I quit my job.

Actually, I quit my job 180 days ago, because that is the number of days my employer requested I give as “notice” when I signed my contract more than six years ago. Not two weeks’ notice. Not 90 days. 180 days.

I quit my job before I had a new one lined up. And that was scary…the prospect of not securing a new job before that 180 days was up.

I quit my job even though I knew, that due to what is known as a “non-compete clause”, in order to continue to do the work I love, as a Trauma/Acute Care Surgeon at a Level 1 trauma center, I would have to move my family out of state.

I quit my job knowing I was giving up two prestigious leadership titles. Titles I had worked a decade to achieve.

I quit my job knowing I would spend hundreds of dollars of my own money, and dozens of hours of my own time, to secure a new medical license in a new state. And be faced with answering invasive questions about any personal mental health history…questions few other employees are asked in any other field.

I quit my job knowing that I would uproot my husband and two middle-school-aged kids, have to prepare to sell our home, and seek a new home in a booming real-estate market that will dramatically increase our monthly mortgage.

Knowing all of this…I quit my job.

Throughout the Great Resignation, millions of Americans have left their jobs, seeking new or different jobs, or some who have the luxury, have left the workforce completely. So while me quitting my job simply puts me in the ranks with millions of others, I think there is something special about the threshold that those of us in clinical medicine have to reach to execute on the threat of quitting.

With all due respect to our clinical colleagues in nursing, who can leave one hospital and take a job at a competitor down the street, all the while maintaining stability at home–same house, same schools; no new license required–physicians usually can’t do the same. The “non-compete clause” in our contracts is designed to prevent our patients from following us from Hospital X to Hospital Y, thus loss of revenue, which is why many hospitals draw a circle around their address and forbid us from working in a 30-50 mile radius around our old shop. Of course, this is absurd for those of us who work in hospital-based specialties such as Emergency Medicine, as Hospitalists, or as Trauma/Acute Care Surgeons. Our patients won’t follow us. To be honest…it’s in our patients’ best interest to never see us again in those fields! Regardless, non-compete clauses remain. And thus…usher many of us out of state when we decide it’s time to leave our current employer, especially in cases like my own where the only three Level 1 trauma centers in the state are clustered within 12 miles. I could either dramatically change my clinical practice and choose to work at a Level 2 center…or leave the state.

For some, the anchor to stay is deep and heavy. Extended family lives close. They have always lived in this area. They feel loyal to the school, the state, the neighbors. Whatever it may be. For others, the anchor is a little smaller and lighter. Such as in my case…my parents and brother’s family don’t live here; we didn’t grow up here; our college-aged kids are in other states. The anchor was easier to pull up. Nonetheless, the threshold was high. As is the case for so many of us. And yet I reached it.

And this is why I think it is crucial for hospital administrators to understand that just below the surface of the “turnover” numbers and percentages for physicians, there are many whose anchor is deep and their threshold is high, so they stay. They stay and remain disengaged, bitter, frustrated, burned out. Because they haven’t quite reached their threshold yet. These are the front-line caregivers who feel trapped. Disillusioned. Exhausted.

I quit because I spent months in self-reflection, some quality therapy, and a long hard look at my career and life goals. I came to the conclusion that while the work I was doing was important, it wasn’t filling me up as I had hoped. I was tired. Disillusioned. And missing closer-knit relationships, more clinical work, and less administrative work. I didn’t quit out of anger. I quit out of self-preservation and the acceptance that what is rewarded in this world, in academia, isn’t always what makes me the happiest. So I quit and found a job that is more in alignment with my skills, my passions, my heart. I released my love affair with building my academic CV, and started loving myself and my family more than my career.

So much has been written recently about physician wellbeing. About burnout. About how to support us all in these “unprecedented” times. I deeply believe one place to start is to release physicians from feeling trapped, commoditized, burdened with paperwork, and irrational productivity goals. We need the autonomy to live our lives, personal and professional, without the threat of being sued for choosing to work in the same city. We need to feel supported with more than cupcakes and kind emails. We need the red tape torn down so we can spend time practicing medicine, not perfecting our computer skills. Yoga and mindfulness are very cute. They are nice. But will never be enough. We need mental health support, and also leaders who mitigate the madness that brings some of us to the point of seeking mental health services in the first place. We need a nation that values the right to basic medical care and a system that isn’t thwarted by state lines. (Yes, patients from Gary, IN, are transferred to Indianapolis because their Indiana Medicaid won’t work in Chicago…at a hospital 10 miles from their home. Insane.) We need leaders, local and national, who value our expertise and have compassion for the mess that is American healthcare today.

The irony is not lost on me and others, that I served as the Chief Wellness Officer for my organization, and yet…I reached my threshold and quit my job. And in that decision, I have found a new peace, a new voice, and a new hope. I am excited about my new job, my new partners, and the new way I will work. I will be closer to patients and my colleagues, which makes me happy. We would do well to honor each other’s thresholds, and maybe even lower them. People need to grow in new gardens. And that can be a beautiful thing for everyone.

Disclaimer: My viewpoints are not necessarily reflective of my employer, or any local, regional or national organization that I belong to. As a matter of fact, I pretty much just speak for myself. Please keep that in mind.