American College of Physicians: Internal Medicine — Doctors for Adults ®


Steps we can take to regain professional satisfaction

From the March 2000 ACP–ASIM Observer, copyright © 2000 by the American College of Physicians–American Society of Internal Medicine.

By S. Spence Meighan, FACP

In my work as a health care consultant, I see a growing number of doctors who are miserable with their careers. At first glance, this may seem to be nothing more than a personal problem. The situation is much more serious, however, because disgruntled doctors often fail to provide top-notch medical care.

While dwelling on the causes of this discontent is a popular pastime for today's physicians, it is not particularly helpful. A more productive approach might be to examine how we can regain our professional satisfaction.

One obvious option is to change jobs and get out of patient care. Most physicians, though, find it hard to abandon the knowledge and skills they have spent so many years amassing. Also, the experience of being in medical practice for some years may ruin an individual's ability to do anything else!

For most of us, a more realistic approach is to learn to adapt to contemporary circumstances and recognize our powerlessness over the forces molding the business of medicine. The longer we believe that we can significantly change these forces, the longer we delay acceptance of our own need to change.

It is all too easy to continue plowing a furrow between home, office and hospital, enduring it grimly without facing up to our unhappiness. From time to time, we all need to stop and assess our emotional well being. Suffering is a powerful motivator for change, and when we deny our suffering we merely support the status quo.

Some of the most contented people I have met have been to the brink of disaster and returned. People who have battled with cancer, alcoholism or some other life-threatening circumstance have confronted their need to change in direct, practical terms and taken the necessary steps.

Many of these individuals, myself included, have turned to self-help groups to turn their lives around. While many physicians are not good at group activities and might even regard the process of seeking help as personal weakness, I suggest that we as a profession could benefit by taking a leaf out of the self-help book. We need to get together as physicians to support each other in the search for greater professional satisfaction.

Here are some suggestions based on my own experience and on conversations I have had with many physicians on how we can regain professional satisfaction. Though I certainly don't claim to have found serenity, I think that these pathways may help those of us who are trying to get there.

  • Advocate for your patients. The circumstances of medical practice (especially primary care) require that physicians see a lot of patients in a short time. With so much focus on efficiency, it is easy to forget to provide the empathy and expressions of concern that patients look for. The number of patients seen and the empathy provided often exist in an inverse relationship to each other. Yet if our patients see us as uncaring, our capacity to influence them becomes limited. We must always remember that the relationship with our patients is at the heart of our professional role.
  • Respect your body. We must do what we advise our patients to do, and that includes exercising, as well as cutting out smoking and drinking. The danger for many of us with perfectionist tendencies is that once we begin to exercise, we want to run marathons. What should be a healthful and enjoyable activity turns into yet another testing ground for us to show our excellence.
  • Preserve time away from patients. Many doctors live lives in which fun is conspicuously absent. When confronted with this, some respond, "I don't have time for fun." I propose that we have all the time in the world, and that we simply need to prioritize our time. One key is to avoid filling every waking hour of your time seeing patients. You need time away from medicine to nurture your physical, emotional and spiritual growth.
  • Make friends outside of medicine. Many physicians forge most of their friendships with other doctors. While it's true that other doctors can understand our concerns and irritations, they also have an uncanny ability to activate our misery. Friends outside of medicine are a particularly valuable resource.
  • Don't limit your choices in the pursuit of wealth. Being a doctor in America carries certain financial expectations, and there is nothing wrong with that. We have worked hard to get where we are, and we continue to put in a lot of hours. But we must remember not to limit our options--and professional satisfaction--to meet those expectations. We must remember that the pursuit of wealth only complicates our search for happiness.
  • Be thankful that you can help others. When I ask people who don't work in medicine about their aspirations, they frequently tell me that they want to make a difference in the lives of others. As physicians, we should be grateful that we get the opportunity to do just that every day. Sometimes the opportunity becomes obscured by the irritations of managed care or other factors that interfere with our work. But expressing gratitude is a powerful tool in the search for contentment and self-worth.
  • Help your community. As physicians, we have enormous expertise to offer our communities. When we share our knowledge with members of the public, they benefit and so do we. It doesn't matter whether it's in a specialized field of cancer or drug abuse or working with the poor in a Salvation Army clinic.
  • Develop humility. When I find myself in an unhappy situation in my professional life, the reason usually has to do with my ego getting out of control. Practicing medicine can make us feel that we are indispensable. Self-importance is a serious malady and it stands in the way of professional satisfaction.

Our level of professional satisfaction is a matter of personal choice. I greatly admire the many physicians who enjoy the practice of medicine and who provide patient care that is unexcelled anywhere in the world. There are other physicians whose lives are not so blessed, and it is for them and myself that I write this article.

Dr. Meighan is a health care consultant in Portland, Ore., who specializes in hospital-physician relationships. He is a frequent contributor to ACP­ASIM Observer.

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