Provider Pulse Ep. 30: Dr. Anuj Khattar, MD (Part 2) - Medicine, Burnout, and Finding Balance

"The medical system we have is very oppressive in this country. It doesn't primarily value humanity and the human experience and the health of human beings."

In Part 2 of our conversation with family physician Dr. Anuj Khattar, the idealism we traced in Part 1 collides with the realities of the American healthcare system. This episode isn't comfortable—it's not meant to be.

Dr. Khattar walks us through what happens when a values-driven physician enters a system designed around different priorities. From 30-hour shifts in residency to patients unable to afford care, from the loss of continuity in family medicine to the question of whether doctors are actually happy—this is a frank conversation about a physician's assessment of his path and the state of medicine.

In Part 2, we explore:

• How witnessing child abuse during pediatrics rotations sparked his passion for reproductive healthcare and patient choice
• The moral distress in residency when he realized "this isn't what I signed up for"
• The painful reality of insurance barriers preventing patients from getting necessary care
• Taking six months after fellowship to reclaim his identity beyond medicine
• The honest answer to "Do you know anyone who's really happy being a doctor?" (Spoiler: "Really happy is a stretch.")
• Why six jobs isn't just burnout—it's an intentional design for maintaining agency within system constraints
• The loss of continuity that drew him to family medicine in the first place: "I get more lost in novels these days because I want to know those things about people's lives"

This isn't a warning to avoid medicine—it's an invitation to enter with clear sight. The healthcare system has real problems. It prioritizes profit over patients. It creates barriers to care. It burns out providers who entered with the best intentions.

But Dr. Khattar hasn't given up. He's created a sustainable practice across multiple settings, refuses to stop advocating for patients, and continues teaching the next generation. He shows up—even in 15-minute appointments—and still cares.

For pre-med students: Better to question now than after medical school. Channel your anger about the system into motivation to change it.

For medical students: You're not alone in the frustration. The gap between what you hoped medicine would be and what it is—that's real, and it's okay to name it.

For anyone in healthcare: This conversation validates what many feel but don't say out loud.

Dr. Khattar's story doesn't end with easy answers. What it offers is honesty, agency within constraints, and the refusal to look away.

Visit EthnoMed.org for additional resources. Follow us on YouTube and Instagram @EthnoMedUW

Chapters

• 0:00 Anuj Khattar Opening Quote
• 0:40 Intro to Part 2: Idealism Meets Reality
• 1:44 Redemption Continued: Respectful Training Environment
• 2:29 The Spark: Reproductive Healthcare - Medical students for choice opened a new interest in reproductive healthcare
• 3:46 Pediatrics and Child Abuse: A Practical Awakening
• 6:55 Externship in Reproductive Medicine in Seattle
• 7:57 Deciding on Family Medicine: Discussion of the factors Anuj weighed
• 9:27 Residency at Swedish Family Medicine Cherry Hill
• 10:43 Residency Reality: 30-Hour Shifts and System Frustrations
• 13:20 Insurance Coverage Reality and Patient Care: Anuj notices the people who are unable to access care in our system
• 15:30 Reflections on ACA and Coverage Changes
• 17:31 The Maze of Medical Billing: Anuj shares his own experience of being overbilled for a procedure
• 19:42 Reflections on the Loss of Ancillary Services, Increased Burden on Physicians
• 20:59 Secondary Trauma of Healthcare Providers
• 21:44 Advice for Undergrads Interested in Medicine
• 24:21 Compartmentalizing: Living a Life Outside of Medicine
• 26:29 "Do you know anyone really happy being a doctor?"
• 27:24 Reflections on Lack of Continuity of Care in His Practice
• 27:56 The Six Jobs Explained: Why multiple roles create sustainability and preserve skills
• 30:14 Closing Reflections and Outro

Transcript

251029 Anuj

Part 2: "What the System Hides"

[00:00:00] 

Anuj: Uh, there are days I'm excited to be a doctor and there's days I'm not excited about being a doctor. I think the one-to-one experiences I have with patients are always amazing, and I feel grateful that I can support people in the way that I do. The medical system we have is very oppressive in this country.

And it's hard for me to continuously work in a system that doesn't primarily value humanity and the human experience and the health of [00:00:30] human beings.

