Sunday, June 19, 2005

The Joy of Medicine - finding meaning in medicine

Even though medicine has traditionally been regarded as a profession which provides tremendous job satisfaction, many doctors are finding themselves increasingly dissatisfied with the practice of medicine. In the past , when doctors met, they used to talk about the interesting patients they helped to treat. These days they usually talk about financial stresses, job pressures, bureaucratic hassles and red tape. Doctors are increasingly toying with the idea of changing careers , while others are burning out in their mid-forties. Where has the joy of practicing medicine gone ?

In order to find joy in medicine, we need to find meaning in our profession. Work is an essential part of being alive and physicians are fortunate to work in a job which can provide so much satisfaction . They are presented with new challenges daily ; they can apply their mental abilities and their physical dexterity to successfully solve many of these problems; they are accorded respect and status; and they have control and autonomy . Unfortunately, many doctors no longer work for the sake of working - they’re working for a car, a new house, or a vacation. It’s no longer the work itself that’s important to them, and this is a shame, because there is such joy in doing work well.

We are privileged to help take care of patients, and we need to respect our role, so we can learn to respect ourselves. If you do what you love and love what you do , you will find a higher purpose in life - and if you are passionate about your work , your life will be full of meaning. Getting paid for this should be seen to be the ultimate bonus !

We are fortunate to be doctors, because we can learn so much from our patients. They bare their heart to us, and make us privy to their innermost confidences, so that daily we get a ringside view of human drama, suffering, courage, life and death – the stuff of which life is made ! Doctors have a chance to plumb the depths of the human soul, as they accompany their patients through their suffering. Our work lends itself to contemplation and introspection – allowing us insights which few other people are privileged to have. Our patients can teach us how to live and how to die – and we need to keep our hearts open to their lessons. While it is true that daily exposure to misery and suffering can drain some doctors, causing compassion fatigue; and leave others hardened and unfeeling, these same experiences can also invigorate and rejuvenate you.

Watching patients die should remind you of your own mortality , so that you remember to learn to live each day well . Seeing very ill patients recover should renew your sense of amazement at the marvels of the human body , so that you appreciate the perfection of your own body every day. Observing friends and loved ones provide comfort and courage to the ill should awaken your own feelings of compassion, so that you remember to touch all your near and dear ones with love every day. To live life to the fullest, we need to recapture our sense of wonder at life daily – and being a doctor allows you the privilege of doing that at close quarters !

It is true that physician morale is declining today, and doctors are hard pressed to find job satisfaction. However, instead of focusing our efforts on trying to identify what is wrong with medicine today, we should identify happy doctors and delve into their secrets. I am sure we all know doctors who still look forward to each day as an opportunity to do good, and to become more skilled physicians. We should try to learn from their successes. Many of these happy physicians may never become the president of the medical association, or grab media headlines , or be written about in House Calls, but they are the true stars of our profession, because they have found meaning in their lives. My personal role model is my father, who is one of the most satisfied people I know. His primary source of happiness is his patients , and they have provided him a major source of personal sustenance. He enjoys talking to them, they enjoy talking to him, and his links with them are deep and personal. Even more importantly, I have learned that professional satisfaction does not come from acquiring money, but instead from gaining “social capital” through community ties. He has numerous extracurricular activities , and is very well connected with his family, friends and neighbors, and these social bonds contribute enormously to his satisfaction.

The first rule for being a happy doctor is very simple – it simply means caring for your patients. Treat all your patients like VIPs – whether they come from Dharavi or from London . Remember that the relationship with our patients is at the heart of our professional role – and a healthy doctor-patient relationship can nurture both patient and doctor ! Medicine is really about service, not science - and the true meaning of medicine is found in the relationships we have with our patients. Savor your patients. When a patient thanks you for your work or says that you've become like a family member, stop and relish that moment. Those moments are the real reward for being a doctor, if you can slow down to let them in. When it comes to getting positive feedback, no profession in the world comes close to medicine ! The joy of medicine is in doing good , which is why patients still confer a special status on us – we need to prove ourselves worthy of it..

