Creating your own happiness

Medicine has changed a lot since I began practicing 15 years ago. There were no MIPS measures, no sepsis protocols, no door to provider times;  in fact, the term provider was not even a ‘thing’. Medicine wasn’t perfect, but the stress level was exponentially lower. Back in the early 2000’s, the biggest concern was malpractice. Now? We have times and measures and protocols and numbers and metrics AND malpractice. Add to this the government-mandated Electronic Medical Record (EMR), which can make documentation exponentially more cumbersome.

 In spite of it all, I am happier now with my career and my work life than ever. It took some time and learning, but I had to adjust my mindset, my lifestyle, and my practice patterns to bring about this change.  After years of being cranky and miserable and whining about things out of my control, I took some steps to creating a happier work life.  You can, too.

Step 1

 The first step was identifying the problem. For me, I was working too many shifts with inequitable scheduling.  Many of my off days were spent turning around from night shift to day shift. When I took my first job, I cashed in on the security of a long-established group with a stable contract; unfortunately, in doing so, I allowed myself to be treated as the most junior person in the group for ten years (which was how long it took before another doctor was hired).  There is no such thing as a “perfect job”. Decide your priorities, and realize that everything is a trade-off. Money, equitable scheduling, benefits, medical staff dynamics (or, how easy/difficult are interactions with medical staff), patient mix (volume, acuity, payor mix), and group dynamics are all considerations when choosing a job. If you opt to prioritize money, you may find yourself working substantially more nights/ weekends and sacrificing your circadian rhythm as well as valuable family time. If you choose a job with lower volume/lower acuity, you will likely find yourself compensated at a lower rate. Choosing to work at a hospital or site that is known for contentious, difficult medical staff relations will exponentially increase your stress level while on duty. A group of providers that does not get along makes for difficulty covering shifts in times of emergencies.

Step 2

Second, I found ways to reduce my stress while working.  For me, having an organized work flow pattern (ie, see one patient, document a chart, disposition another patient, repeat) keeps me on track. I tend to get flustered if I realize I did not enter orders on a critical patient, or if I find people getting upset because I forgot to do their discharge orders in a timely manner.  Certainly, if a crisis occurs, I may be forced to deviate from this routine, but I force myself back on track at the first opportunity. 

Attitude is everything. I used to become very agitated when patients would launch into a long-winded story. Now? I like to say I love a good story. By adjusting my outlook, I have managed to often find humor in interactions I had previously considered painful. I try to get to know people, and you would not believe how forgiving folks can be about wait times if you have bonded with them by talking about dogs or football or children.

Steps 3 & 4

My last two pieces of advice are “focus on what you can control” and “If you have a headache? Transfer that headache to someone else”. Often, I believe we take on problems we should be delegating, which only adds to our frustration. I utilize my case managers, charge nurses, radiology/lab supervisors, patient advocates, and volunteers whenever possible.  Make the patients the focal point of your shift, treat your staff with courtesy and respect, and let others handle complex non-medical problems when appropriate. 

Can you think of any other techniques you have used to improve your happiness at work?