Exploring Alternatives in the Midst of Natural Events

Exploration has been described as curiosity put into action. Physicians often explore avocations that give them personal satisfaction. The physician workforce is full of writers, artists, performers, musicians, sculptors, athletes, and adventurists who have become quite accomplished in their pursuits.

Activities oriented to the outdoors and endurance sports have been a mainstay in my life for many years, and they helped me pursue both personal and professional satisfaction in late 2020 as I adventured through several of the lower 48 states in a robust overland rig. This pursuit helped quell a transient sense of uncertainty and refreshed my vigor for promoting physician leadership via the AAPL thought leadership platform. Fortunately, with today’s technology, I was able to easily maintain my responsibilities with AAPL.

What do you explore as your avocation? Have you found professional and personal satisfaction, even in the midst of crises?

Curious about physicians’ avocations, I recently searched online for a variety of related terms such as alternative physician careers and common physician avocations. The results surprised me in some ways, but not in others. There were well more than 35 million results related to alternative physician careers but only about 1.3 million for physician avocations.

Search results for alternate physician careers were several pages deep; many pages related to stress and burnout, not career satisfaction. There was less than a single page of results related specifically to physician avocation before the results shifted to generic items on all types of avocations, vocations, hobbies, but nothing specific to physicians.

Are Physicians Happy?

Fortunately, the annual Medscape lifestyle-happiness survey arrived, and I was able to tease out my thinking further. This year, there were over 15,000 respondents in 29 specialties, and they were sorted by age groups: Boomers (ages 55–73), GenerationX (ages 40–54), and Millennials (ages 25–39). A sampling of the overall results includes:

• Fewer than 20 percent of physicians are unhappy outside of their work.

• Almost 60 percent of physicians say they do not have enough time to themselves. Boomers are slightly happier with personal time availability.

• About 84 percent of physicians are married or living with a partner, 6 percent are divorced, and 8 percent are single. About 85 percent state their relationships are good or very good.

• About 23 percent of physicians work up to 40 hours/week, 35 percent work 40–50 hours/week, 25 percent work 50–60 hours/week, and 17 percent work more than 60 hours/week

• Approximately 44 percent of physicians take three to four weeks of vacation; almost 15 percent take more than four weeks.

Differences across age groups were not as diverse or profound as anticipated. You can see the full results at www.medscape.com/slideshow/2020-lifestyle-happiness-6012424 .

My take? It was encouraging to see that more than 80 percent of physicians are apparently happy outside of their work and therefore have a degree of personal satisfaction. Similarly, 85 percent are doing fine in their personal relationships and well over half are getting a reasonable amount of vacation time. Most, however, are continuing to work well over the proverbial normal 40-hour work week.

Couple the lengthy work hours with all the complexities of trying to deliver optimal patient care in today’s healthcare environment, and it is no surprise that professional satisfaction continues to be under strain in spite of the buffers related to strong personal relationships and good amounts of vacation time. This may well correlate with the high volume of search results on alternative physician careers and work stress or burnout — especially with a global pandemic still actively influencing the healthcare industry.

And, as the results indicate, roughly 20 percent of physicians are not happy outside of their work!

Turning to Osler

Interesingly, in the relatively few search results on physician avocation, Sir William Osler showed up quite early. While Osler died a hundred years ago, he apparently was prescient with his advice (https://litfl.com/eponymictionary/oslerisms ):

• The very first step towards success in any occupation is to become interested in it.

• While medicine is to be your vocation, or calling, see to it that you have also an avocation — some intellectual pastime which may serve to keep you in touch with the world of art, of science, or of letters.

• The young doctor should look about early for an avocation, a pastime, that will take him away from patients, pills, and potions….

• The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.

• Keep a looking glass in your own heart, and the more carefully you scan your own frailties, the more tender you are for those of your fellow creatures.

For those with an interest in medical history, Sir William Osler, deemed the Father of Modern Medicine, was born in 1849 in Bond Head, Canada West (Ontario). He attended Trinity College, Toronto, from 1866 until 1868 in preparation for career as a minister, then enrolled in the Toronto School of Medicine and McGill University School of Medicine, 1868–1872.

