Physician, Know Thyself! Tips for Navigating Mid-Career Transitions in Otolaryngology

“Physician, heal thyself” is an ancient proverb encouraging the importance of examining one’s own professional identity, strengths, and limitations to better serve patients. But if you’re an otolaryngologist contemplating a mid-career change, “Physician, know thyself” may be a better guidepost for finding the best match for your personal needs and professional talents.

Such self-awareness was one of several tools ENT physicians cited during a panel on mid-career transitions held during The Triological Society’s 2025 Combined Sections Meeting in Orlando, Fla.

It certainly was one of the core skills that LaKeisha Henry, MD, the moderator of the panel who is now in private practice with the Ear, Nose, and Throat Consultants of Nevada, in Las Vegas, reached for as she neared the end of her 29-year career in the Air Force.

Dr. Henry knew that in navigating this next phase, she would be drawing heavily on the knowledge, experience, and self-awareness she had gained in the military, but with one key difference. Due to the fast-paced nature of change in the military, “I had to make many major transitions with limited advanced planning,” she said. “This change, however, was on my terms and at a time I chose. I needed to get it right because it would have a lasting impact on both me and my family. So I embraced change and started planning.”

To that end, she began exploring options through several locum tenens positions, carefully selecting ones that would give her a wide range of different practice experiences. During that process, she relied on trusted friends and mentors who “gave me some frank warnings about avoiding the type of practice that sometimes emphasizes numbers of patients seen—and bonus or revenue promises—over the potential for teaching, growth, and deliberate, patient-focused care,” Dr. Henry said. The former practice model “is just not who I am as a physician,” she said. “I am compassionate and I listen to my patients; I need to make them feel seen and heard.”

Dr. Henry also knew she wanted to draw on her military experience in leadership and logistics to make suggestions about practice improvements. “I have that opportunity now, and I’d like to think that some of my recommendations, such as mentoring others regarding equipment and technology changes impacting budgets and efficiency, have resulted in savings,” she said. “So, even though I may not be the highest-volume physician in the practice—by choice—I still bring significant value to it.”

Fortunately, “I feel heard in my current position,” Dr. Henry added. “It’s a very collegial team that allows me to be the effective problem solver I’ve always been.” But if you don’t let a potential employer know you want to offer practice guidance and feedback up front, “it can come off as intrusive and be unwelcome later on,” she stressed.

Getting these decisions right is not always possible, but the downsides of getting it wrong could be catastrophic, Dr. Henry cautioned. “I have colleagues who had to leave the state after their first position out of the military didn’t work out, because there was no other option for them to have meaningful employment due to geographically broad non-compete clauses,” she said.

These cases are not uncommon. A significant percentage of retired military physicians leave their first job, Dr. Henry noted. Sometimes it’s due to unexpected factors. “But it also can be due to a lack of awareness or experience with aspects of the business of medicine,” she said, including not appreciating the importance of reviewing contracts from prospective employers. “There are lawyers and consulting firms who can do those contract reviews a lot better than you can. So it’s smart to use them.”

Not Ready to Give Up Clinical Work

After Samuel A. Spear, MD, rose to the rank of colonel in the U.S. Air Force, he began thinking about the next phase of his career. He had spent his time in the military amassing an impressive list of clinical accomplishments, including a research fellowship at The Ohio State University in Columbus, and a clinical neurotology fellowship at Louisiana State University Health Sciences Center in New Orleans. But once he became a colonel, “there’s no guarantee they’d keep me in a medically related position,” he said.

Dr. Spear’s solution was not to leave the military. Instead, he became the chief of the Department of Defense (DOD) Hearing Center of Excellence. The center was in San Antonio, “which meant we did not have to move, and that was a huge plus for me and my family,” he said. It also enabled him to pursue an interest in military service-related hearing loss, the importance of which “really needed to be elevated in the medical community.”

After three years at the DOD Hearing Center of Excellence, “I knew it was time to leave the military,” Dr. Spear said. His first search strategy was to reach out to colleagues. That effort resulted in connecting with a fellow Air Force member who was an otologist and general ENT physician who had left the military and was now in private practice in Florida.