Duncan: Like that's not the primary focus of our healthcare system. Making money is a primary focus of our healthcare system, and I think that is a challenge for me. Welcome back to the EthnoMed podcast. I'm Dr. Duncan Reid, and this is part two of our conversation with Dr. Anuj Khattar. If you're a pre-med student, parts of this episode take a critical look at our medical system. This might make you uncomfortable.

That's intentional. Not to discourage you, but to prepare you. In part one, we [00:01:00] followed Anuj from his diverse childhood in San Jose through UCLA to medical school at OHSU. We watched him develop idealism, the belief that medicine could serve marginalized people, that meaningful work was possible. We ended with him finding his mentor, seeing proof that value aligned medicine actually exists. Today's episode picks up where we left off Anuj entering residency, working 30 hour shifts, starting to see patients, not as a medical student, but as an actual doctor.

And he notices something deeply [00:01:30] unsettling. The medicine he wanted to practice and the medicine the system demanded were not aligned. 

What follows is an honest account of what that misalignment feels like. 

So let's continue Anuj's story with the understanding that clear sight about problems is the first step towards solutions.

Duncan: We start off by revisiting the positive experiences in the last two years of medical school and his decision on a specialty. 

Anuj: it was very respectful relationships I had with my physician attendings.

Duncan: Which is not always the case, I think, in medical training.

Anuj: no, I actually got [00:02:00] invited to some of their weddings. I really appreciated that we got to work directly with the attendings and I feel lucky that I wasn't in a large academic center with a big team and it felt so much more personal, in that way.

Duncan: And how about the residents when you're on medicine, for example, at OHSU, do you remember interactions with them?

Anuj: Yeah. Um, I do. They were great. I don't actually, I don't have anything negative to say about that. Everything was

Duncan: which sounds incredible. So it sounds like this is redemption for those first two years.

Interest in Reproductive Healthcare

Duncan: Anuj [00:02:30] wasn't sure what specialty he wanted to pursue after residency, however, it was his interest in reproductive healthcare and experiences in medical school, which steered him towards a career in family medicine.

Anuj: I was debating between general surgery, internal medicine and family medicine, until the very end. And I think ultimately what pushed me into doing family medicine was my passion for reproductive healthcare. And I felt like I would not be able to pursue that to the fullest extent had I done either of the [00:03:00] other careers.

Duncan: Can you talk more about that? when did you become interested in reproductive healthcare?

Anuj: So, at OHSU, we did have a reasonable curriculum for reproductive healthcare, but it was still like only two hours. It wasn't like a huge thing.

So, to augment our education, there was a medical students for choice organization or group, at our school. And I joined that just because I wanted to learn more. I think I was one of those people who's like, oh, I want to like just see what's going on on campus. and.

It [00:03:30] was great. They only had like a couple events a year, but they'd have counseling about contraception. You know, they had the general events. But I think what cemented this idea of choice and need to have choice for me was actually my pediatrics rotation during, medical school.

Duncan: Although he hadn't given the idea of reproductive choice much thought before medical school, it was Anuj's experience working with children who are victims of abuse, which led to his interest in decreasing the number of unwanted pregnancies. 

Anuj: In my inpatient [00:04:00] pediatrics, there were numerous patients that were admitted for non-accidental trauma. And I was just so confused as a child that was wanted and raised that way, it was hard for me to imagine that people were having children that were undesired. And I think just not having the most profound sex ed education growing up, nobody ever really talked about unintended pregnancies. I think that was the thing that was always missing is like sometimes contraception fails. Like no matter how [00:04:30] well you use contraception, sometimes it fails. And I think the expectation was if it fails, you would just have the baby.

But I don't think that's always the best course of action and I don't know what people's variables are in their life and I can't tell 'em how to live their lives. But I think it's important that people have a choice about parenting and whether they want to parent. And to see people choose to have children and then abuse them and sometimes hurt them to the point of devastation was really hard [00:05:00] to witness.

And it made me feel really passionate that people need to have access to the choice to parent, whether it's to prevent pregnancy or to stop a pregnancy if they know that they're not gonna be able to care for that newborn in their life.

Duncan: Do you feel like you had thought through reproductive rights and reproductive access before?

Anuj: Not before that pediatrics rotation.

Duncan: Oh, really? So that really forced

Anuj: that really forced me to think about it. And then it was the spark to my evolution and thought process around that. I was [00:05:30] able to secure a medical students for choice externship, during medical school in Seattle. And that was when I like, really had my eyes opened to so many of the nuances of that choice.