Osler held a variety of positions, including:

• Professor of physiology at McGill University, fellow of the Veterinary College, Montreal.

• President of the Montreal Veterinary Medical Association.

• Professor of medicine successively at McGill University, the University of Pennsylvania, Johns Hopkins University, and Oxford University.

• Honorary professor of medicine at Johns Hopkins University.

• Fellow of the Royal Microscopical Society, London.

• Regius Professor of Medicine, Oxford.

Beyond his influential medical career and prolific writings, Osler was a person of many interests, who in addition to being a physician, was a bibliophile, historian, author, and renowned practical joker. He explored many avocations in his life and had a mischievous alter ego under a productive pseudonym: Egerton Yorick Davis. Osler died December 29, 1919, at the age of 70 during the Spanish influenza pandemic, most likely of complications from undiagnosed pneumonia and bronchiectasis. (https://en.wikipedia.org/wiki/William_Osler )

Periods of stress and insecurity create a sense of need for change for many. The urge to move rapidly toward new, uncharted decisions is often compelling and difficult to resist at times. Understanding one’s internal drivers in these situations can be a stabilizing influence when confronted with these urges; this is one example of where drawing on the resourcefulness provided by avocations can help improve decision making during these times.

Osler comes to mind once more:

• At the outset do not be worried about this big question — Truth. It is a very simple matter if each one of you starts with the desire to get as much as possible. No human being is constituted to know the truth, the whole truth and nothing but the truth; and even the best of men must be content with fragments, with partial glimpses, never the full fruition.

• Throw away all ambition beyond that of doing the day’s work well. The travelers on the road to success live in the present, heedless of taking thought for the morrow. Live neither in the past nor in the future, but let each day’s work absorb your entire energies, and satisfy your wildest ambition. (https://litfl.com/eponymictionary/oslerisms )

Exploring alternatives in the midst of natural events in this day and age is something that should be considered as a matter of good planning and preparation for ongoing success and stability. Living in the moment is generally a good key for a balanced approach to life, but adequate planning and preparation is equally critical — especially where there is the need to be considerate of one’s family and others who depend on one’s decision making.

So, when considering those alternatives with just a focus on yourself in trying times, always remember one of the better Oslerisms: “A physician who treats himself has a fool for a patient.”

Finding the Light

Like so many others, I was taken by surprise by our current Youth Poet Laureate, Amanda Gorman, who recited during the recent presidential inauguration, and while the full text of her poem is too much for this piece, her opening and closing lines are especially relevant as we all continue to explore our professional and personal alternatives in the midst of natural events:

“When day comes, we ask ourselves,
where can we find light in this never-ending shade?...
…When day comes, we step out of the shade,
aflame and unafraid,
the new dawn blooms as we free it.
For there is always light,
if only we’re brave enough to see it.
If only we’re brave enough to be it.”

Remember, leading and creating significant change in healthcare is our overall intent as physicians. AAPL focuses on maximizing the potential of physician-led, interprofessional leadership to help create personal and organizational transformation that benefits patient outcomes, improves workforce wellness, and refines the delivery of healthcare internationally.

We must all continue to seek deeper levels of professional and personal development, and to recognize ways we can each generate constructive influence for one another at all levels. As physician leaders, let us become more engaged, stay engaged, and help others to become engaged.

Exploring and creating the opportunities for broader levels of positive transformation in healthcare is within our reach — individually and collectively.

Postscript: If you have a strong personal desire to explore further, The Explorers Club (www.explorers.org ), founded in 1904 by a group of America’s leading explorers, is an international, multidisciplinary professional society dedicated to the advancement of field research, scientific exploration, and the ideal that it is vital to preserve the instinct to explore. The Explorers Club has over 100 years of exploration legacy, empowered by many extraordinary accomplishments by its members: first to the North Pole, first to the South Pole, first to the summit of Mount Everest, first to the deepest point in the ocean, first to the surface of the Moon. There are several physician members.