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The Golden Handcuffs of Medicine and How to Remove Them

I have a Physician Assistant friend who goes into a funk when her paycheck gets deposited each month.  It’s not the amount getting her down—She makes a lot of money.  She’s been with a great medical university for 15 years and receives an annual 3% raise.  She doesn’t hate her job, but she doesn’t love it either.  She stays because, by this point, her insurance and retirement benefits are excellent, not to mention her six weeks of vacation and three weeks of sick leave.  She also stays because it’s easy.  After fifteen years, she can do it with her eyes closed. 

I wasn’t surprised when my friend confessed to feeling depressed on payday.  I’ve been there myself. At my last job, I’d feel nauseated when I’d get my yearly bonus. The check was a colossal boost to our finances, but it represented ignoring my Inner Self’s desires and choosing money over happiness.

Gilded Cages and Golden Handcuffs

Sacrificing happiness over a comfy income is often referred to as wearing “golden handcuffs.”  Golden Handcuffs are next to impossible to unlatch.  You feel trapped.  Trapped by the job, the security, the money, and the fear of starting over. 

It’s not that you can’t leave or don’t have other options, but you like getting this paycheck and these benefits and this prestige.  You don’t want “everyone” saying you’re crazy to leave.  You know you’ve got a good thing going.  Maybe you think, “who in their right mind would ever fathom leaving this job?”  And yet you do.  You constantly daydream about leaving the stress, the long hours, and the insane workload. You miss the passion and enthusiasm you once had for this job.  

The crazy thing about the handcuffs is that the key is in your pocket.  But.  But the handcuffs are GOLD. Who in their right mind would willingly let go of gold?

Live to Work or Work to Live?

Your job is holding you back from your True Self.  You know this deep down when you get quiet and listen.  Over and over, the thoughts come, “How can I possibly leave?”  and then, “How can I possibly stay?!”  You make lists: pros and cons.  The money is always at the top of the pro list.  It always will be.  Until you realize the money is actually a con.  It’s holding you back.  You’re an amazing person who’s not letting yourself be amazing because you’re handcuffed to the gold.

I have another friend, one who isn’t in medicine, who recently turned down a promotion.  This guy doesn’t have a college degree, but he’s worked his way up in a restaurant franchise.  He’s happy with his department, his supervisor, and his tasks.  He recently turned down a chance to move up and over to a higher position.  The new role would require working with a different team in the company, but the pay bump was significant.  My friend explained why he turned it down, “We’re happy.  We have enough money every month to live a good life.  I’m happy with my job. I like what I do.  If we make more money, we end up buying more stuff.  If we buy more stuff, we’ll eventually buy a bigger house.  A bigger house means a bigger house payment and more stress.  More to clean, more to fix, and more to worry about.  No, thank you”.

How Much is Too Much?

I think about this conversation often.  Most of us hear “more money,” and we don’t think twice.  We don’t examine our “why.”  We don’t even stop to question if we need or want more money.  We don’t think about the cost to our happiness if we chain ourselves to a certain income.

How do you remove golden handcuffs?  First, start believing better things await you.  Maybe not money, but a better life.  A life lived fully and joyfully is better than a life of financial wealth and misery.  You let go.  Take a deep breath, gather up your courage, and let go.

“But wait!” you might say, “What if I just save until we’re able to put in a swimming pool, pay off our house, or go on that big trip?  Maybe that’s the answer.  I’ll have something to look forward to, so it’ll all be worth it.”

But will it be worth it?  If you’ve played this game, you know the stress is robbing you of months or years you can’t replace with material things like a pool or new house.  And there’s no end.  Once you go on that trip, you’ll decide to save for a new car or an RV.  It’s a never-ending loop, just like your thinking.

The Key to Unlocking Golden Handcuffs

1) First, decide if you’re willing to let go of the money, the prestige, and the security.  You have to be willing to face your money fears and confront limiting beliefs about money.  Read Jen Sincero’s You Are a Bad Ass at Making Money and do her exercise of writing a letter to money

2) As much as the word “budget” makes you shudder, you have to sit down and figure out how much money you need monthly and whether you can go 6-12 months with potentially no income.  If you can’t, unsubscribe from Amazon Prime, Netflix, etc., and start saving.

3) Get ready for Fear to attack you many times a day.  Be prepared with comebacks.  For example, 

  • “What will they think?”  Comeback:  Who cares what they think?  What does my Inner Self think?  My Inner Self knows this isn’t a good fit.  It’s urging me toward a different path
  • “What if __________ happens, you’ll be destitute!”  Come up with answers like, “Well, I’d apply for a job at _________, “or, “I’d move back home with my Mom,” or “I’d sell my hair/ovaries/plasma if I had to.”  

You can always come up with an answer to combat the Fear Monster once you calm down and get creative.

4) Be prepared for friends and family to show confusion and disappointment over your decision.  When you take a leap, it makes them question their own lives, causing them feelings of dis-ease.  They may attack your decision to make themselves feel better about their choice to live in Stuckville.  Surround yourself with cheerleaders and people who adore you.  Avoid Negative Neds.

5) Focus on where you want to be.  Create a vision board or write out how you envision your life a year or five years from now.  Verbalize and write positive affirmations and roll yourself in a bubble wrap of abundance, good energy, and gratitude.  Some days it’ll take every woo-woo trick just to make it through.  Write messages to yourself daily to help boost your morale.  Ask a couple of trusted friends to be your encouragers during this time.  Self-doubt about your decision will plague you but stay focused on the road ahead.

6) Think about your deathbed—a lot.  Think, “What would I think on my deathbed if I stayed at this job?  Would I be proud of myself for sticking it out, or would I be relieved I dared to leave when I did?”  One of the biggest deathbed regrets is living a life on someone else’s terms.  Start living your life on your terms.  Now.  

7) If you still can’t make yourself leave, make a one-year plan.  Think of your current job as your investor for your next chapter.  Use your current paycheck (the gold of your golden handcuffs) to fund the steps leading toward your dream.  

8) Take a deep breath and JUMP!  You’ll be astounded by how high and far you can go without the gold weighing you down!

Feeling overwhelmed and directionless? Do you feel lost when thinking about your next step? Do you find yourself in a rut with your career, marriage, and parenting? Do you long for energy, excitement, and a sense of purpose in your life? Are you ready to take control of your life and start being the best version of you? Reach Hope at

Hope Cook, PA

A full-time Physician Assistant in dermatology and Mom to an 8 and 13-year-old, Hope also works part-time as a burnout coach and freelance writer. She recently published a piece about her experience with career burnout on KevinMD. She also published an article on Scary Mommy. Her other essays can be found on her site,

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