Hemalee Patel is taking a leap. After six years as a hospitalist and clinical instructor at one of the country’s top academic health systems, she left to find a new way to practice. She is focusing again on her lifelong passion for lifestyle medicine, prevention, and nutrition. She’s in hospital medicine part-time, practicing integrative medicine at a major tech company, and advising health technology investors and startups — all with the goal of making healthcare healthier for herself, her patients, and other providers.
EP: What have you realized from your time outside academic medicine this last year and a half? Do you have a new focus?
Dr. Patel: I want to bring back the joy in medicine. I want to turn the word “burnout” on its head. I’m thinking a lot about “burning-in.” How can we use feelings of frustration and dissatisfaction to change the practice of medicine? I don’t want to be a physician who complains and then gets out of the field. I want to be a physician who recognizes how much I love my practice and gets deeper in the field. Even in the short amount of time I’ve been out of the traditional hospital role, I’ve been inspired by all the new ways that people are practicing. It can be so much fun to practice medicine. It can be lovely.
EP: Did you feel brave when you decided to leave?
Dr. Patel: I felt more scared than brave at the time. By leaving that role, I was going against the grain, in a different direction from everyone around me. I feel brave now, though. “I did that! Wow, it was really empowering.” By breaking out, I’ve better realized my self-worth and my professional-worth.
The hospital threw me a nice, very touching going-away party. They made cards with notes about how I had changed the nurses’ lives, the practitioners’ lives, and pulled in positive patient feedback. I’d never had that before. I wish every physician could have that feeling of being appreciated and knowing you’ve made a positive impact — without the going-away party.
EP: Were you surprised by how your friends and colleagues reacted to your leaving?
Dr. Patel: More than a few people called me afterwards to ask “how did you leave? I’ve always wanted to, I just don’t know how.” They identify themselves so much in their job and in their institution that they’re thinking, “I’m not anything outside of this.” Those were really interesting phone calls to take. For me it was a necessity. I had to go.
EP: Was there a specific moment that led you to that choice? Or was it a gradual process?
Dr. Patel: I felt the “golden handcuffs” phenomenon: lucky to be in a top academic hospital but also stuck. I was working with surgeons in a high-intensity cardiothoracic unit and then a colorectal surgical unit. Many of the patients that I saw had chronic diseases that led them to have major procedures such as open-heart surgeries — diseases that could have been mitigated or prevented if someone helped intervene earlier.
I had wonderful mentors, and the opportunity was awesome, but I started to feel “this isn’t necessarily what I set out to do.” Every day, I kept battling my own personal values. Is this something that I enjoy? Am I doing what I came to medicine to do? Am I following my true north?
I didn’t want to feel like a cog in the wheel. I wasn’t fully burned out yet, but I was heading in that direction.
EP: Do you remember when you first heard about burnout? It is seen as an epidemic among physicians today, but it has only fairly recently been openly discussed in healthcare.
Dr. Patel: One of my mentors, an anesthesiologist who has also now left for a new role, helped create a physician wellness committee. There was a retreat with a cohort of physicians interested in their own wellness, and the first thing they talked about was physician burnout. That was the first time that I heard it being talked about. To hear a professor who had been there for 20 years talking about feeling imposter syndrome, the same thing I was feeling my first year out of residency, it was eye-opening. You realize that a lot of your stressors are similar and that these feelings of isolation and de-personalization are not unique. When you’re used to the culture of medicine and so deeply embedded in it, you think that that is how a physician’s life should be.
Burnout is a critical issue, but I don’t like the term. Your posture changes when you hear it. Burnout is often packaged as something that physicians can’t control. An epidemic that is happening to us, something we need to react to. We have more agency than that. We have the ability to pick something better for us and our patients.
Read the rest of Hemalee’s chapter in Procedure: Women Remaking Medicine Vol. 1