And there's so many different reasons why people make those choices and I can never know what's going on in somebody's mind. All I know is that I cannot coerce somebody into making a decision. That has to be somebody's decision, and I have to trust that whatever decision they're making is the right decision for their [00:06:00] life.

Duncan: Fascinating to me that the way you got introduced to this whole question is from a very practical and very tangible, and traumatic point of view, right? It's not from some philosophical starting point. It's from, some very practical starting point. There's a child that has an injury because of this.

What is a way of mitigating it?

Anuj: Yeah, it's interesting. I haven't heard more people share this experience, and I don't know why. It just feels so practical to me, as you said. And I'm just wondering if [00:06:30] people choose not to see it or if it just isn't something people want to talk about.

Duncan: I think the idea of child abuse is so hard for people to stomach to even talk about. I think it's one of those taboo things 

Anuj: I, I hear that. I think the other thing that I often think about in process is systems and upstream solutions. And for me, an upstream solution to not having child abuse is not having an unwanted child.

Externship in Reproductive Medicine

Duncan: So I did that externship during medical school in [00:07:00] Seattle, and that's where I gained my mentor in reproductive medicine. Dr. Deb Oyer, who's now retired, she had a small clinic, and by the time I actually was doing that rotation, I knew that I was matching in Seattle for residency.

Anuj: She was very gracious and kind and offered me a longitudinal educational experience during my residency. So I was able to get the training that I needed to provide abortion care to competency, by the time I was done with residency. And, when I finished [00:07:30] residency, there was a huge need and demand for abortion providers in the United States in a way that just doesn't exist anymore because of the national legal landscape.

So, after I graduated from my fellowship, I started providing travel abortion care in the south to states like Tennessee, Texas, and Oklahoma. That all stopped in 2022 after the Dobbs decision, once Roe was reversed and, abortion became illegal in a lot of those states.

Deciding on Family Medicine

Duncan: Anuj discusses some of the other [00:08:00] considerations and the decision making process in selecting family medicine residency over surgery and internal medicine.

And so you matched into family medicine already with an idea of this being one of the things that you're going into family medicine because of, 

Anuj: Correct. 

Duncan: you passed up on general surgery, which is in a quite different domain.

Anuj: It is, I think it would've fulfilled a lot of my needs for being able to do something with my hands. And I think that's something that's very fulfilling to me. but I also don't think [00:08:30] that lifestyle is the right lifestyle for me.

Duncan: And then internal medicine you would have to do a fellowship to be able to do a lot of the hands-on things and your scope of practice would be much more limited.

Anuj: It would, yeah. But the thing I, was drawn to in internal medicine as the hospitalist career, and having shift work and being on and then not being on and not having to take things home with you in the same way. I just was always seeing outpatient physicians having to [00:09:00] deal with labs in the inbox or finishing charting at home.

And it just felt like there were fewer boundaries in when work is off with outpatient medicine so that was one of the, things that I was worried about going into family medicine. And, I think it's a true thing to be worried about, but, I think the trade off of the care that I can provide to patients as a family medicine physician was more meaningful for me and that's why I chose to pursue that instead.

Residency in Family Medicine in Seattle

Duncan: And how was your residency experience? You did [00:09:30] it here in Seattle.

Anuj: Yep. I completed my residency at Swedish Family Medicine, Cherry Hill, just up the street from here. It was lovely. I think it was the right program for me. I took away what I needed from it. I feel very proud of my colleagues and myself and the care that we provided to our patients, and it was great.

 you know, knowing that I wanted to do reproductive medicine, I remember walking in during orientation week and talking to the program director and saying, I wanna learn how to do vasectomy and I want to do this abortion [00:10:00] elective. How can I make that happen? so, you know, it was good to have clear guidelines and desires and to express them early on to make sure I could meet my goals during my education

Duncan: I'm imagining family medicine is so broad. If you didn't have some semblance of interest, it'd be quite easy to just get spread all over the place, I imagine.

Anuj: Absolutely. sports medicine, addiction medicine, sleep medicine, there's so many other things besides diabetes, hypertension, cholesterol management, that we do. I mean, so [00:10:30] much mental health. and you know, I mentioned earlier that I do ketamine assisted therapy, and I think one of the beautiful things about family medicine is that it's so broad and it gives you the opportunity to pursue a lot of different passions and interests if you want.

