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Crafting A Job You Love From the One You Have

May 15, 2019

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Editor’s note: I rewrote this post for a broader audience (outside of medicine) for the ChooseFI community. You can read that version here. For my original post, read on.

At whatever career stage you’re in, I hope you craft the job of your dreams.


Tired Superheroine

Crafting a job I love

I ran into one of my mentors at a recent meeting. He was proud of me for finding a job when there weren’t many available, and for honing it into one that suited me over time. How do you craft a job you love from the job you have?

Do you see potential in the position you are currently in? Or are there immovable forces making it a suboptimal situation for you? If the latter seems true, it may be time to move on. If you’re not sure, read on for my ideas to shape a job you love from the job currently have.

Practice how you want

Most doctors train at academic centers, and so they “grow up,” thinking academic jobs are the only acceptable option. Some think private practice won’t offer challenging cases, or that it will be a sweatshop. I can attest that burnout is possible in private practice; however, academic jobs are not immune to the problem. Each type of practice and each job has its own positive and negative attributes; they must be judged independently.

Some radiologists claim that since clinical interventional radiology (IR) activities produce no revenue, diagnostic radiologists will never support them. I was clear about my intention to practice the clinical model of IR when I interviewed with my current group. Having at least verbal buy-in for the practice pattern I desired was helpful in managing expectations for day to day workflow, and ultimately to crafting a job I love to do.

The Dichotomy in Radiology: IR and DR

There are practices where IRs are expected to read as many films as possible between procedures, but not all private practice jobs are like that. When I am on IR service, I’m 100% responsible for procedures around the clock. A regular day could mean 9 hours of cases with intervening time to dictate, round, and plan outpatient procedures. Other days, the work falls on me like an avalanche, with no one else to decompress it. For better or worse, I am the master of my own IR destiny. I get every case and conundrum coming through the door, and decide what must happen now, or today, or tomorrow. This responsibility for and ownership of the service gives me a deep sense of satisfaction and joy, providing much of the autonomy we all crave to be satisfied at work.

Start something to feel engaged in the job you love

Going somewhere your field is less established, like in the community is a challenge, and a tremendous opportunity. You can be one of the first at your institution to offer a given service. For example, I began working in a location with a cancer center but no percutaneous ablation program. Getting the program started, I encountered engrained referral patterns that didn’t include IR (beyond the biopsy). Patients were offered surgery, chemo, or radiation. If patients wanted an ablation, they had to travel to a distant referral center.

Bringing this service to the community involved a long approval process. It took over a year to get the equipment through our resource utilization committee, and to negotiate with various vendors.

It’s not necessary to join an established practice like the one at which you received your training. In fact, if I wanted to perform ablations in Los Angeles, I’d be competing with many other doctors for patients and turf. In becoming a physician, I had a sense that I wanted to be located outside a major metro, where I could provide services to people who otherwise wouldn’t have access to them. By being out in the desert, serving a smaller community, I’m able to add tremendous value every day, and live that dream.

Speaking up: key to crafting the job you love

When you work somewhere you are really needed, you can work yourself to the bone. In my first few years in the desert, I found myself on “Q2” call: this means I was on call half of all weekdays, and half the weekends of the year. Sometimes, I was on call around the clock for 21 days straight.

I put my head down and worked, until I felt my personality change. There were moments I could not fake another polite phone call; I was burnt to a crisp within my first two years of practice.

Finally, another interventionalist was hired to share the call burden. It was a huge relief. As I prepared to give birth to my son, the group was forced to scramble for ten weeks’ coverage. They needed several locums to cover what I had done. Unexpectedly, going on maternity leave made me feel incredibly valuable.

What do you really want?

Over the years, the job boards filled with alluring opportunities around the country. I was pretty content with my position at this point, but noticed that the most tempting jobs offered up to twelve weeks off per year. With so much time to myself, I could spend time with my child, travel, or cultivate hobbies. I could cook or do projects around the house. I could have an entire life outside of work!

My radiology group granted all employees the same amount of vacation, and it was non-negotiable. Therefore, I opted to become an independent contractor and work 3 weeks per month. Whether this is considered a special “mommy schedule” or not, it’s what I really wanted.

Now, I can attend as many conferences as I wish, without feeling it’s cutting into my R&R. This fall, I am attending two personal development conferences: Fincon and Brave Enough. I have time to visit friends and family, or simply stay home on a “staycation.” For a week at a time, I can play the role of stay at home parent along with my husband.

Crafting the way I work:

When I choose to work less, I make less money. When I work more, I make more. On some weeks off, I’ve been able to fill in for a critical overnight shift, and thus be viewed as a key team player. In this way, everyone wins. Some might say I went part time, but that doesn’t bother me. In April, despite taking a week off, I averaged 49 hours per week! For me, this schedule is a sustainable way to work hard without burning out.

Not only have I decided to take 12 weeks off per year, but I can dictate my desired schedule. On maternity leave, my husband and I discussed limiting the amount of 24 hour IR call I’d take, largely for logistical reasons. We decided I would do IR at our trauma center, and therefore take the accompanying call for two weeks per month. The third week, I work at a smaller hospital that does not require call coverage. I’ve earned the seniority to schedule as I wish over the past five years. That period, as anything else, may vary depending on one’s locale.

Enjoy the perks of a job you love

If you’re living in a trauma center part-time like I do, there are some simple pleasures to enjoy. When I’m working, it’s harder to spend any money, so I take joy in getting closer to my financial goals. I love having access to free food and endless coffee. When procedures run into the evening, or patient transport is delayed, I walk to the next building to use the cardiac rehab gym. I can grind out five minutes on the rowing machine, or jog on the treadmill, watching HGTV. When I commute to a smaller, more distant hospital, I listen to books on CD from the library, or Audible, or my favorite podcasts. These small pleasures and acts of self-care truly help make my day to day happiness, and I feel lucky to enjoy them.

Craft a job you love when you’re in golden handcuffs

When I took Q2 call, it was like golden handcuffs. I was in the position I’d dreamed of, but I was so needed, I couldn’t leave town. When the temperatures hit 120 degrees, I couldn’t escape with everyone else. I had to stay close to the hospital in case of an emergency. Located ten minutes from the hospital, our new home was a refuge and a gilded cage. At least now I had something tangible to toil for.

We live in a vacation town, where techno plays in the distance on festival weekends. Pool parties reign. A couple weeks ago, the annual White Party ended with a fireworks display worthy of the fourth of July. I held my son, barefoot in the driveway, as we watched the spectacle erupt between silhouetted palm trees. We enjoy the eccentric beauty of life in the Southern California desert for now.

The rocky road to opportunity

There is a doctor shortage in our valley. Whether for the blistering heat of summer, a spouse’s job, or a need to be near a coastline, many doctors do not stay here long term. It is hard to retain doctors who would rather live in LA, San Diego, or the Bay Area. For me, this has meant opportunity. Staying put for five years now, I’ve been a present and a viable candidate when leadership vacancies arise.

Half a decade into attendinghood, I’ve hit peak leadership and earning power. You can do it too.

At whatever stage you’re in, I hope you take control, and craft the job you love from the one you have.

Download my free Dream Job Toolkit, which you can use to brainstorm your next moves to help you love what you do.

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