“What we have is an untapped resource—mid- to late-career physicians now have the bandwidth to share their passions and experience.” This is just a bit of the wisdom shared by Heidi Schwarz, MD, at the American Academy of Neurology’s annual meeting earlier this month. In the panel discussion titled “Not Dead Yet: How to Remain Relevant and Engaged in Mid to Late Career,” Dr. Schwarz discussed burnout, engagement, and relevance with colleagues Laurie Gutmann, MD, and Ludwig Gutmann, MD.

It must be said that any practicing neurologist who makes diagnoses, formulates treatment plans, and generally provides the high standard of care promoted by the AAN is still quite relevant. But the panel rightly pointed out the unique challenges—and opportunities—facing neurologists later in their careers. They often find themselves at a point where they are seeking more meaning and ways to share their hard-won knowledge and experience.


Burnout is a perennial topic at AAN, and understanding its source is the key to beating it. Dr. Ludwig Gutmann listed four things that often lead to burnout for neurologists:

1. Emphasizing money.

A money focus is not fulfilling, and it stifles your ability to take a fresh approach to your practice. Take advantage of the fact that you’ve reached a point of relative financial security to branch out and try new things.

2. Administrative work.

Administration has its time and place, but there is a time to leave it behind and focus on other interests and passions. According to Gutmann, “Life after chair is better than life during chair.”

3. Lack of support.

Finding a supportive environment to work in at this stage is key. Lack of support can suck the joy out of practice and cause you to head for retirement sooner than you otherwise would.

4. Complaining about Epic.

Gutmann emphasizes that even though EMR software like Epic is here to stay, it’s been a real source of burnout for some physicians who have been unhappy with the transition. For more peace with your practice, accept it as a given and avoid devoting unnecessary mental resources to it.

Beyond these common issues, all three panelists agreed that your own health is critical. According to Dr. Schwarz, “Your career or calling is only part of your life, so taking care of yourself must be a priority. You can only defer this so long before you realize you’ve deferred it too long.” It’s true that burnout will be expedited if you find your health suffering.

This includes physical and mental health—maintaining healthy diet and exercise habits is only part of the equation. Dr. Ludwig Gutmann explains, “Whatever it takes for you to have a good time, that’s what will keep you fresh and keep you going. For me it has always been the science.”

Grandfather carrying grandson on shoulders in park

For Dr. Laurie Gutmann, it’s the collegial relationships: “Part of the fun comes from…being able to share a complicated case with a colleague. That sort of interaction keeps it alive and way more fun.”

Paying attention to the things that get you down and the things that lift you up in your practice, along with maintaining a healthy lifestyle, will help you enjoy the end of your career without burnout. It may even encourage you to extend it!

Leaving a Legacy

Avoiding burnout is important, but there is more than simply getting through the day without crashing and burning. Mid to late career  is a time when neurologists think about what they want to leave behind. It’s a nice place to be professionally, according to Schwarz, because there are so many opportunities for teaching, sharing, and writing.

Woman typing on laptop

Dr. Ludwig Gutmann finds writing in particular to be an excellent outlet. He enjoys both writing for and reading the Reflection section of Neurology to be a great way to work out the stresses of patient care. This type of creative activity also gives younger physicians a glimpse into what lies ahead to help them more deliberately choose their own paths.

Dr. Laurie Gutmann advises that this is not the time to back off from trying new things. Even on a voluntary basis, you can do so much with the experience you bring. With a career full of connections and not having to worry quite so much about money, this is the time to spread your wings rather than stick with the status quo. Maybe this is teaching or perhaps it’s clinical research. Whatever it is that sparks your interest, you have much to offer.

“I’ve done all the wrong things—but I think I finally have them figured out,” Dr. Ludwig Gutmann says. Perhaps in the end, these things help put a career in perspective.