A happy life is rare without the right career.
We all want happiness, so we are all desperate to pick a career that we love. Especially doctors.
Choose poorly and we end up surviving on an income that we cannot live without, trapped in a job we cannot tolerate.
But we are desperate for the wrong thing.
Here is a bit of stupid advice: Do what you love, and you never have to work a day in your life. But just because you love to pound drums for screaming fans does not mean you would love to do it for galley slaves.
Bad questions always give wrong answers. We ask what we want to be or do. What do we love? But the question is incomplete. It is equally important to ask about how, where, and under what conditions we would like to work.
Career Choice
When someone asks you for career advice, I suggest you ask:
Do you love customer service?
Does structure help or hold you back?
Do you want responsibility and control?
Customer Service
The essence of customer service is solving problems for someone who holds power. Serving someone whether they want it or not, in whatever way seems best to you, is not service.
A customer’s power lies in being able to either accept your help or torture you for not giving it in the way that they want.
If you have nothing to offer a customer, then you get nothing in return. You waste your time. If you offer something bad, the customer complains. You lose again. But the risk of serving customers pays off when the customer wants what you offer and loves what you give.
This calculus energizes some people. Other people learn to serve but find it tiring. True customer servers feel empowered by customers. They continue to sparkle on break time, while colleagues flop onto sofas, emotionally exhausted.
Non-customer service people want to work without worrying what customers think. If non-service people have to speak with customers, the customer should listen.
Just to be clear, lovers of service are not always nice, and haters not always curmudgeonly. You can love people and hate customer service and vice versa.
Structure
Do you want to work in a regulated industry?
Some jobs exist on rules. Pilots love checklists. If they do not, they will find flying miserable. Structure decreases choice, which minimizes risk and effort. We cannot be faulted for following the rules.
Artists and entrepreneurs hate rules and love exploration. They want to work unfettered by gatekeepers and overlords. To entrepreneurs, rules feel like bungee cords stretched around their chests.
Responsibility and Control
Do you want to be an employer or employee?
Employees value security over freedom. They do not want to think about market cycles, risks or opportunities. Employees want to do their craft and get paid well for it, happy to be a cog in a machine.
The employer-type rots as an employee. She cannot not see how organizations run. She sees opportunities as easily as others see snow falling.
Employer-types subdivide into entrepreneurs and managers. Some employers learn to manage but think like employees. They focus on keeping their jobs, pleasing the board, and resisting change.
Entrepreneurial employers want change. Steering the ship bores them. They want to build new ships.
Career Choice For Doctors
Generalizations are always wrong sometimes and often right too seldom to bother. But we might hazard a few about medicine.
Modern medicine needs a peculiar worker. The ideal doctor is an expert at customer service.
Of course, the best doctors always were, but there used to be room for eccentric curmudgeons with big hearts.
Not anymore. Curmudgeons get cudgelled by regulatory colleges. Actually, med schools try to block curmudgeons from entering medicine in the first place.
It is too bad. Some of the best doctors I ever trained under were spicy, old curmudgeons—feared and adored by patients and staff.
Modern doctors must embrace rules and regulations. Doctors need not love rules, but they cannot be hostile to them.
Some people believe that anything worth doing well deserves its own set of rules. Rules simplify. Rules protect.
If we only have enough rules—smart rules, thoughtful guidelines, ‘right touch regulation’—then everyone would be happy. No one need worry or be sad, just follow the rules.
These sorts of people thrive in modern medicine. They speed through academic promotions; peer-reviewed journals are desperate to publish each new rule they invent.
Finally, the ideal modern doctor should be more employee than employer. Given the choice, modern doctors should welcome the security of a salary. They should see running a business as unattractive and boring; possibly even smarmy, morally suspect at best.
A Good Fit
One-size-fits-all fits none well.
Of course, you can be a doctor without loving customer service. But it might be exhausting. You can hate rules and still be a doctor, but it might asphyxiate you. And you can be an entrepreneurial doctor, but you might be lonely, even outcast.
