The central role your job plays in physician quality of life

Posted by Dike Drummond MD

When optimizing physician wellbeing and happiness, it helps to view a doctor's life in four layers: 


Let's look at them one at a time so we can see where the typical block to a physician's happiness lies.


Each of us made a choice at the Lightworker's Fork in the road. We were called to be a helper and a healer, to ally our professional life to the forces of light in the universe. We chose to make a difference in life's most difficult moments.

We hoped to lead a life of significance and contribution. We felt that answering this calling was an extraordinary choice that would enable an extraordinary life. This choice is our origin story and the start of a long and difficult path through the professional stages below.


Once you are through the medical education process, your career is the arc of your practice over time. It is the sum of the jobs you have held and the people you have helped along the way.

An individual career can resemble climbing the ladder from post to post, or finding a rewarding home and putting down deep roots. Your career may be stable or dramatic shifts in focus from time to time. Each of us has a career arc and each is unique. 


Your practice is the art of your personal style and the expression of your specialty knowledge as you create a healing encounter with your patients and their families.

  • It is how you take a history, make a diagnosis and treatment plan, teach these things to the patients and their families.
  • It is how you create a therapeutic relationship with those who call you their doctor. What you do, what you say, how you lead your team.
  • Your practice is what you do when you are alone with the patient and family, when the door is closed or the curtain pulled.

As a physician and a physician coach, it is clear to me that the practice is separate from the job - see below. Your practice is an art form independent of your job description.

Your Job

Your job is a specific, codified relationship with your employer. It is defined by a job description. That job description has nothing to do with your practice except to provide support and a context for it.

Your job description was created to satisfy the business needs and revenue model of your employer. Your job description translates your practice into your vocation. It converts helping and healing into business value in the form of profit. It translates healing encounters and therapeutic relationships into money.

For most employee physicians, your job description is a standard template with no modifications for your practice. It defines the quid quo pro of your relationship. I will do this and in exchange you will do that. It establishes a trade of RVU's for salary and benefits.

For all employees, the majority of your job satisfaction depends on just two factors

  • The alignment of your job description with your Ideal Job - one that would enable you to build a satisfying PRACTICE with this employer. The core conflict is whether your current JOB description enables or obstructs your PRACTICE satisfaction.
  • The leadership skill of your immediate supervisor (boss) and your relationship with them. "People don't quit the company, they quit their boss."

For self-employed physicians, you have both the power and responsibility to create and maintain your own job description and ensure that it can be used to create a profitable business. This is a separate skill set from the practice of medicine. You do not learn the skills for business success in medical education. Employee physicians delegate these business responsibilities to the employer.

Self employed physicians take on both the practice and the business of medicine at the same time. Some experience this dual challenge as thrilling, others as overwhelming.



The layer cake of your quality of life


One of the defining features of a physician life is our identification with our career. We chose to make a living as a helper and a healer. This is not a hobby. Medicine and our position as a doctor are a huge chunk of who we are. 

  • Our job is our sole source of income
  • Our practice is a massive source of self worth and our quality of life
  • Medicine and the demands of our specific job take up the majority of our waking hours
  • We use the phrase, "I am a doctor" all the time

And when we don't feel good about our quality of life, when we are not happy, it almost always has the same source. 

Self Evaluation/Look in the mirror:

Think about the times when you have felt your life was not going in a good direction. Take a breath and sit with that memory (or your current experience if this is true for you now) for a few seconds.

When you look at the four layers above = LIFE - CAREER - PRACTICE - JOB = where is the source of your discontent?

Is the weak link

  • your larger LIFE,
  • your CAREER arc,
  • your ability to PRACTICE  your specialty
  • or the specifics of your JOB?

In my experience as a physician coach, the answer is almost always your JOB.

It is as if this list is a line of dominoes. An unfulfilling job can knock over all the rest.


This is why job frustration and burnout in doctors frequently leads you to question

  • Your PRACTICE  abilities
  • Your choice of CAREER
  • Even your ability to go on with this physician LIFE in certain extreme circumstances


If your JOB is not worthy of your PRACTICE and blocks you from helping and healing and making a difference in the lives of your patients

  • Your heart will break
  • You will burn out 

And in extreme circumstances you might even 

  • Quit medicine entirely 
  • Or suffer a complication of burnout such as depression, drug and alcohol addiction or even suicide


All because of a conflict between your JOB and your PRACTICE

So, when exhaustion, dissatisfaction, discontent and burnout take center stage,
the path to recovery is to align your JOB with your ideal PRACTICE
and put you back on a path with more purpose
to make the difference you dreamed of at the Lightworker's Fork
and regain a sense of meaning and satisfaction across all levels 





Building Your Ideal Job Description





  • What is your current level of job satisfaction?
  • What role does your job satisfaction play in your satisfaction with your practice, career and life?
  • Where do you see the biggest misalignment between your current job and your Ideal Job?


Tags: physician wellness, physician quality of life