“Long story short, I visited Florida, and I loved it,” Dr. Spear said. “I took my family out later, and we all felt like it was a great fit. We now live really close to the beach in a beautiful area bordering Jupiter and West Palm Beach, and we just love it here. So, as of April 2024, I have been working at ENT and Allergy Associates of Florida.”

As for the strategies he used to ensure the practice was a good fit, “the key for me was visiting and getting a feel for the team I’d be working with,” Dr. Spear said. “The staff seemed genuinely happy, and the environment felt positive. I could just tell it was a good situation for me.” He stressed, however, that it was not all just a Kumbaya moment. “They also offered me a clear path to becoming a full partner after two years as an associate. That was a big positive.”

A final deciding factor was the ability to continue research and advocacy focused on hearing loss. “My partner [John Li, MD] is a champion of raising awareness about hidden hearing loss, which is a condition I researched in the Air Force,” Dr. Spear said. Also known as cochlear synaptopathy, the condition affects a person’s ability to understand speech, especially in noisy environments, despite a normal audiogram. “Dr. Li launched a website, earaware.com, that focuses on helping people, not just in the military but in civilian life, realize that hearing loss after exposure to noise is a real problem, and that it can be prevented or, if already present, treated effectively.”

The other important factor one should consider when contemplating a mid-career change is work–life balance, Dr. Spear stressed. “If you have hobbies or passions, make sure you choose a practice and a location that allows you to pursue them,” he said. “I love bagpiping—I know, not necessarily a Florida thing! But I also love surfing, fishing, and scuba diving. I can do all of that here. So it’s just a great time for me and my family.”

Knowing When It’s Time to Go

For Peter A. Weisskopf, MD, an otolaryngology–head and neck surgery specialist practicing in Phoenix, Ariz., one of the first keys to making an effective mid-career change was to know when the timing was right to make such a change. The crux for Dr. Weisskopf came after he had amassed more than a decade of military service in a wide variety of roles, including a flight surgeon on the East Coast and a clinician and researcher for NASA and the space shuttle.

I tell people to think about what they really want—whether it’s more time with family, more surgery, or more time with each patient. Then figure out where you can achieve that and what trade-offs you’re willing to make.” – Peter A. Weisskopf, MD

In 2001, Dr. Weisskopf was approved to do a two-year fellowship in neurotology at the House Clinic in Los Angeles, renowned for its work in the treatment of skull base tumors and other challenging conditions. But when he asked his Navy supervisors what their plan was for him after that fellowship was over, “they didn’t have an answer for me,” Dr. Weisskopf said. “So I thought, great, I’ll spend two years at this cutting-edge clinic, and then after it ends, I’d be taking out tonsils at Camp Lejeune instead of the brain tumor surgery that I had become an expert at? That’s when I decided to leave the Navy.”

However, Dr. Weisskopf did not say no to the House Clinic: He did that two-year fellowship as a private citizen and then worked with neurosurgeons at the Barrow Neurological Institute in Phoenix. After more than a decade, he was recruited to the Mayo Clinic. After eight years practicing at Mayo, “I actually made the decision to leave a few months ago.”

Dr. Weisskopf’s choice to leave a large multisite hybrid academic/private practice came from knowing the type of ENT physician he wants—and does not want—to be. He cited, as one example, the growing focus on measuring patient satisfaction as a key indicator of one’s worth as a physician. “Of course, doctors should not be jerks; I’m not saying we disregard cultivating an effective bedside manner,” he said. “But the reality is that some of our patients are going to walk away unhappy due to issues that have nothing to do with the care we provided. And that should be okay; maybe you told them the truth about their condition they didn’t want to hear. My job is to give you the best clinical advice I can, regardless of whether or not that will translate to five stars or high Press–Ganey scores.”

But it’s not just the focus on patient satisfaction that is fueling Dr. Weisskopf’s disillusionment. It’s also due to a steady erosion in reimbursement and a loss of social cache that historically had been quite a bit higher than what he sees today. And that’s not an observation based on reading history books. Dr. Weisskopf’s father was a ship doctor in World War II and went on to a distinguished career as a highly regarded ENT physician.

