How physicians can find meaning in their work

By | March 29, 2019

“Seriously, do you often/very often reflect on how your work helps make the world a better place?”

I was recently involved in an email exchange with a colleague when she sent me this line. We will get to the answer to that question at the end. I was disappointed, but not surprised because until about three years ago, I probably would have answered, “No.” However, I have had a paradigm shift and discovered that finding the meaning in our work is one of the most important things we can do for ourselves.

Moreover, as leaders and educators helping others find purpose and meaning in their work is one of the most important things we can do for them and our organizations.

Let me explain my transition: I came to work one day and saw a flurry of emails about a resident who had essentially saved a patient’s life the night before doing a marvelous job with a code and resuscitation. Multiple emails of congrats were being sent around. My initial reaction was this is great, but isn’t this what we are supposed to do as physicians.

Wow — hit the pause button. In what other profession (maybe fire firefighters or police) would saving someone’s life be considered a ho-hum event?

I really had to stop and reflect on my thoughts.

After this event, I recall seeing a video by Drew Dudley about lollipop moments. It made me think about all the impacts that we have on a daily basis that we as health care providers likely take for granted. If you haven’t seen this video check it out. It is incredibly funny and poignant. It tells the interaction of Drew and a student he met. He did not even remember the interaction with the student, but it profoundly changed the course of her life and ultimately his. Trust me — it will get you thinking about the daily interactions you have and their impact. And, just maybe, it will encourage you to give someone else a lollipop moment and show them the purpose in their work.

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I subsequently read the book Drive by Daniel Pink. He talked about how we are motivated by purpose, autonomy, and expertise. It fit perfectly with the Drew Dudley video. Here it was again. The fact that by finding purpose in our work, we were motivated. I couldn’t help but think about the things I enjoy most at work — teaching students, mentoring residents and junior faculty and providing direct patient care.

These were all the things that I felt energized after doing.

Finally, I came across the work of Tait Shanafelt, MD who currently runs the Stanford Medicine WellMD Center. He has published extensively on burnout in medicine. He had two articles in particular that resonated with me. The first was a paper that demonstrated that first-line supervisors and department chairs leadership correlated with burnout and motivation among subordinates. He subsequently wrote an article with nine strategies that leaders can use to enhance wellness in their organizations. Not surprisingly, embedded within those nine strategies were points about helping those you work with see the meaning and purpose in their work. This paper should be required reading for everyone in health care and medical education.

Putting these three authors’ works together has helped me think about how to approach burnout and wellness in medicine. First, this is a systems issue that we need to tackle as leaders and not just as individuals. We take the most resilient and capable students in the world and then — through medical school, residency and early staff — we steal their souls, energy and drive leaving many feeling burned out.

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This has to stop. The days of saying, “Well, if he or she had more resiliency,” are over. All of us, including our leadership, has a responsibility to figure this out. The resources above are a good place to start the conversation and provide some straightforward ways leaders and organizations can tackle the problem. I will finish with a few easy steps that I have collected from others that you can do today to
help a colleague recognize the meaning in his or her work.

1. Give out thank you cards. No need for a special occasion, just do it when you want to tell someone what they have meant to you. Possibly create a lollipop moment!

2. Give a book as a gift and inscribe the cover detailing why they are important to you.

3. Send an email to the author of the paper you read and tell them how it changed your clinical practice, teaching or personal life.

4. Send a tweet of thanks.

5. Stop the nurse, tech, pharmacist, administrator, janitor (you get the point), cafeteria worker, garage attendant, and tell them thank you for what they do. No one in the health care business should go long periods without someone giving them a meaningful thank you.

6. Journal about the impact you have at work.

7. Start meetings by asking everyone to reflect on and state something of purpose they have done the past week/month or point out what someone has done.

8. Nominate a colleague or subordinate for an award and let them read the nomination letter. They win no matter what. In many cases, the thought and reading the nomination have more impact than the award itself. You win because you feel purpose and value from writing
the letter for them.

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So, to answer her question — you better believe I think about the meaning in my work, and I do my best to help trainees and others I work with to think about the meaning in their work as well.

We should celebrate that meaning and the impact we have in the lives of others. It may seem simple, but create some space in your day to find meaning in your work and help others see the meaning in theirs.

Disclaimer: The views expressed in this abstract are those of the author and do not reflect the official policy of the Department of Army/ Navy/Air Force, Department of Defense, or U.S. Government.

Joshua D. Hartzell is an internal medicine physician.

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