Duncan: On the surface, residency sounds great. Anuj is at a program that he likes. He's learning the skills that he needs for his future career. However, residency is where medical training becomes medical practice, where you work 30 hour shifts and start to see that the system you're a part of has its own [00:11:00] priorities, and they might not be the same as your priorities. And you are still doing long shifts though, in residency. Right? These 30 hour shifts

And it was reasonable

Anuj: and it was reasonable.

I mean, yeah, you're still sacrificing a lot to get that education and I think it's okay to be grumpy and frustrated and all the feelings about it, but in the end, again, we're given skills and licenses to be able to practice medicine and care for people in a way that other people cannot.

And I think [00:11:30] a lot of times people in our lives don't realize how much we sacrifice to become clinicians. I don't think we even acknowledge or talk about how much we give up to become physicians. And it is a privilege, like to take care of people. So of course there's gonna be some sacrifice to have this privilege.

I just don't think we grieve it or talk about it in a way that allows us to at least respect that that happened.

Duncan: And excited to be a doctor.

Anuj: Uh, there are days I'm excited to be a [00:12:00] doctor and there's days I'm not excited about being a doctor. I think the one-to-one experiences I have with patients are always amazing, and I feel grateful that I can support people in the way that I do. The medical system we have is very oppressive in this country.

And I think so much of that is built on capitalism. you know, we live in a society that was founded on capitalism. Why isn't our medical system going to be a mirror image of that as well? And it's hard for [00:12:30] me to continuously work in a system that doesn't primarily value humanity and the human experience and the health of human beings.

Like that's not the primary focus of our healthcare system. Making money is a primary focus of our healthcare system, and I think that is a challenge for me. I know that all healthcare systems around the world have their own struggles and issues. I'm not saying that anywhere is perfect, but I think something that's more values aligned is something I would [00:13:00] probably do better working in.

Anuj notes this misalignment between his own values, which attracted him to the field of medicine and the bureaucratic reality of daily medicine as early as medical school.

Duncan: When did you notice this misalignment?

Anuj: uh, I started noticing it in medical school, but I think it was too late to say no, there's too much debt acquired at that point.

 it's interesting that we have these front desk staff to triage and schedule patients for us. So we don't often even know how many [00:13:30] people are not being seen by us, right? Like, how many people get turned away because they don't have the right insurance, or they're uninsured or something else is going on.

I just remember hearing some of those conversations and being like, oh crap. There's still so many people that are trying to get help, but they cannot get help and volunteering at different free clinics, like unhoused clinics and other situations where patients would come in with stage four cancer or these melanomas that have been festering for years because they couldn't get into [00:14:00] healthcare sooner.

Like, we are allowing people to die because we are not giving them access to healthcare. And it's just hard to live with that consciousness.

Duncan: And so what you're saying is no matter how well you treat patients within your own system, there's a certain group of people that is excluded from medical care in this country.

Anuj: Yes, healthcare is a privilege in this country and it's so closely tied to employment, and the idea of what one is contributing to this society. And until, [00:14:30] for me, we can live in a society that just values humanity or human beings for just existing, like, I don't think we're gonna be able to truly provide excellent healthcare to a society.

Anuj: Here's what's important for pre-health students to understand. That realization we are allowing people to die because we're not giving them access.

 That's not burnout talking, that's not depression, that's not weakness. That's a physician seeing clearly. And when you see that clearly, when you understand that front desk staff are [00:15:00] turning people away every day when you volunteer at free clinics and see stage four cancers that went untreated for years, you face a choice.

You can stop seeing it. Narrow your focus to just the patients in front of you. Accept the system as it is, or you can keep seeing it and carry the weight of that knowledge every single day.  Neither choice is easy and no one prepares you for that choice in medical school. Anuj chose to keep seeing, and it's made him a better advocate for his patients, but it's also made him acutely aware of his own limitations within a broken [00:15:30] system. 

Duncan: Were there times in medical school or residency where you felt the practice was closer to that ideal?

Anuj: Yeah. I think, the expansion of the Affordable Care Act, getting more people onto Medicaid, like there were a lot of things that were moving in the right direction that made me feel hopeful about us potentially getting to a place where we could enact some of these beautiful human values in my mind.

but I feel like a lot of that eroded, and unfortunately had to do with [00:16:00] politics and who deserves to receive care in this country. So there's been a reversal of a lot of that progress we've made, and I don't know how long it's gonna take to recover from that. So it feels really challenging right now.

