Physician Professional Fulfillment

Occasionally in life there are those moments of unutterable fulfillment

which cannot be completely explained by those symbols called words.

Their meanings can only be articulated by the inaudible language of the heart.

Martin Luther King Jr.

We each define and experience professional fulfillment in different ways.  For me, as a family physician, relationships with patients and peers bring a sense of meaning and fulfillment to my work.

One evening at about 9pm I received a call from Mary, an elderly woman who had been a patient for many years.  She struggled with anxiety about her health, so I made every effort to return her calls quickly.  When I received her call, I was tucked in bed with a high fever.  I had contracted pneumonia and had been out of the office for a few days when my pager went off.

“Hi Mary, this is Dr. Roman.  What’s going on?”

There was silence on the phone.  After a few seconds, she responded:

“Dr. Roman, is that you?  Oh my goodness, you are way more sick than I am.  I want you to hang up this phone, get some tea and wrap yourself in a blanket.  Don’t call me back until you feel better.   You hear me?  I will call to check on you tomorrow.“

As I cared for Mary, she cared for me.  These compassionate moments with patients fill me up. They give me energy for the long hours and many demands and challenges of medical practice.

My relationships with physician colleagues are equally fulfilling.  Throughout my career, when I have encountered circumstances that challenge me, I have connected with peers.  These relationships provide a stable foundation for open, non-judgmental conversations.  They help me to make sense of my world and find my way forward.

The landscape of medicine has changed dramatically over the past few decades and the daily practice of medicine has been significantly altered.  For many physicians, time with patients has been drastically reduced, making it difficult to cultivate strong, mutually respectful relationships.   My colleagues and I no longer meet in the doctors lounge each evening while completing our hospital rounds after office hours.  Many of us work in what has been described as “silos” without the benefit of regular conversation with peers.

These changes in healthcare have prompted me to look more closely at the factors that enhance and diminish my level of professional fulfillment and identify specific ways to respond in alignment with my values.

A relatively new resource for physicians seeking fulfillment is professional coaching.

Participants who received professional coaching had a significant reduction in emotional exhaustion and overall symptoms of burnout, as well as improvements in overall quality of life.

JAMA Internal Medicine 2019

During group coaching, physicians come together in community with peers who share the physician experience to explore and address issues that are relevant and meaningful to them. The participants benefit from the support and insights of colleagues as professional coaches (who are also physicians) facilitate.   

The topics for each session are determined by the physician participants.  Discussion topics may include the transition to new roles, misalignment between individual values and those of the physician’s employer, cultural biases, administrative/regulatory demands, interpersonal conflicts, disillusionment and other issues that are of interest to the group.

I am continually inspired by the insights, engagement and enthusiasm that arise during group coaching sessions. Three foundational aspects of physician group coaching contribute to meaningful and transformational experiences for physicians:

1. Respect for the unique experiences, creativity and resourcefulness of each physician participant:  A coach can’t possibly know what another physician is experiencing or which factors will lead to an enhanced sense of meaning or fulfillment for that individual.  Coaches cultivate a non-judgmental space for exploration and encourage physician participants to identify these factors for themselves.

2. Integration of deep listening and reflective inquiry:  Professional coaching differs from conventional coaching (in athletics, for example) where development of specific skills is the focus. Professional coaches do not advise, mentor or teach.  Instead, experienced coaches actively listen, offer reflections and ask pertinent questions to allow participants to view situations from new perspectives and uncover possibilities that may not have been appreciated earlier. Active listening and reflective inquiry are also practiced by the participants.

3.  Focus on forward movement:  As insight and clarity emerge, physicians decide how they would like to integrate their new awareness moving forward. Many physicians share that when they determine for themselves how they would like to respond, their experience is meaningful, sustainable and empowering.

At a time when there is a great deal of isolation and division in healthcare, and many physicians express that they do not feel heard, lack autonomy and have minimal control over factors that are significantly impacting their work, group coaching provides a unique and valuable opportunity for physicians to access their capacity to choose and achieve changes that contribute to a greater sense of satisfaction and fulfillment.

Between stimulus and response there is a space.

In that space is our power to choose our response.

In our response lies our growth and our freedom.

Viktor Frankl