Career contentment

Key Points

What if all of these conditions suddenly became reality? Would that be enough, or would you continue to look for more?

In this first of two articles, we will focus on how professional fulfillment must come from within and not from other people or organizations. We'll also explore why job satisfaction and career contentment don't necessarily go hand-in-hand.

It's human nature that people rarely are completely satisfied. As a physician, your focus is constantly on what is wrong and how to fix it; therefore, you are pre-programmed for continuous improvement, even more so than most people.

As we age and our interests evolve, we often come to expect more or something new to keep us satisfied. Marketing tactics are based on this basic premise-a new iPhone model is debuted almost every year, loaded with even more features.

Even hospital CEOs or practice owners/partners or administrators don't have complete control over all of the people and conditions that can affect physician satisfaction. They can't control big government, insurance providers, patient adherence to medication regimens, disease patterns, or other factors that can affect your work schedule and morale. You understand this even more if you own or run a practice.

So what keeps physicians in their jobs and productive despite conditions you can't control and that can't be made satisfying except on a temporary basis?

Some physicians say intrinsic factors keep them at the job despite dissatisfaction with the extrinsic factors. Extrinsic factors were listed in the first paragraph of this article and include pay, vacation, scheduling, and other considerations.

In contrast, intrinsic factors include the satisfaction of helping another human being, the mental challenge of working up a disease, and the need to constantly learn and grow intellectually.

"Interacting with grateful patients and the ability to see that I am making a tangible difference in someone's life is what is I appreciate the most about practicing medicine," says Danielle Eigner, DO, MPH, who is on the faculty at the University of San Francisco, California.

The assumption is that you still have control over your intrinsic job satisfaction, even if it isn't possible to be extrinsically satisfied. But to what extent can you actually exert control over your intrinsic job satisfaction?

Your control over your intrinsic job satisfaction is not guaranteed. You depend on patients presenting with challenging medical problems that you can help, on lab work being accomplished in a timely manner, on patients following instructions, and so forth.

It may seem like a stretch at first to consider that your inner work satisfaction is contingent on external factors that you may not be able to influence. Consider this, however: as a physician, you can see two different people for the same exact symptoms. Extensive work-ups of both patients reveal the same disease process. The same treatment plans are given to both. Patient 1 is very grateful and thankful for all your hard work and time spent with her and is very happy that you "fixed the problem." Patient 2 is very upset that the diagnosis took "so long" and required lots of tests, and that he is now "stuck on a medication" for the rest of his life.

One patient interaction resulted in high intrinsic job satisfaction, and the second patient interaction did not. The point is that you cannot consistently rely on intrinsic factors to be fully and always present.

Whether job satisfaction is intrinsic or extrinsic, it is codependent on someone doing something and conditional on whether expectations were fulfilled.

So the same question is still unresolved: If you lack control over the conditions that make you extrinsically and intrinsically satisfied, what is it that actually keeps most physicians in their jobs?