Duncan: How about on a day-to-day individual interaction with patients? is that still a positive experience for you?

Anuj: I think so. But the day-to-day interactions have a lot more anxiety built into them. I think patients are unsure about what the future holds. They're unsure [00:16:30] if they can afford their medical bills. They're unsure if they even want to engage in healthcare because they don't want to go bankrupt. Right? Like there's a lot of things that create hesitation for people to access healthcare.

Duncan: Anuj makes an important distinction here, and it's one every future healthcare worker should understand. On an individual level, sitting with a patient, having a conversation, making a clinical decision, medicine can still be meaningful. The human connection is real.  The care you provide in that moment is real.

 The problem isn't the patient [00:17:00] interaction. The problem is everything around it. The insurance company that denies coverage, the electronic medical record that prioritizes billing codes over narrative, the productivity demands that limit your time, the copays your patient can't afford, the prior authorization that can take three weeks while someone suffers. You can have idealism about the patient in front of you while developing clear eye understanding about everything else, but holding both of those caring deeply while seeing systemic failure is exhausting and it's not what anyone signs up for when they [00:17:30] decide to become a doctor. 

Anuj: I sometimes wonder like, do I want to do this thing? Am I worried about my copay? Like, and I'm a, I'm a doctor and should I be worrying about healthcare in that way too? It's, it seems silly, but, navigating this healthcare system is just as challenging for us as it is for our patients.

Duncan: Anuj shares an experience with dealing with bills as a patient, highlighting the complexity of medical billing, and the challenges of navigating the system as a patient, even as a trained physician.

Anuj: When I was in medical school, I broke my [00:18:00] patella in half and I had to have surgery. And I did have the surgery, and I remember receiving bills and paying my bills, and I paid the anesthesiology group. I paid the hospital group where the surgery was done.

I paid the surgeon and I kept getting bills. And at one point I called the surgeon's office and I said, Hey. I don't understand what I'm continuing to get bills for. Can you please audit my chart and explain to me what's going on? And then they called me back two [00:18:30] days later saying, we're so sorry. We've overcharged you, we actually owe you $1,200.

And they sent me a check for my money. But if I didn't have what I consider to be the power to call and inquire, I would've continued to pay into this healthcare system for who knows what reason. So the accountability part of it is also challenging and like it doesn't make me feel like I have a lot of trust in the system if they can't figure out my billing appropriately.

So I just worry about my [00:19:00] patients who don't have the same level of education, who don't have the same grasp of the English language, who don't necessarily know how to advocate for themselves in these situations.

Duncan: So you're wrestling right now with a changing political climate

Anuj: Mm-hmm.

Duncan: and a money driven system that is not aligned with your own humanistic values, How does this play out going forward? 

Anuj: I think the future is unknown. anything is possible. Maybe the US gets its act together and decides that it wants to value this. Highly [00:19:30] unlikely but possible. I think becoming a physician or a nurse practitioner, or a PA or somebody who's providing direct medical care is gonna always be a safe financial decision in this country.

 So I think our jobs are secure it's just whether or not we want to deal with all the stressors surrounding it. And we're seeing a lot of these ancillary services being taken away right now like our diabetes educators, our interpreters, our counselors, our social workers, [00:20:00] all these services that were in, a lot of our federally qualified healthcare systems are being taken away because the budgets to support those services are no longer there.

And then that responsibility for these things that traditionally haven't been done by physicians end up falling on our shoulders. And how much more responsibility do we wanna hold onto? So I think you'll see a lot of people leave medicine because they feel like it's just too much of a burden.

It's too much to hold. I didn't sign up to do all these additional [00:20:30] things. But I also think there's a capacity for change. I think we live in a democracy, ideally, in which people have power with their voice. And I think if we keep raising up our voices and demanding that we deserve to have healthcare, things could change.

I just don't know how quickly we're gonna be able to catalyze that change.

Duncan: what I'm hearing from you is that to give the best care, you're gonna have to dig deeper and deeper as a physician because of all of these financial, constraints and patients are feeling the stress.

So you're getting [00:21:00] that secondhand stress from what they're going through.

Anuj: Yeah's secondary trauma, right? Like there's always gonna be secondary trauma as healthcare providers in a broken system. We're gonna see people who we know what the right thing to do is for them. We know what the right medicine is to be on, but for whatever reason, they can't afford it or they can't take it or something and they're gonna suffer. And that makes us suffer too because we also truly want what's best for our patients that we're caring for. Sometimes we just don't have the ability to make that work out socially for [00:21:30] them.

