Physicians Who Make Career Changes in Mid-life and Later Find Rewards — and Occasional Challenges

By Bonnie Darves, a freelance health care writer

Physicians who choose to shake up their practice careers and try something different, whether that’s a job in an unfamiliar setting, locum tenens practice, a leadership role, a nonclinical endeavor, or a side pursuit often find embracing change pays dividends.

It’s not uncommon for physicians in mid-career, roughly the ages of 45 to 55, to experience either a bit of the blahs or an outright itch to try something else. And when they do, the options and potential paths are plentiful.

Heath Jolliff, DO, an Ohio-based clinical toxicologist whose own mid-career transition six years ago found him launching a coaching and leadership consulting practice, has witnessed all manner of physician mid-career pivots. Physicians he has coached have moved from traditional clinical practice into public health advocacy, health-care leadership, medical writing, digital health, consulting, and the pharmaceutical sector. Some have found ways to reconfigure existing jobs or move to a new, more varied one for greater professional satisfaction, while others have incorporated medical-mission assignments into their schedules.

Other options Dr. Jolliffe recommends for mid-career physicians include medical research or clinical trial work, medical education, administration, nonprofit sector work, and medicolegal activities. He also urges physicians to consider the now well-established telemedicine field.

“There are plenty of opportunities for mid-career physicians seeking a change, but it’s important to engage in self-learning and to get some clarity before considering a shift,” Dr. Jolliff said. “Keep in mind that you’re not stuck in a cage — and that your experience and skills are both valuable and needed.” He advises physicians to first identify what they find meaningful in their work, what they don’t like or find intolerable, and what their personal values are. On the practical front, physicians also need to identify the level of compensation they’ll require.

Once physicians have a sense of the avenues they’d like to consider, Dr. Jolliff said, the next step is to “personally explore those options. It’s important to test the waters first,” he said. Physicians can set up informational interviews, for example, or reach out to individuals to learn about what their days and work lives look like on the ground. The idea, Dr. Jolliff said, is to follow your curiosity.

Exploring mid-career options

Neil Baum, MD, a professor of urology at Tulane University Medical School and retired urologic surgeon who writes and podcasts about medical practice and career matters, advises mid-career physicians seeking change to take an incremental approach. “I recommend a hybrid model — reducing clinical time and getting involved in other pursuits and avenues of income,” Dr. Baum said.

“If you want to make a shift, don’t quit your day job first, and don’t burn a bridge behind you.”

— Neil Baum, MD, New Orleans urologic surgeon and podcaster

In Dr. Baum’s view, part-time expert-witness work can be gratifying and lucrative for physicians with the requisite qualifications. Besides being up to speed on the standard of care in their specialties, expert witnesses should have top-notch communication skills. “It’s easy to get your foot in the door, but you must be a good speaker, and you must write well,” he said. Other part-time income avenues he recommends include becoming a coding expert, for which there’s high demand, and getting involved in social media and podcasting.

For physicians who want to boost their business skills with an eye to administration or consulting, Dr. Baum advises taking individual courses first rather than committing to a degree program. “Start with a few courses — you can even just audit them — and see what interests you,” he said.

Nisha Mehta, MD, a North Carolina radiologist, has turned her own mid-career exploration into a duo of successful forums. She launched the Facebook group Physician Side Gigs in 2016, to promote business and financial skills for physicians, and today it boasts 121,000 members. Likewise, her Physician Community, a virtual lounge for discussing and improving life in medicine, has grown to include 87,000 members.

Dr. Mehta considers mid-career an ideal time to expand horizons and revisit life goals, and the activity on her busy forums suggests that physicians are doing just that. “What starts to happen, in our mid-forties, is that we begin asking more questions about what we truly want in our lives and our careers,” she said. “We’re confident in our skill set, and we’re in a groove, but maybe we’re also a little bored or frustrated.”

What Dr. Mehta has witnessed on her forums is that mid-career physicians are making more lifestyle decisions than in the past and adjusting their practice lives accordingly. “What we’re seeing with Side Gigs is that physicians are trying not to be completely tied to their clinical work,” she said. Physicians are also trying to figure out what they can afford to do, she added, if they’re considering reallocating their time between clinical and other activities.

