• Wenche Iren

WHY I quit my job as a physician and became a health and wellness coach instead

It’s a normal day in the hospital. I am talking with a patient who just got diagnosed with heart failure. He had experienced increasing shortness of breath over the last couple of weeks, which led him to finally seek medical attention, but describes himself as otherwise healthy. He has no prior diagnoses, and has barely taken medications in his life. He did not expect

this at all. “Heart failure? What the h…is that?? Sounds like I’m going to keel over at any

point”, he says. “All I had was some shortness of breath”.

My beeper goes off and I have to run. I apologize, and he is left with no further answers and increasing anxiety. I attend to my responsibility, and of course, the documentation that goes with it. Answering to a few other requests and finishing up my documentation makes me late for a meeting. Then there is delegation of new tasks. Hours later, I finally get a moment to go back to my anxious patient. He is understanding, and happy to see me. I ask him if he has any questions. He has many, but they are hard to put into words as he’s still trying to make sense of all this. As he starts to say something, the nurse comes in for a blood pressure check ( he needs to be quiet and relaxed, mind you, during that). Then there’s a new IV fluid bag to hang. Then there’s a saturation level and a temperature check. The nurse is pleasant and caring, and apologizes for the interruption. We both smile and understand. She’s doing her work, which is important.

My patient is floored by the number of medications he is started on. 7! 7 different medications! He had none before. He was healthy. How can this be? I empathize. Offer to explain why they are all important. He is a smart guy and wants to understand. We are interrupted again, by meal service. He says the food can wait. We speak for another couple minutes before my beeper goes off again and I have to run. I apologize. He understands. His food is cold. We both hate it.

My patient’s breathing has improved, and he’s discharged. 1 week later, however, he’s readmitted. Increasing shortness of breath. Weight gain. He hasn’t taken all his medications as prescribed (some he couldn’t even afford to buy in the first place), and he has not changed his eating pattern. Too much salt. The heart isn’t pumping efficiently, and he didn’t want to take his water pills as they make him get up to urinate during the night. The fluid has gathered in his lungs and his tissues, explaining his symptoms. Several colleagues are rolling their eyes. Silly patient. Not following doctor’s orders. How does he expect to get better without changing his lifestyle?

This time I am able to get about an hour in total with him, spread over several talks. He asks questions, I explain. He tells me why he hasn’t, or can’t, or won’t take some of the medications. I listen. His reasons don’t make sense medically, but they are strong and valid. More importantly, they are his reasons. Touching on diet: he kind of knows what foods are bad for him, but he doesn’t really know what to replace them with. Or if he’s able to. Or heck, even if he wants to. He knows he needs to do something, though, but it’s all still so much to take in.

We got a good connection. I empathized with him. Of course, I also reinforced the importance of him taking the medications as prescribed, but I knew he wouldn’t, because he told me straight out, During our little time together he came to trust me enough to be honest. I appreciated that. He got better and was discharged. And I knew he would be readmitted again. And again. And again.

I completely hated the fact that I, as the doctor, with the best treatment and best practice and best medications could not help him. Not only could I not help him physically (sure, immediately, but not in the long run), but this experience was anxiety provoking to him, and I couldn’t provide emotional support. There was not enough time to talk, or better yet, to listen to him, in the hospital, and there was no chance for follow-up as an outpatient. Sure, there are programs, and he had a primary physician, but he would need more than that.

He would need somebody to help him make significant lifestyle changes and motivate him to follow through. That is not done in an hour or ten, and certainly not in a busy hospital or clinic environment with constant interruptions. Because he would need to “own” his changes and choices and develop internal motivation to make them. Giving him a plan and say “do this”, just wouldn’t cut it.

This was one person. Really, it could have been any 3-4 of my patients every day. As much as I loved certain aspects of being a physician, this I hated. The feeling of uselessness drained me emotionally and the hours and commute drained me physically. In the end, the beauty of my job was not enough to make up for the negatives, and I decided to quit. A lot of people thought I was crazy: how could I give up all these years of education and hard work, and honor of being a physician? Well, my take on it was, and still is, that I didn’t give that up. Sure, I gave up my chance to practice medicine in the United States, but I am so thankful for all I have learned; from the books and the practice, and I treasure every single conversations I’ve had with my thousands of patients over the years. All they have shared, in some of their most vulnerable moments, has thought me so much. And that is priceless.

So I quit being a physician. But I didn’t want to quit talking to people and being able to help them. I decided I wanted to help people make lifestyle changes. I wanted to motivate and support them, and help them becoming healthier both physically and emotionally. I wanted to help people experience better quality of life, chronic illness or not, overwhelmed, stressed and anxious, or not. I basically wanted to do the things I didn’t have time to do for my heart failure patient. So I found health and wellness coaching, or maybe, it found me.

I started my own business, which means I am flexible, and I can provide each of my clients with the time they need and want. However, I was humble to the fact that even with my medical background, I didn’t have the right tools to help people implement the lifestyle changes I had previously recommended, so I completed the Wellness Coaching Training program with the Mayo Clinic and got certified.

Do I sometimes miss the hustle and bustle of the hospital? Kind of. Do I miss my colleagues and being in an educational environment? For sure. Do I miss the constant feeling of not doing enough, not having enough time and being physically exhausted? Never. I am so happy I realized this was not for me before it ate me up. And I’m even happier that I found a way to take with me what I loved the most; the chance to interact with clients and help them. And most of all, I am happy because my support helps my clients take control of their health, and life, to make it how they want it. It’s not my business to make choices for someone else, merely to help them figure out what’s important to them and how to get it.

It usually takes more than an hour, or ten. But now, we have time.

Take good care of yourself!

All my best,


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