Duncan: We are getting close to the question Every pre-med student wants answered, should I still do this? And Anuj's answer is nuanced. It's not, yes, definitely. It's not no runaway. It's something more honest and more useful.

Anuj: If you could go back and talk to a younger Anuj, who has an idealized version of medicine back in undergrad.What message would you tell that younger version of yourself or some of these undergrads, Yeah. I, you know, it's hard because we need that [00:22:00] hope, we need that optimism if we are gonna change as a system. But I also don't want it to ruin those people when they realize that that idealism isn't gonna be enacted potentially in their lifetime. But we need people who can visualize a change and imagine a change for that change to happen at some point.

So what I often say to pre-med people or people considering the idea of medicine is if you can imagine yourself being happy doing anything else, I recommend doing that [00:22:30] other thing. But if you don't think you can be happy following any other career path, you should definitely do medicine. I don't think it's a bad career.

I don't think it's a wrong career. I think at some point you just have to remember that it is a career, it is just a job. There is a life that you will be living outside of it, and it's important to invest just as much into that as you are in your career, so that you don't lose yourself in how broken everything is in your career.

Let's unpack that because it's important. [00:23:00] If you can imagine yourself being happy doing anything else, do that other thing. That might sound discouraging, but it's actually protective because medicine is hard enough when it's your calling, when it's what you can't imagine not doing. If you're doing medicine because it's prestigious or your parents want you to, or you think you should.

The debts, the constraints, the misalignment. They can be unbearable because there's no deeper purpose holding you there. But if medicine is genuinely what you want, if you thought about it, shadowed, volunteered, and can't [00:23:30] imagine doing anything else, then go for it.

Just go in with your eyes open. Know that it's hard. Know that the system has problems. Know that you'll face constraints and frustrations. Know that the idealism you bring won't be enough by itself. You'll need boundaries, support systems, sustainable practices. But also know meaningful work is still possible.

You can still help people. You can still build therapeutic relationships. You can still practice medicine that aligns with your values, even if it looks different than you imagined. [00:24:00] That's a realistic hope Anuj is offering. Not naive optimism, not crushing despair, but it's hard and it matters. Go I talked to an afterward if he thought he could imagine himself being happy doing anything else. He thought about it and he said he would probably choose medicine again.

Duncan: That's a.

Anuj: Yeah, I'm.

Yeah. I, I like to say that, but still feel like I'm not pessimistic. I don't know. I, I think for [00:24:30] me, being able to separate this job from my life has been something that's allowed me to continue working in it.

Duncan: When did that happen? When did that dichotomy start? Because I think the traditional view of a doctor has been that there's no work life balance. Right. 

And. That shift has happened in the field of medicine slowly. But when did it happen for you that you really put up a separator between those?

Anuj: I think, in 2016, when I graduated from Fellowship, I was like, I've given a lot of my life to the [00:25:00] pursuit of this. Who am I? I remember after finishing my graduate medical education, it took me six months to like rebound from the challenges of the medical training and like the expectations of the medical training.

And I gave myself six months where I was like, I'm not gonna commit to a career. I'm gonna travel. I'm gonna explore the world. I'm gonna figure out what my hobbies and my passions are. I'm gonna invest in myself. Because I've been investing in my career for too [00:25:30] long. And I think when I started to realize I have friends, I have hobbies, I have things I want to do, it helped me reprioritize where I was spending my time.

Duncan: Do you feel like you're able to show up better for your patients having that balance?

Anuj: Absolutely. I think the happier your physician is, the happier you're gonna be with the care that they're providing you. I think misery breeds company, right? Like I think if your, provider is unhappy with their personal life, it's inevitably gonna leak into the care that [00:26:00] they're giving you.

Duncan: And I think, I guess the, the heart of that matter is make sure you feel passionate about your career choice.

Anuj: And I think the reason I say if you can imagine yourself being happy doing anything else, is because I had classmates and colleagues who went into medicine because it was like a family tradition, right? Mm-hmm. Their parents were physicians, but I don't actually think they wanted to be physicians.

I think they were doing it because that was the expectation, and they just seemed so much more miserable throughout the process.

Duncan: [00:26:30] Do you know anyone that's really happy being a doctor?

