The Podcast by Kevin MD is a daily run medical podcast where healthcare professionals and their stories are discussed.
In an episode of The Podcast by KevinMD titled “Balancing Life and Medicine,” published on October 28, 2023, dermatologist Stephen Lewellis discussed his career dissatisfaction and recounted an abrupt contract termination. His account has prompted discussion on Facebook about physician autonomy, workplace culture and the challenges of speaking up within healthcare organizations.
Dr. Lewellis, in his early career as a dermatologist, started feeling a sense of dissatisfaction. Rather than claiming to be burned out, he recalled questioning himself whether the conventional structure of clinical practice was what he wanted for the long term.
He described the hassle of moving between patient consultations, managing electronic medical records, completing documentation and trying to maintain a life outside work.
He did not want to leave medicine, instead, he wanted to figure out if there was a more fulfilling way to continue practising it.
He gradually became interested in learning about the experiences of other physicians who were exploring opportunities as entrepreneurs beyond conventional employed positions. Their accounts helped him realize that doctors could pursue better professional autonomy.
Lewellis said that for him, this shift resulted in significant personal development. The transition made him more willing to be uncomfortable. He recognized that career satisfaction might require deliberate action rather than simply waiting for the right opportunity.
Dr. Lewellis mentioned that he had worked in an employed position for approximately four years. He initially valued the stability his job offered to his family and the opportunity it provided the opportunity to develop his clinical skills.
However, over time, he became concerned about the organization's direction and the dissatisfaction he perceived among colleagues. He also began speaking more openly about his concerns.
According to Lewellis, he had worked at the organization for two years, and his contract was set to renew automatically. He wanted to discuss his performance and renegotiate the contract rather than allow it to renew without a discussion.
He requested a meeting to obtain feedback on his performance and discuss his contract. Instead, two vice presidents and an HR representative told him that his contract would not be renewed and that the day would be his last in the clinic, according to his account on the podcast.
He described the company’s decision as very unexpected, especially when he believed he was performing well, citing high patient ratings and positive relationships with his staff. He said the difficulties were primarily associated with his interactions with senior leadership.
His account illustrates the uncertainty that can accompany employment in corporate healthcare organizations. However, the account was an old experience and did not include the employer’s perspective.
Responses to the podcast's discussion on Facebook reflected concerns about workplace culture, professional autonomy and the experience of advocating for patients and colleagues.
Commenter Annie Melinda Harberger, a general practice physician, mentioned that she often spoke up for colleagues and patients in her organization, which led to her being negatively characterized at her workplace, after which she suffered a ‘moral injury’.
Scott Huitink, MD, CEO, Compass Peds, drawing on his experience in corporate medical groups, offered a different perspective on professional autonomy. He mentioned that despite his strong performance with staff and patients, he often felt undervalued at work, which consequently led him to establish an independent clinic. He also said he now makes a deliberate effort not to devalue others in the way he felt he had been treated.
Another comment by David Seidel, Internal Medicine Physician at Kaiser Permanente, described his wife’s experience at her previous job, where she was fired for making suggestions on how to improve the practice. According to him, her office manager spread false information about her to the lead physician, who worked from a different office and had never known his wife professionally. They terminated her without any particular reason, simply saying she was “not a good fit.” The company was also demanding that she abide by the non-compete contract, and David and his wife had to hire an attorney and threaten the company with a defamation lawsuit for defamation. He also mentioned that she is at a much better workplace now.
The discussion also raises broader questions about physicians' autonomy and their relationship with healthcare organizations. In February 2025, the American Medical Association (AMA) reported findings from a study involving more than 2,100 physicians surveyed in 2022 and 2023. The study found an association between physicians' control over aspects of their work environment and burnout, as well as their intentions to leave their jobs or reduce their working hours. The factors examined included control over patient loads, workloads, clinical schedules and team composition
The findings provide broader context for the concerns Lewellis described about professional autonomy. However, they do not establish why his contract was not renewed or show that his experience is representative of physician employment across healthcare organizations.
1. “Balancing Life and Medicine.” The Podcast by KevinMD. October 28, 2023.
2. “A Message of Hope for Physicians.” KevinMD, September 17, 2023.
3. American Medical Association. “Want Happier Doctors? Restoring Their Practice Autonomy Is a Must.” February 18, 2025. https://www.ama-assn.org/practice-management/physician-health/want-happier-doctors-restoring-their-practice-autonomy-must.
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