“There are many opportunities out there where physicians can split their time between clinical and other roles, but you have to be intentional and have a financial plan in place to make the transition,” Dr. Mehta said. She suggests chart review and expert witness work as viable starting side gigs. She acknowledges that consulting work takes considerable time to plan and launch and that cherished editor roles are rare. Regarding the pharmaceutical sector, she notes that it’s difficult for physicians to break into because the market is somewhat saturated. In addition, she cautions that compensation for entry roles or side gigs might be on the low end compared to clinical practice.

Lisa Grabl, president of CHG Healthcare, has seen physicians’ mid-career “wants and wishes” change over the 24 years she has worked in the recruiting sector, but today, three themes predominate. “The main reasons mid-career physicians want to make a change are better work/life balance, a more flexible schedule, or increased compensation,” Ms. Grabl said. Women appear to place work/life balance highest on the list, along with a better practice culture. For men, Ms. Grabl said, a better schedule and higher compensation top the list.

Regardless of their motivations for change, physicians are making transitions in greater numbers than in the past, according to data from CHG’s 2024 Healthcare Survey. Between 2022 and 2024, 39 percent of physicians changed jobs, 15 percent took a side job, and 2 percent left patient care for nonclinical work. The survey found that physicians most likely to have changed jobs were in the following specialties: emergency medicine, psychiatry, family medicine, OB/GYN, surgery, pediatrics, anesthesiology, internal medicine, cardiology, and internal medicine specialties. Of the 15 percent who took a side job, 60 percent opted for locum tenens assignments and 40 percent sought per-diem work.

“More physicians are now expressing an interest in locum tenens and side work than ever before, either to supplement their incomes or to explore locums as a next career move,” Ms. Grabl said. “The survey also found that physicians are not as loyal to their employers as they used to be — especially the younger generation — and that job satisfaction and engagement are not necessarily indicators of retention.”

How physicians manage transitions

After decades practicing in a teaching hospital affiliated with the University of Chicago and finding herself tied to a challenging call schedule, OB/GYN Linda Hughey Holt, MD, knew that she needed to make a career adjustment. “As much as I enjoyed my practice, the schedule was grueling, and I had no ability to take prolonged breaks,” said Dr. Holt.

Dr. Holt tried teaching part time, to shake things up, but quickly got bored. Then she started researching the locum tenens market, which she had always wanted to try, and decided to take the plunge. She started with assignments of a few months each and found that the work suited her. It also enabled her to get the breaks she’d been seeking — allowing her to spend time with her adult children and, later, grandchildren.

“This feels more balanced,” Dr. Holt said. So far, all the assignments she has taken through Weatherby Healthcare have worked out well, but there can be downsides. For starters, she explains, “You’re always an outsider, even if people appreciate you being there and are friendly. It’s not easy working in a place where you don’t know the ropes.”  She also points out that licensing and credentialing can take time; she advises physicians to plan well ahead if they think they’ll take assignments in multiple states. To date, Dr. Holt has taken five assignments and has practiced in three states.

One key to carving out a successful locums practice is to thoroughly vet assignments before accepting them, Dr. Holt advised. She always asks about available backup (and related plans) should an emergency arise and is careful to gauge the caliber and commitment of the nursing staff.  “Both are key in my field,” she said. In addition, she advises physicians considering locums to take their time finding an individual recruiter who pays attention to their needs and wishes and only presents opportunities that fit those criteria.

“If you’re planning a career transition, it’s important to make sure that you don’t have any [time-period] breaks in your resume. That can be a red flag.”

—Linda Hughey Holt, MD, locum tenens OB/GYN

Bridging mid- and late-career practice

Louise B. Andrew, MD, JD, an emergency medicine physician, decided to “refashion” her career in her fifties, after decades in practice. She worked from the premise that because she was double boarded in emergency medicine and internal medicine, and is also a lawyer, her options were plentiful.

“It’s important to realize that you’ll always be a physician but that the skills you’ve acquired are also readily translatable into other arenas beyond traditional white-coat [practice].”

—Louise B. Andrew, MD, JD, emergency medicine physician and legal consultant

In addition, as a former associate director for the Center for Professional Well-Being and a former chair of the American Academy of Emergency Physicians Personal and Professional Well-Being Committee, Dr. Andrew also knew that paying attention to potential is crucial to preserving physicians’ mental health and resilience.

