Are You a Miserable Doctor?

“It’s almost impossible for anyone, even the most ineffective among us, to continue to choose misery after becoming aware that it is a choice.”

—William Glasser, MD

Something called the Physician’s Misery Index is out and the results aren’t pretty. Overall, the nationwide PMI is now 3.7 out of 5—meaning that for America’s doctors “the scales are tipping from satisfaction to misery.”

The index is a creation of Pennsylvania-based Geneia, which specializes in the development of advanced clinical, analytical, and technical solutions for health care. Other findings from their recent survey of doctors show that:

• 87% say the business of health care has changed the practice of medicine for the worse.

• 84% believe that quality patient time may be a thing of the past.

• 78% say they frequently feel rushed when seeing patients.

• 67% know a colleague who plans to quit medicine in the next 5 years because of burnout.

• 51% say they have considered a career outside of medicine.

“Most physicians still love medicine, but increasingly are frustrated by the business of medicine,” said Heather Lavoie, Geneia's COO. “For most physicians, the ability to create meaningful relationships with their patients and truly impact health outcomes is why they entered the practice of medicine in the first place, and is critical to experiencing joy in their work.”

Is misery a choice? I remember my physician-dad telling me it was. For a guy who was abandoned by his father, forced to live in poverty for many years, struck with a debilitating virus in his 30s, lost 2 young daughters in auto accidents 3 years part, and had a wife die from cancer in her early 60s, my father certainly had cause to be miserable.

But I can’t say he was. And as much as today’s doctors think they are miserable because of their career, I truly believe it was dad’s work as a doctor that made him be not miserable. The challenge, the fast pace, the human bonding, the duty, the capacity to help others—all brought him contentment. Seems he was onto something.

I recently ran across the work of an internationally-recognized psychiatrist, the late Dr. William Glasser (1925-2013). The 1953 graduate of Case Western Reserve School of Medicine confirms my dad’s theory—it’s a choice.

His 1998 book, Choice Theory: A New Psychology of Personal Freedom, is the primary text used by the organization he founded, The William Glasser Institute. Choice theory states that: “all we do is behave, that almost all behavior is chosen, and that we are driven by our genes to satisfy a few basic needs: survival, love and belonging, power, freedom and fun.”

The 10 Axioms of Choice Theory are:

1. The only person whose behavior we can control is our own.

2. All we can give another person is information.

3. All long-lasting psychological problems are relationship problems.

4. The problem relationship is always part of our present life.

5. What happened in the past has everything to do with what we are today, but we can only satisfy our basic needs right now and plan to continue satisfying them in the future.

6. We can only satisfy our needs by satisfying the pictures in our Quality World.

7. All we do is behave.

8. All behavior is Total Behavior and is made up of four components: acting, thinking, feeling and physiology.

9. All Total Behavior is chosen, but we only have direct control over the acting and thinking components. We can only control our feeling and physiology indirectly through how we choose to act and think.

10. All Total Behavior is designated by verbs and named by the part that is the most recognizable.