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    The long journey to eventual work-life balance

    Every Sunday evening, a blanket of gloom shrouded me as I contemplated my upcoming work week. I felt trapped by my work contract, my financial obligations, and my family’s expectations. I couldn’t envision how I could change my life.  

    In reality, I was the only person who could make changes.

    My inability to enjoy work baffled me. I’d finally achieved what I worked for through college, medical school and residency. I was a board-certified physician of internal medicine, well-trained and prepared to care for patients in a rural practice setting.

    This was in the early 1990s, and in my area, hospitalists didn’t exist. I saw patients in the office by day, at the hospital by night and squeezed in a dozen or so nursing home patients during free time. I worked around 70 hours per week as I raced down the road to burnout.

    During those years, I was a thirsty person trying to drink from a fire hose. It was good stuff, but too much for me.

    Then I developed a medical issue, which in retrospect could have been avoided or mitigated by a less stressful work situation.  I took a few years off work to regain my health. What at first felt like a personal health disaster eventually became my opportunity to reorganize my life into a full and happy existence, with time to enjoy everything I love. This included taking care of sick patients.

    During my two-year hiatus, I missed being a physician. Though I now had an identity outside of medicine, I missed patient interactions and the intellectual challenges.  I wanted to return to work, but in new circumstances. 

    Initially, I thought the solution was to work part-time. That helped, but though I was well-rested, I was dissatisfied with primary care practice. That’s not where my heart was.

    I networked with other physician friends, scoured the internet for different practice settings and became involved with a physician support group near me. I kept an open mind and considered areas outside of mainstream medicine: occupational medicine, working for insurance companies and drug companies and doing locum tenens work. 

    I investigated areas like forensic medicine and even completed a different residency. I made thoughtful decisions based on my research.

    Eventually I found my niche in addiction medicine, after I agreed to work for a physician friend who was the medical director of an addiction medicine facility.

    I thought I would enjoy doing admission histories and physicals on patients entering residential care, but gradually I was drawn to the treatment of opioid use disorder with medications such as naltrexone, buprenorphine and methadone. I knew next to nothing about this area of medicine, and was amazed to learn the results of 60 years of research that support this treatment.

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