Have you ever thought about taking your career in an entirely new direction? Maybe you’re in the community and you want to get back to academics. For me, it was the opposite. This is my story: why I did it, what I do now, and what I’ve learned. My hope in sharing is that it might help you think through what matters to you as you look into the future of your own career in medicine.

After 15 years in academic medicine at the University of Pennsylvania in Philadelphia and George Washington University in Washington, D.C., I took a new job at US Acute Care Solutions (USACS) in September 2018 as its national director of clinical innovation. In all honesty, my move was met with both positive and negative feedback. There were many well-wishers (thank you!) but others with pointed questions: Why leave a successful academic career, particularly given the controversial role of management groups like USACS in emergency medicine?

Well, here is why. The first part of my career was dedicated almost entirely to scholarship—primarily writing papers (I love writing) and writing grants (I love less), teaching, and clinical practice. Along the way, I enjoyed success in publishing, great interactions with colleagues, and satisfaction in advancing science in emergency care. I also had opportunities to work in policy circles around Washington, D.C., and in academic leadership. 

Like many of you, I follow the Facebook group EM Docs. In many posts I read, I sense undercurrents of angst and burnout. Discussions abound on desires for life redesign, often through reflections on clinical cases or other remarkable work situations.

Sometimes EM Docs posts are disheartening. Many suggest: “This is not what I signed up for!” Yet in reality, that’s mostly wrong. We actually knew the pain points. Maybe we just romanticized emergency medicine or didn’t fully comprehend its cumulative effects. Perhaps it’s not medicine that changes, it’s us who change as we grow and age. To no surprise, your 30-year-old self should have different goals than your 50-year-old self, with greater experience in life’s successes and failures. Call it what you will—midlife crises or another name—emergency physicians regularly re-examine identity, specifically why we do what we do and to what end.

In the 2018 book, Designing Your Life: How to Build a Well-Lived, Joyful Life, authors Bill Burnett and Dave Evans—who also lead the Stanford Life Design Lab—apply design thinking to life and career redesign. The book offers many tools: journaling and self-reflection and a road map for getting “unstuck” through creating and prototyping alternative life plans. The goal of life redesign is to improve job satisfaction and overall happiness across all aspects of life.