From Burnout to Building Something New: My Journey to Becoming a Physician Entrepreneur
As physicians, we’re go-getters by nature. Getting into medical school meant years of grinding, studying as much as we could, volunteering, shadowing, and taking on leadership roles to stand out in a sea of applicants. Once in, we had to keep that same intensity to match into a top residency: research, strategic rotations, networking with the right people.
After training, some of us finally exhale. We settle into practice, enjoy the work, and find satisfaction in taking care of patients. But for some of us, that drive never really shuts off. It’s just part of who we are.
For me, that meant going into academic emergency medicine. I wasn’t satisfied with only helping the patient in front of me. I wanted to have a bigger impact, to shape how care was delivered, and to train the next generation.
I’ve always loved teaching. I love the look on a learner’s face when they do a procedure for the first time or do it better than they ever have before. I love talking through tricky clinical cases, helping them see the patterns, and then hearing later that what they learned from me changed their practice. As a point-of-care ultrasound (POCUS) enthusiast, my favorite moments are when they send me their scans after graduation just to share something cool they found.
Early in my career, I became the residency ultrasound director, which entailed building a curriculum and running a dedicated rotation. A few years later, I landed what I thought was my dream job: fellowship director for a thriving ultrasound program at a prestigious institution. I threw myself into it, making sure the fellows got the best possible experience and pushing to make the program one of the country’s best. We even became one of the first accredited ultrasound fellowships in the nation.
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When the Dream Job Stops Feeling Like a Dream
But over time, something changed. The admin work kept piling up, and the parts of the job that I used to look forward to, such as conference days, image review sessions, and deep discussions with fellows started to feel like obligations.
I could still separate work from home, but at work, it showed. I was less patient with learners, quicker to get frustrated, and just not the version of myself I wanted to be.
A senior colleague once told me, “When you’d rather work a clinical shift than have another admin day, it’s time to step down.” That hit me hard. I’d never stepped down from anything before, only moved into roles with more responsibility. But it wasn’t fair to the fellows to have a director who wasn’t fully in it anymore.
I made the decision to step down. It was nerve-wracking, but my chair was supportive, and I was lucky to have someone ready to take over who I knew would do a great job.
A Year of Recovery — and Restlessness
I spent close to a year recovering and regrouping. But eventually, that drive came back. I needed something new, something that wasn’t just more teaching or research.
During my time as fellowship director, I’d built a lot of relationships. I’d helped other departments start their ultrasound programs. I’d gotten deep into POCUS operations and reimbursement, both locally and nationally. That’s when it clicked: I could take that experience and turn it into something of my own.
Leaving My Comfort Zone
I decided to start a business called Peachtree POCUS, which helps practices and hospitals build, optimize and sustain high-performing POCUS programs. Starting Peachtree POCUS was a leap into unknown territory. I didn’t have close friends or mentors who were entrepreneurs. My family is all professionals, not business owners. I had no idea what I was getting into. I was excited, but also scared of failing.
I went in with almost no expectations, open to wherever it might lead, and every step taught me something new:
- I read a book on StoryBrand to help me create my website.
- When my first client required business insurance, I realized I didn’t have any and learned what I needed.
- After losing big potential contracts, I read two books on sales (New Sales.Simplified and 7th level) and realized there’s an entire world to that skill set.
- I created a LinkedIn account for the first time and found an entire community of physician entrepreneurs I never knew existed.
Along the way, opportunities popped up that I never planned for. Another emergency physician, Patrick O’Malley, saw my early videos and told me I could do better — then pointed me toward a course on building a professional studio. Now I actually enjoy geeking out about lighting angles and microphones, and my videos look a lot better.
My branding efforts even led medical technology companies to reach out. Consulting for them wasn’t part of my original plan, but it’s become one of the most rewarding parts of what I do. They get my clinical perspective, and I get to learn the tech and business side of things. It’s a two-way exchange that I didn’t see coming.
The Burnout Shift
Has starting a business completely fixed burnout? No. It’s not that simple. But getting into something totally new has brought my energy back. I realized I do best when I’m learning and putting new skills into practice.
Learning new things mid-career has helped me grow — and it’s kept me feeling engaged and balanced. Building something of my own, having people come to me for advice outside the usual resident-to-attending setup, and making an impact beyond my own patients has been incredibly rewarding.
I still love my clinical shifts and teaching residents. But my passion has grown beyond that. I’m part of a broader community now, talking to people and industries I never would have crossed paths with otherwise.
And I don’t know exactly what’s next. But for the first time in a while, that uncertainty feels exciting.
If you’re feeling stuck or burned out, try learning something completely new. Find something with a steep learning curve that forces you out of your comfort zone. You might be surprised at how much it changes your perspective and how much it re-energizes your career.
If my story resonates with you, I’d love to hear from you. Send me an email (drjoshuaguttman@gmail.com) or send me a message via LinkedIn.
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Joshua Guttman MD is founder of Peachtree POCUS. He is an Associate Professor of Emergency Medicine at the Emory University School of Medicine. He completed medical school and residency at McGill University and an emergency medicine ultrasound fellowship at the Icahn School of Medicine at Mount Sinai. He recently completed a 5-year tenure as the advanced emergency medicine ultrasound fellowship director. Under his leadership, the Emory University program was among the first programs to receive formal accreditation.