New Attending Survival: Uncertainty, Self-Trust, and the Hidden Curriculum with Dr. Karen Leitner Episode 163
Welcome to another episode of the Sustainable Clinical Medicine Podcast!
The host and physician coach Dr. Karen Leitner discuss why the transition to new attending is often harder than training, marked by impostor feelings, shame about not knowing, and decision paralysis in clinical uncertainty. They compare systems in the US, Canada, and Australia, including practice ownership models, overhead, billing learning curves, and how lack of business training and negotiation skills can affect long-term earnings; they share an example of lost income due to paperwork capacity and not realizing support could be hired. They emphasize that regret is unhelpful, mistakes and bad outcomes can happen despite good intentions, and guilt should be replaced with compassion and connection by talking with trusted colleagues. They address burnout dynamicsâskipping food, water, and bathroom breaksâadvocating radical responsibility, analyzing the âmathâ of workload, small workflow fixes, and boundaries, including not relying on external praise. Leitner mentions her eight-week coaching program for women physicians.
Here are 3 key takeaways from this episode:
- Being a new attending is a normal developmental milestone, not a sign of failure: Feeling overwhelmed, looking everything up, and comparing yourself to colleagues 20 years ahead is universal. The struggle isn't because you're unpreparedâit's because no one prepares physicians for this transition. It can take 5-6 years to truly feel confident.
- Self-compassion beats guilt when outcomes don't go as planned: When bad things happen to patients, guilt is the wrong emotion if you showed up with good intentions and made the best decision with available information. Replace self-punishment with compassion for both the patient and yourselfâand reach out to trusted colleagues instead of isolating in shame.
- Radical responsibility means protecting your time and energyâno one else will: No one is coming to save you from inbox overload, double-booked schedules, or skipping lunch. Taking care of yourself (eating, hydrating, setting boundaries) isn't selfishâit's essential for sustainable patient care. Learn to respect your own time before burnout forces you to leave medicine entirely.
Meet Dr. Karen Leitner:
Dr. Karen Leitner spends the bulk of her time helping women doctors recognize their amazingness and feel better in their lives (in addition to getting paid what they deserve.) She lives outside Boston< MA with her husband, her beloved mini goldendoodle Oscar, and three school-age daughtersâand loves to travel, sing karaoke, and fight the patriarchy (preferably in that order).
Connect with Dr. Karen Leitner:
đ Website https://www.karenleitnermd.com/
Instagram https://www.instagram.com/karenleitnermd/
đ https://go.karenleitnermd.com/masterclass free class for women physicians
looking for more time/less stress
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