Regaining happiness in our medical careers

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In the previous blog, I discussed why physicians are unhappy. It is a multifactorial problem, but there are solutions to our unhappiness. In this article, I will provide a few suggestions that will allow us to return to those halcyon days when we enjoyed the practice of medicine. We can regain that same passion for medicine when we start our careers, and it allows us to take our eyes off the computer EMR and once again focus on the patient.

I think the road to happiness includes paths to financial security, prioritizing our own health, and achieving a favorable work-life balance.

Our finances

One of the most popular and conflicting statements is, "Money can't buy happiness." However, money is a factor that determines happiness worldwide, including for physicians.

Contrary to popular belief, doctors are not filthy rich. In fact, finances are a huge stressor for many physicians. Between decreasing reimbursements, rising overhead costs, and paying down student debt, it's easy to see why becoming a doctor isn't as financially favorable as it once was.

Being smart about your finances from the beginning of your medical career is essential.

With the average graduating medical student having a debt of $250K, it's common sense to want to pay it down as soon as possible. When a young physician begins their practice and makes more substantial payments on their loans, that debt is closer to $400,000.

Physicians, especially recently graduated or practicing physicians, often make the common mistake of thinking that they'll worry about finances and their debt later. That $250K debt starts accruing interest the moment they receive their diploma, and the interest on the loan starts accruing immediately after graduation.

For these reasons, it is necessary to understand financial basics. Unfortunately, our medical education systems do not prioritize business basics during our training. As a result, many doctors make mistakes that cost them a small fortune.

Importance of compounding

Compounding is a powerful investing concept that involves earning returns on both the original investment and the interest received on that investment. For compounding to work, you need to reinvest the principal plus the interest accrued.

Assume you are a physician in practice for a few years, and you begin by saving $1000 a month at 7% interest for twenty years.

To calculate the impact of compound interest, use the following formula:

A = P X (1 + r/n)t

Where:

A = the future value of the investment/account balance

P = the principal amount (the initial investment)

r = the annual interest rate (in decimal)

n = the number of times interest is compounded per period (usually a year)

t = the number of months

Assuming you're investing $1,000 monthly at an annual interest rate of 7% over 20 years (240 months), it would accumulate to $609,794. This result reflects the initial contributions and the additional wealth generated through compound interest over the investment period. A free calculator is available at investor.gov.

For physicians juggling demanding schedules, complex financial obligations, and long-term goals, regularly tracking finances can be difficult and daunting. However, advancements in technology have introduced budgeting apps as powerful tools to help physicians better manage their money.

Budgeting apps streamline tracking income, expenses, and investments, saving doctors valuable time. By automatically categorizing transactions and providing real-time updates, these apps make it easy to monitor spending and savings.

Using a budgeting app can help doctors manage their money, achieve long-term goals, and build a solid foundation for financial security.

I recommend beginning using a budgeting app to track your expenses. A complete list of free budgeting apps is available from capterra.com.

Your personal health

Our health and well-being should be the highest priority. We advise our patients to practice good health habits but don't take the same advice we give our patients. We need to prioritize our health because if we aren't healthy, nothing else matters, and we will never regain the happiness that we once had. This is like the advice regarding using the oxygen mask on an airplane. The adult passenger must use the oxygen mask first before putting the mask on a child.

I surveyed a group of male physicians and an aged-matched group of male attorneys. I asked each group about regular screening for cholesterol levels, colonoscopy, and PSA testing. It was of interest that lawyers participated in preventive health with greater frequency than physicians. How can we expect our patients to practice good health habits when their doctors don't set an example?

Suggestions for improving our physical health:

Start with small, achievable goals that fit your schedule, such as exercising for 15-20 minutes daily. We can incorporate more physical activity into our daily routine by taking the stairs instead of using the elevator.

Consider using a fitness app or wearables to track your progress and help you stay motivated. I recommend TechRadar, which lists top fitness apps with ratings, detailed features, compatibility, and pricing information.

PCMag provides a curated list of fitness apps along with their ratings, pros and cons, pricing, and detailed reviews. A website for home gym equipment is also available from pcmag.com.

My take-home message: Exercise is one of the first things we compromise on as we become busier. We must avoid sacrificing exercise to be busy. You can't take good care of patients unless you care for yourself. When you take care of yourself, you perform better and are better equipped to take care of patients.

Work-life balance

Physician burnout and unhappiness have reached epidemic levels. Few physicians disagree that our professional lives are often out of balance. Many of us had not even heard of the term burnout at the start of our careers. Now, more than 50% of physicians complain of one or more symptoms of the condition. Burnout can adversely affect patient care and is even causing doctors to retire earlier than they had originally planned.

Becoming a physician is an arduous journey, often taking more than 12 years after graduation from high school. Further, beyond seeing an increasing number of patients each day, many practices and health systems mandate same-day entry of detailed notes in the electronic medical record. That requirement has added a new term to the medical lexicon: pajama time. This is the time – typically one to two hours a day- that physicians devote to completing their medical records in the evening. This is time away from family, friends, and non-medical activities, such as hobbies, exercise, and relaxation. As physicians, we are seldom off duty. We are tethered to our mobile phones and make ourselves available to our patients 24/7. As a result, we don't take time to recharge our batteries.

In this blog, I cannot provide comprehensive solutions to the challenges of burnout. However, I do have one suggestion that will favorably impact your work-life balance: get unplugged. (This was described in Physician Practice in the December 15, 2023 issue) Disciplining yourself to not respond to emails, Facebook, Instagram, or TikTok videos for one day a week will allow you to move from imbalance to a better work-life balance.

Bottom Line: The amount of pressure and risk you take seeing patients for eight to ten minutes per session, the educational debt, and the fear of getting sued have created a climate of dissatisfaction and unhappiness in our profession. Physicians must cultivate healthy habits around sleep, exercise, nutrition, finances, and relationship building. A physician's career is fraught with challenges, stress, and anxiety. Doctors who do not prioritize healthy habits risk burnout and more dire health consequences, including increased mortality. Investing in relationships and fulfilling hobbies improves career performance and creates a favorable work-life balance. When doctors take care of themselves financially and physically, they perform better. They are also equipped to take care of their patients, and they put joy and satisfaction back into their medical practices. Ultimately, physicians prioritizing finances, health, and balance are healthy and financially secure when it is time to hang up the shingle.

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.