The Quiet Deadline: Why October Is When You Decide Next Year Without Noticing
Pull out your employment contract. Not the offer letter. The contract. Find the section on term and termination, and look for two things: the renewal date and the number of days' notice you owe.
For many physicians, 90 days is the standard notice period. If your contract renews on January 1, do the math. Your window to give notice closes the first week of October.
Most physicians never do the math. They don’t decide to stay another year. They just don’t decide to leave. And the calendar makes the call for them.
A Decision Made by Default
Here’s a pattern I see in coaching. A physician spends the spring and summer unhappy. Not in crisis. Just worn down. Sunday nights feel heavy. Something about the schedule, the comp plan, or the leadership isn’t working, and they know it.
They tell themselves they’ll think about it seriously after the summer. After the kids are back in school. After the new EHR go-live settles down. Then it’s November. The notice window has closed, the contract has rolled over, and they’re committed to another year.
Nobody chose that. It just happened. That’s the problem.
A default is still a decision. It carries the same consequences as a deliberate one: the same schedule, the same frustrations, the same pay structure for another twelve months. The only difference is that you didn’t get a vote.
You Are Not the Only One Thinking About It
If you’ve been quietly wondering whether this is still the right job, you're not alone. The AMA’s most recent national physician comparison report, drawn from roughly 19,000 physicians, found that 32% intend to leave their organization within two years. More than half said they don’t feel valued by their organization.
Those aren’t physicians in crisis. That’s about a third of the profession looking at the door. Most won’t walk through it this year. Some should. And many will stay without ever actually deciding to.
Why Smart Physicians Miss the Window
You would never let a time-critical order slide on a septic patient. You live by deadlines. So why does this one slip past?
A few reasons come up again and again.
The contract lives in a drawer. Most physicians read their contract closely once, the week they sign it. Ask them their renewal date or notice period a few years later and they have to go look. The deadline is invisible because nobody put it on the calendar.
Leaving feels like failure. Medicine trains you to push through. Seriously considering an exit can feel like admitting you couldn’t handle it. So you never let the question get far enough to act on. But a job that no longer fits is not a character flaw. Very often it’s a system problem you’ve been absorbing as a personal one.
The golden handcuffs are real. A mortgage, tuition, loan payments. Retention bonuses with clawbacks. Deferred compensation that vests next year. These are legitimate constraints. They’re also a very convenient reason to stop thinking.
Exhaustion kills planning. When you’re running on empty, next year is too far away to consider. You’re getting through this week. I wrote in August about how decision fatigue erodes clinical judgment by mid-afternoon. It does the same thing to career decisions. The biggest choices get made by whatever version of you has the least left.
Staying Can Be the Right Answer
This is not an argument for leaving.
Plenty of physicians look hard at their situation and conclude that staying is right. The job is good enough. The team is worth it. Stability matters more right now than anything else. That’s a legitimate outcome.
What matters is that you get there on purpose. A physician who chooses to stay shows up differently in January than one who got stuck. The first one owns the decision. The second one resents it, and that resentment leaks into every clinic day.
Deciding on purpose also gives you leverage. In many organizations, fall is when next year gets built: schedules, FTE, call structure, compensation, new leadership roles. If you know what you want, this is the season to ask for it. A request for a lower FTE or a protected admin day lands very differently in October than it does in March, after the schedule is already set.
What to Do This Week
You don’t need the answer yet. You need to stop the clock from answering for you.
1. Find your dates. Pull the contract. Write down the renewal date, the notice period, and how you must deliver notice. Your renewal may not be January 1. It may be your hire anniversary. Know which.
2. Know what staying is tied to. Retention bonuses, sign-on clawbacks, vesting dates, non-compete terms. Put a dollar figure on what leaving would actually cost. A number is easier to work with than dread.
3. Answer one question honestly. If this contract were ending on its own, would you sign it again as written? Yes, no, or yes with changes. Write your answer down.
4. If it’s “yes with changes,” ask now. Make the request while you're still building next year.
5. If it’s no, get the right help. Talk to a physician contract attorney before you send anything. Then talk to someone who can help you figure out what you’re moving toward, not just what you’re leaving.
None of that takes more than an hour. The first step takes ten minutes.
The Year You Don’t Get Back
Late in my emergency medicine career, I was burned out and I knew it. What finally changed things wasn’t a crisis. It was working with a coach who asked what I actually wanted next. I didn’t have a good answer at first. But once the question was on the table, I couldn’t keep letting the years decide for me.
Time is the one resource physicians can’t earn more of. Every year that rolls over by default is a year spent on a choice you never made.
This deadline is quiet. It won’t page you. It won’t show up in your inbox. That’s exactly why you have to go looking for it.
If you want help thinking it through with someone who has been in the same chair, that’s the work I do. But start with the contract. It’s in a drawer somewhere, and the window is closing.
Heath Jolliff, DO, ACC
Executive Physician Coach | Founder, Physician Coaching Solutions
Three decades in clinical medicine taught me what breaks physicians. A decade coaching residents and fellows as a program director, and six years since as an executive coach, taught me what rebuilds them. I work with physicians who are burned out, at a crossroads, or practicing in systems that no longer reflect why they went into medicine.
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