Anuj: Really happy is a stretch. I know people who feel good about the care that they provide as physicians, but I think everybody is frustrated in a different way. I think everybody would want things to change, I think most people understand that this is so much larger than they have control over, and at some point you just have to learn to work within it if you choose to work within it. And that's the other thing, there's always a choice. Like if you are truly unhappy with your career, please step [00:27:00] away from it.

It's not worth hurting yourself.

Duncan: And right now you're still feel okay working within the confines 

Anuj: I mean, I would argue that I don't necessarily work within the confines of a traditional system. I don't have my own panel. I don't work like a traditional family medicine physician. I feel really proud of the care that I provide in reproductive medicine, and I feel grateful that my patients get excellent care.

I think one of the sad things for me is I don't have that continuity aspect of family medicine that I went into [00:27:30] it wanting, like that relationship building. I think I can build a relationship with a patient over 10, 15 minutes, but like, am I ever gonna see them again? Probably not. And that's sad for me because I like these stories of people's lives over time and I wanna know what they're doing and where they've been and have I changed their life.

I don't know. I guess I get more lost in novels these days because I wanna know those things and, I just don't think I'll ever know them. 

Duncan: You have such a eclectic assortment of different [00:28:00] roles. what's the thinking behind that?

Anuj: Yeah. I think one of the beautiful things about family medicine education is you learn a lot. You get exposure to a lot of different things. You can deliver babies if you want. You can do addiction medicine. If you want sports medicine, you know, all the things we talked about before. And the growth and the knowledge is just so exponential during residency, I didn't want to leave residency and specialize in something and forget everything that I learned. So the reason I [00:28:30] have all these jobs is because I want to retain the knowledge I learned and I want to use the skills to support people in ways that I can. And there's a part of me that is feeling like if I have the skills and the power, like I feel obligated to provide them to the community.

So I think that's where some of that comes from. But I truly also enjoy the things that I do. I, I don't deliver babies anymore. I don't do well with being up in the middle of the night. 

Like I also don't need to do [00:29:00] everything. as I've grown older, I've allowed myself to be a little bit more selfish in that way. And like, what are my needs? What are my priorities? And, you know, if that's not in alignment, I think it's okay for me to step away from that.

Duncan: Here's what's important about the six jobs. It's not just burnout. It's not just fragmentation. It's also an intentional design, Anuj worked hard to develop skills in residency, reproductive healthcare, teaching and he didn't want to lose those skills by narrowing too much.

Anuj: But also, and he doesn't quite say this, but you can hear [00:29:30] it.  Having six jobs means no single system fully captures him. He's not entirely dependent on any one employer's priorities.  He maintains perspective across the healthcare landscape. That's adaptation, that's agency within constraints.

For students, your career might not look like the traditional model one job, one specialty, one employer, and that's okay. You might need to design something that works for you. The six jobs aren't the point. The point is you can create a practice that's sustainable for you, [00:30:00] even if it looks unconventional.

Duncan: Well, thanks so much for your time. I really appreciate you being so candid about everything, and I think it's, like you said, if you're feeling it, a lot of other people are feeling it as well.

Anuj: Mm-hmm. Well, thank you.

Duncan: So thanks for your

Anuj: Yeah.

Outro

Anuj: This concludes our two part conversation with Dr. Anuj And if you're a pre-med student listening, maybe you're questioning whether medicine is right for you. Better to question now than after medical school.

Maybe you're angry that the system is broken channel, that we need [00:30:30] physicians who are angry about the right things and motivated to change them. Dr. Anuj Khattar's story doesn't end with easy answers. He hasn't solved the tension between idealism and system constraints.

He hasn't figured out how to practice medicine that perfectly aligns with his values within a system designed for other purposes. What he has done is refuse to look the other way. Refuse to accept that this is just how it is. Refuse to stop seeing clearly. He works six jobs across reproductive healthcare, urgent care, teaching [00:31:00] integrative medicine, ketamine therapy, none of them perfect, all of them together, creating something livable, something sustainable.

He still provides reproductive healthcare. He still teaches the next generation of physicians. He still shows up for individual patients. Even in 15 minute appointments, he still cares. That's not failure, that's practicing medicine with your eyes open.

 you've been listening to the EthnoMed podcast. My name is Dr. Duncan Reid.

 If you enjoyed this episode, please share it with a friend.  Until next [00:31:30] time.