Find an area of special interest in your field which you enjoy, and acquire a depth of knowledge in this focused area. Once you've mastered an area, then master its intricacies. Not only is it personally rewarding, it'll be professionally rewarding, as well. Your colleagues will refer problem patients in this area to you ( allowing you to become even more expert in the topic), and you will also acquire a reputation amongst patients as being very good in this area.
If you find your practice has become boring, tedious and monotonous, you need to recharge your batteries. Be willing to do something new, even if it involves a risk – after all, if you continue doing the things which bore you, the situation will get even worse ! You can consider hiring an assistant, to take care of the parts of medicine you find boring, so you can concentrate on what interests you. Other doctors have rediscovered joy not by narrowing their scope but broadening it to encompass a new area of expertise – for example, by exploring alternative medicine, such as acupuncture, homeopathy and chiropractic.
Try to publish and present your clinical experiences. This will force you to read the medical literature and provide intellectual discipline as well , as you have to carefully document your experiences and answer your colleague’s queries. Advances in medicine depend upon clinical acumen, and if we apply scientific rigor to our clinical experience , we can all contribute to improving medical practice. Treasure your rare patients and your difficult cases – they can teach you the most !

Develop humility. Often you will find that the reason you are unhappy in your professional life is that you have let your ego get out of control. Practicing medicine can make us feel that we are indispensable, and self-importance is a serious malady that stands in the way of professional satisfaction.

Learn to develop interests and friends outside medicine. While it is true that medicine can be a demanding mistress, don’t let her take over your life. Good doctors are well-rounded individuals , who have an open mind and are curious about everything. Having outside interests will not only make you a better person , it will also help make you a better doctor, as you apply what you learn from other fields to your medical practice. For example, I enjoy playing tennis, and have found that learning how to serve has helped improve my surgical skills by honing my hand-eye coordination.

Do some charitable work – for example, offer a free clinic once a week. One of the best ways of feeling good about yourself is by doing good for others , with no strings attached. The gratitude of the patients you see free of charge is worth much more than any amount of money . As a doctor you have many opportunities for being altruistic – make the most of them !

Don't make the mistake of equating wealth with happiness - the pursuit of wealth only complicates our search for happiness. . As physicians, we should be grateful that we get the opportunity to make a positive difference in the lives of others every day – a goal most humans aspire to. Be thankful daily that you can help others - expressing gratitude is a powerful tool in the search for contentment and self-worth.


Most of us become doctors in order to help others, and all of us get this opportunity to do so on a daily basis, whether we work in Mayo Clinic, or in the heart of rural India. We should remember how lucky we are to belong to such a privileged profession. Even in ancient India, vaidyas were considered to be very fortunate, because their lives offered them the opportunity of fulfilling all the three aims of a good life – dharma ( religious gain, by relieving the suffering of patients); artha ( material gain, by building up a rich practice); and kama ( personal satisfaction, by curing those whom he loves and respects, and by acquiring fame for his expertise). This is as true today as it has been through the centuries ! Medicine is a wonderful way to make a living – be glad you are a doctor and make the most of your profession – for your sake, and for the sake of your patients !

3 comments:

  1. Dear Doctor,

    True happiness or job satisfaction can come only from being able to see concrete results. It is the innate frustration among the physicians at not having the results they crave for that has led them to be manipulated by the drug industry.

    The vicious cycle will be very difficult to break. Modern medicine has held out the concept of "quick cures" and has made medication an integral part of their practice. While these practices have resulted in steep popularity, these very factors will lead to its downfall.

    Today everyone seeks a "quick fix" solution little realising that disease requires rest and recuperation more than medicines. Disease is natures way of telling a living organism that it is out of sync with its environment and that it needs to stop, reflect and correct itself.

    Medication is an easy tool and it absolves the patient of all responsibility. Thus has developed various "lifestyle" diseases. Unnecessary medication also hampers the body's own healing and recuperation capabilities.

    Modern medicine is a diseased entity. It is out of sync with the reality that the Universe is a interconnected, interdependant web and not a mechanistic model. It needs to pause, reflect and correct itself for the sake of its own and also for its patients.

    And then the joy of medicine will be available once again.

    Regards,
    Jagannath.

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  2. Thank you for providing such a valuable information and thanks for sharing this matter.

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  3. Anonymous11:22 AM

    Dear Dr,

    This is such a wonderful post straight from your heart!I wish I were a doctor too :( I am sure your dad is a great role model for you. I am very happy to get a chance to know a person like you.

    May God bless you! Be happy always!

    Miss reading your blog posts. Hope you are having a nice time :)

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