The pandemic didn't break Sejal Desai, MD. It clarified things. As a single mother working long hours caring for COVID patients, she was simultaneously managing virtual school, running a household, and keeping an insurance-based practice afloat. At some point during those months, she recognized a pattern in herself that she'd spent years training to identify in others: she was present in body but absent in every way that mattered.
"I realized I was simply going through the motions and not truly present for my kids."
With her daughter approaching college age, she felt the window closing. In 2021, she left her employed position to launch her own virtual obesity medicine practice. The financial risk was real. So was the professional uncertainty. She describes it without hesitation as both the hardest and the best decision she's ever made.
There's a particular kind of invisibility that settles over the operational side of a physician's life, especially a physician-parent who also owns a practice. Her kids understand her work in broad strokes: she talks to people about food, weight, and healthy habits. That framing, she says, is exactly what she wants for them. The labs, the treatment plans, the administrative weight of running a small business, the patient worry she carries home without saying so. That layer stays hers. Keeping her children's picture of her work uncomplicated feels like a deliberate act of protection, for them and possibly for herself.
The advice she offers to other physician-parents is the same advice she admits she doesn't always follow.
"Don't wait for a crisis to start prioritizing yourself. The habits that support your health, relationships, and well-being are just as important as the responsibilities on your to-do list."She's candid that she's a work in progress. What she resists, though, is the framing that self-care is a luxury physicians earn after they've satisfied every other obligation. In her view, it's a prerequisite for showing up at all.
There's something worth sitting with in that tension. The stories that rarely travel beyond the car ride home from school pickup tend to be the ones where a physician finally admits the system extracted something they can't fully account for yet. Desai made her exit before that accounting came due. Whether that choice is replicable for physicians without the flexibility her specialty and practice model eventually allowed is a question the profession has been slow to take seriously.
