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A surgeon’s perspective: The cost, challenges and calling of practicing medicine

By: Miechia A. Esco, MD, PhD, chief medical resource officer | Updated on July 21, 2025

A surgeon’s perspective: The cost, challenges and calling of practicing medicine

Medicine is much more than a profession. It is an all-consuming calling that draws those who are passionate about helping and healing people. It is also core to our identity, a concept that stands out among other professions.

In the recent survey report by Jackson Physician Search and LocumTenens.com, “Is Medicine Still a Calling?” 81% of clinicians who responded felt that being a clinician is an integral part of their identity.

I always knew I was going to be a doctor. But nothing fully prepares you for what it means to live medicine every day.

 

The notion that medicine is more than just a job isn’t new. In 1967, Dr. D. Emerick Szilagyi, MD, wrote about the concept of the physician as a savant, saint, or servant — an idea that resonates with many in the medical field, underscoring the multifaceted realities of life as a practicing doctor. While extensive training in medical school and hands-on experience build a foundation of technical expertise, practicing medicine is ultimately more involved; it’s a career intertwining scientific rigor, human compassion and the navigation of difficult bureaucratic systems.

The cost of a career in medicine

Not many professions in the U.S. demand such a balance between the mastery of life-saving techniques, care for others and the will to serve. Physicians and advanced practice providers (APPs) walk a tightrope line while taking on the responsibility of their patients’ wellbeing.

Time is also a consideration. The nine-to-five workday is a fantasy for those delivering patient care. Long shifts, calls that might come at any time and the pressure of high-stakes decision-making take a toll on practitioners’ personal lives and time spent with family. It is expected that clinicians will miss milestones, sacrifice normal weekend leisure time while operating at the top of their abilities.

Compensation is a contradiction. Physician pay is generally perceived as high, but medical training is unanimously accepted as a creator of tremendous personal debt, a high-stress crucible which we are all expected to overcome. Additionally, compensation topics rarely take into account the arduous workload and emotional pressure that are considered par for the course across most medical specialties. When compared to the intensity and meaning of medical work, is compensation really so high?

As a practicing surgeon, I am often reminded of the movie Whiplash, an exaggeration to be sure, but a vivid depiction of high-pressure work that demands excellence — and one which medical practitioners may find relatable.


Source: Is Medicine Still a Calling? (LocumTenens.com and Jackson Physician Search, 2025)

 

We went into medicine to help people. Nearly three-quarters of survey respondents in the report cited a desire to help others and serve humanity as a primary motivator for their decision to practice medicine.

The challenges of a career in medicine today

A career in practicing medicine brings with it a panoply of obstacles extending beyond the clinical expertise for which clinicians have been rigorously trained. Physicians and APPs are tasked with navigating challenges that often feel at odds with their dedication to providing care.

  • Administrative hurdles: An excess of paperwork, negotiating insurance and regulatory compliance take time — often, time that is meant for patient care. Reduced administrative burden was a top answer that respondents provided in response to the question “What could strengthen your ability to live out your life’s purpose?”

  • “Always-on” work: Many clinicians feel they are expected to be available 24/7, whether that means responding to patient messages, managing their on-call duties, or completing electronic medical record (EMR) work even when at home. Setting reasonable boundaries is necessary but challenging in this line of work.

  • Butting heads with “Dr. Google”: Between the proliferation of search-driven web articles discussing medical conditions and the meteoric rise of user-friendly generative A.I. solutions like ChatGPT, patients are increasingly self-diagnosing based on their own brief research. Obviously, this can complicate care and patient education.

These difficulties add up. On top of the everyday sacrifices that come with a career in medicine, there is little wonder that nearly one-third of respondents said they are planning to leave their employer in the next 1-3 years.

Why reconnecting with your calling in medicine matters

Despite these and other difficulties in an evolving industry, most mission-driven clinicians will agree that having a positive impact in a patient’s life is unparalleled. This is why physicians keep going even against the strong headwinds of imperfect systems. In fact, 77% of survey respondents said the positive outweighs the negative. It’s worth taking into account that those numbers are after a multi-year global pandemic that put extraordinary strain on these clinicians—and they continue to press forward.

Source: Is Medicine Still a Calling? (LocumTenens.com and Jackson Physician Search, 2025)


Physicians continue their work not for its ease but because their calling is deeply ingrained in who they are. Looking through Dr. Szilagyi’s lens, the “savant” aspect (pursuing knowledge and skill) forms the foundation, but over indexing on the “saint” mindset can exhaust clinicians’ emotional reserve due to moral injury and the demands of patients and the industry at large.

We have to remember how it all started.

 

For medical practitioners struggling to stay connected to their purpose in medicine, pursuing work that is more flexible and offers work-life balance can refresh this motivation. It is imperative for those in administrative positions to work closely with their physicians and APPs to ensure they can work in a way that is congruent with their training, their beliefs and their identity as providers of medical care.

If you are a clinician who is no longer feeling inspired by your calling — or if you manage a team of medical practitioners and want to reconnect them with their original calling —download the report today to get insightful, inspirational and valuable data and testimonials from today’s hardworking clinicians.

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About the author

Miechia A. Esco

Dr. Miechia Esco is a vascular surgeon focused on full-time locum tenens work and licensed in 15 states. For the past several years she has served as a consultative member on the LocumTenens.com Customer Advisory Board and now serves as the company’s Chief Medical Resource Advisor.