The master plan was to have a functioning phototherapy clinic so I could offer the world the my favorite dermatology treatment while I studied functional medicine. I quickly realized that I couldn’t operate even in this narrow scope without seeing functional medicine. It was everywhere. Even something as simple as my beloved phototherapy, which works beautifully to treat eczema, psoriasis, hives and more, was all of a sudden incomplete without the functional approach. Crap. So I jumped, learning as fast as I could how to run a medical practice and all about an entirely new world of medicine.
For anyone who doesn’t know what functional medicine is, functional medicine is an approach to medicine that takes all aspects of a person in consideration and uses a systems approach to determine the root-cause of a disease. It is founded on the concept that the human organism is always organizing back towards health- and our goal as physicians and healthcare providers is to identify what is preventing the healing and then get the heck out of the way. The model is both beautifully simple and alarmingly interwoven and complex.
For a dermatologist, functional medicine means asking why someone has psoriasis, why someone has an autoimmune skin condition, or acne or even skin cancers. The answer might trickle down to gut microbiome dysbiosis, cumulative toxic exposures, sensitivities or long-term effects of chronic stress, but the answer almost never rests on bad luck and genetics. My head still explodes a little when I see people shed their chronic disease with personalized lifestyle and gut-healing interventions.
Here’s to the Future.
There will always be a role for sick care and trauma care. Surgeons will probably always have cringe-worthy people-skills but be technical gods at their life-saving craft. Doctors should be respected for the time and commitment that was dedicated to achieve our degrees, but we also must recognize the boiling pot of water that we are in and evolve from the current mindset. The modern healthcare system is suffocated by protocols and top-down care, and doctors are allowing people to believe that they are victims of their disease, oppressed by and dependent on the system for health through pharmaceutical intervention. We need more healthcare. It’s time we liberated people to be self-determined creators of their own health. The goal is complete reversal of chronic disease and the key is education and health autonomy. It is the only way to turn this ship around.
I look forward to the road ahead as I wed holistic wellness to my traditional training, and I will do my very best to be part of the solution. The whole journey so far has been humbling, intimidating and utterly glorious. I am finally operating in an environment that speaks to me and feels shamelessly honest and coherent. I hope that maybe the rest of the 20% of doctors that are leaving their practice will find their way to functional medicine, and that they too will find joy and meaning in medicine again.
1. Mayo Clinic Proceedings: Innovation, Quality & Outcomes https://www.mcpiqojournal.org/article/S2542-4548(21)00126-0/fulltext