“Of course, my father used to make fun of me when I talked about ‘the good old days’ of medicine,” Dr. Weisskopf said. “He’d say they weren’t all that good. But I can tell you his social standing in the community was outstanding; in today’s dollars, [he] made a very good wage, and at the end of the day, he felt like he was able to deliver very high-quality patient care.”

Fast forward to today, and “many of us are making less money, in real dollars, than we did when we started practicing medicine; a lot of that social cache is gone, and for myself, at least, I often felt treated more like a technician than a physician. So that’s why I got out.”

Dr. Weisskopf also stressed the importance of “enlightened self-interest” as a guiding principle for finding a good professional fit. “We are conditioned to believe that self-sacrifice is part of our job as physicians,” he said. “That’s not true. I tell people to think about what they really want—whether it’s more time with family, more surgery, or more time with each patient. Then figure out where you can achieve that and what trade-offs you’re willing to make.”

Getting that balance is critically important, “because when you end up in situations that you really don’t want to be in, you will get burned out,” Dr. Weisskopf said. “And make no mistake, burned-out physicians make bad doctors.”

Still in Air Force, but Prepping for New Launch

Becoming an expert on career changes doesn’t always require that one leave the military. Sarah N. Bowe, MD, EdM, is starting her 17th year of a career in the Air Force. During this time, she has filled a wide range of clinical, teaching, and leadership roles, including the director of surgical simulation for Brooke Army Medical Center (BAMC), chair of the well-being subcommittee for the San Antonio Uniformed Services Health Education Consortium (SAUSHEC), and her current position as the program director for the otolaryngology residency program at SAUSHEC.

It’s easy to come in with excitement and a desire to make changes or implement a new vision. But I’ve learned that you’re often entering an established culture. So it’s important to take the time to under-stand that culture, build relationships, and work with the team before moving too fast.” — Sarah N. Bowe, MD, EdM

Taking on so many different posts, “you develop an incredible breadth and depth of professional experience, both in the hospital and also in medical education,” said Dr. Bowe, who is also an associate professor of surgery with the Uniformed Services University of the Health Sciences, in Bethesda, Md. “But it does require one to be able to pursue and embrace not just one or two but several, often major, career changes throughout your military trajectory.”

One of those changes involved transitioning from a general to a pediatric otolaryngologist several years ago. Now, Dr. Bowe’s current primary focus, pediatric otolaryngology, involves clinical work most days of the week, plus her otolaryngology residency training duties. But a few more big changes are on the horizon. Most immediately, Dr. Bowe is on the cusp of becoming a colonel. If approved by the Senate, the promotion will bring even more leadership opportunities her way. And then, in about three years from now, when her active duty military commitment is over, “I probably will retire from the service, at which point I will have to decide what my next professional step will be.”

Whatever her landing spot, Dr. Bowe said she is confident that the skills she learned in the Air Force will guide her next career choice. She cited, as one example, the importance of patience. When starting in a new position, “it’s easy to come in with excitement and a desire to make changes or implement a new vision,” she said. “But I’ve learned that you’re often entering an established culture. So it’s important to take the time to understand that culture, build relationships, and work with the team before moving too fast.”

Dr. Bowe also echoed the other TRIO panelists’ emphasis on self-awareness. In her case, she knew that continuing in leadership and service was key. To that end, Dr. Bowe recently became TRIO’S social media and culture coordinator, where she is able to mentor residents, fellows, and junior faculty on the committee, get their perspectives on TRIO activities, “and learn how we can continue to grow the kind of future leaders we need to keep the society strong.”

As for what civilian life may bring, the “physician, know thyself” guidepost will be just as valuable for Dr. Bowe as it has been for the other TRIO panelists. “I am fairly sure of one thing: I want to continue practicing medicine,” she said. “Because once you leave it behind completely, it is very hard to come back. So I’m not ready to turn in my otoscope just yet.”  

David Bronstein is a freelance medical writer based in New Jersey.

Disclosure: Dr. Bowe disclosed that her expressed views are hers, and do not necessarily reflect the official policy or position of the Defense Health Agency, the Brooke Army Medical Center, the Department of Defense, nor any agencies under the United States government.