With her extensive skill set as a platform, Dr. Andrew created a multifaceted career transition when she left the ER in Maryland and moved to the Pacific Northwest. She practiced telemedicine and also founded two consulting entities, MD Mentor and PhysicianDepression.com, to help physicians who were undergoing malpractice lawsuits or dealing with mental-health challenges. Later, in concert with her physician husband, Dr. Andrew launched a regenerative medicine practice in the Washington, to focus on wellness strategies. “We wanted to take care of people our age who wanted to do the same things,” she said.

Today, in her seventies, Dr. Andrew calls herself semi-retired but continues to counsel physicians involved in medical liability cases or facing resulting regulatory-agency challenges. She also maintains a keen interest in the expert-witness realm and sometimes consults as a records reviewer in malpractice lawsuits. Her numerous activities have kept her professional life both interesting and gratifying. “I’m reminded of something an older resident told me when I was in training — that it’s important to pursue things that are life affirming and to always have a fallback plan,” she said.

Marye McCroskey, MD, a family medicine physician, began her career pivot in her early fifties, to figure out how she could accomplish two objectives: reinvigorate her love of patient care and do the extensive traveling she’d been unable to accomplish working for a busy multi-specialty practice in Tennessee. She turned to locums practice eventually but first she spent two years planning for the transition because her travel plans included focusing on tropical and international locations.

“I knew that I had to get the licensing situation in place, that I had to prepare myself mentally, and that my husband and I had to get our home in order,” said Dr. McCroskey. Assignment location was key, she noted, because her husband is a scuba instructor and needed to be able to work wherever she decided to practice.

Dr. McCroskey also decided to set her bar high, for the types of settings and the patient populations she wanted. “I did the same thing I now advise other physicians considering locums to do: pick out the ideal situation and shoot for the moon,” she said. Admitting that she has had to compromise on occasion, Dr. McCroskey has mostly managed to meet that high bar in the assignments she’s taken. So far, she and her husband, now based in Key West, Florida, have lived and worked in Hawaii, the Caribbean, Guam, and Florida, among other spots, and she has practiced both family medicine and urgent care.

Dr. McCroskey’s shortest assignment was a few weeks, at Cleveland Clinic; others have been up to several months in duration. One of her favorites was a stint in Hawaii, where Dr. McCroskey worked for Kaiser. “It was a fun to practice in a different kind of culture than I was used to,” she said.

Like Dr. Holt, Dr. McCroskey sets criteria for the assignments she accepts. Besides a suitable, desirable location, she looks for a well-run practice environment, a workable schedule and compensation, and sufficient ramp-up time before she starts seeing patients. “Most of the larger organizations will provide a solid orientation, and that’s key,” she said. She usually doesn’t have to worry about housing because the locums firm manages that. Her preference is for an apartment or an extended-stay unit, when available, instead of a hotel room, to make the living situation feel more homelike.

Her advice to physicians who want to try locums is to get their feet wet with a short assignment before making a wholesale career change. She admits that the transition can be challenging initially, especially when working with different electronic health record (EHR) systems, but worth pursuing for physicians who embrace change.

“Once you’ve managed an assignment or two outside your comfort zone, you realize that you’re more flexible than you thought you were, it’s been a wonderful journey.”

—Marye L. McCroskey, family medicine locum tenens physician

Wayne B. Jonas, MD, a former emergency medicine physician who now practices urgent care medicine part time, took a stepwise approach to phasing out of his 40 years “in the pit.” He remained in emergency medicine into his sixties — he is now 75 — but began reducing the number of shifts he took when the going got too physically demanding. Then he began scouting around for a way to continue practicing medicine without the physical demands of the ER, and he landed on urgent care, on the central California coast.

“It’s very rewarding work, and it gives me a peg around which to organize my time,” said Dr. Jonas, who admits he’s “not the golfing type.” He also does medical volunteer work and has taken occasional assignments as a cruise-ship-doctor or a wilderness-adventure physician on call. Today, Dr. Jonas finds it gratifying to do two things that his ER career didn’t permit: mentor the young physician assistants he oversees in the urgent care clinic, who appreciate his acquired wisdom, and develop the occasional relationship with patients who return to the clinic with new or persisting medical issues. “It’s life at a slower pace than in the ER, and it enables me to maximize kindness and grace.”