The pioneering, curmudgeonly cowboy doctor worked well when we had little structure to support him. But he does not work well in modern hospitals, with multi-disciplinary teams, in group-learning sessions on civility.
What we do is important. But how and where we do it even more so. If medicine were drumming, then doctors still get to play the drums. But where and how they are played—and who gets to choose—makes all the difference.
Photo credit Pixabay
Doug Jackson’s 16 factor Personality test is highly reliable and has had a lot of research associating career choices with profiles across the 16 variables. He was a UWO psychologist renown for this work.
Regards, Joe DiStefano
Thanks Joe!
I’m not sure how many people have found the personality tests useful for career choice. Information always helps, for sure. Perhaps I was too thick to be able to apply them practically. 🙂
Thanks for posting a comment!
For those who are lucky enough to have a vocation….no problem….even with a vocation , however, there can be frustrations…there was a time when , if ones vocation was medicine, there was an ability to change direction within the profession…general practitioners , for example, discovering a passion for a speciality that required retraining on their part were free to do so and often they turned out to be the most understanding specialists.
The ability to switch direction within medicine is far more difficult these days and one suspects that there are many who feel trapped within a confined situation that they had chosen prematurely resulting in chronic dissatisfaction and unhappiness.
Goethe / Longfellow stated that in life one is either the hammer or the anvil….many of my generation commenced their careers in medicine choosing to be the hammer, with a great deal of autonomy choosing where, when and how to practice medicine….now there is an increasing loss of autonomy…new graduates will be told by faceless managers where, when and how to work , their personal clinical judgements will play second fiddle to those of the “ we know best” bureaucratic hierarchies lacking coal face / grass roots understanding, with their EMR box checking, guidelines and protocols.
For those who value autonomy, the increasing lack of professional freedom in medicine will become increasingly unattractive….there are other careers out there for them.
For those who prefer to be told what to do and how to do it, eager and willing to obey authority figures …medicine will become increasingly attractive.
Stanley Milgram, a psychologist, studied such “ nice” people…agreeable conscientious personalities , who, not wishing to upset others, are more likely to follow orders and deliver electric shocks that they believe could harm innocent people, while contrarian, less agreeable, with supposedly “unfriendly” personalities are more likely to stick up for themselves and to refuse to hurt others.
Paradoxically so called antisocial dispositions are more likely to be linked to pro social behaviour.
May I suggest Psychological personality testing such as the Big Five be taken before making vital career decisions…Dr. Jordan Peterson can be found speaking on the subject on You tube , in particular touching on agreeableness traits.
Fascinating comment, Andris! I always learn something from you. I will explore the references you mention.
I think you captured the change perfectly. We are part-way through a very long transition. Readers should check out Tommy Douglas’ 4:50 minute speech at the Ottawa SOS Medicare Conference 1970. Douglas made it clear that he saw two phases to Medicare: paying for it, then transforming delivery. He and others had been thinking about this through the 40s, 50s, and 60s. He thought payment would include government structures and institutions to control costs. He called it the easiest phase.
Douglas saw phase 2 as much harder. He thought, in 1979, that we had not put enough effort into it yet (transforming delivery).
As far as I can tell, transformation started to ramp up toward the end of the 1980s. It has plowed forward ever since.
I entered medical school in 1992 despite warnings from every single physician I spoke with (8 or 9 of them). They all mentioned administration, bureaucracy, and paperwork. I could not understand them. I guess I was warned, but I could never have known what they meant. I do not even think I realized what they were truly talking about until I got consumed by medical leadership in the 2000s. Until that point, I thought disorganization happened because we did not do a good enough job. I realized later that it happened by design.
I think you captured it best here: “For those who prefer to be told what to do and how to do it, eager and willing to obey authority figures …medicine will become increasingly attractive.” I hope that medical schools are letting students know what is expected of them.
Thanks again for an interesting comment!
Cheers
Here’s an article about the Stanley Milgram obedience to authority experiment that Andris mentioned.
I agree that choice of career is critical to a happy life. But, we have very little freedom in our quota controlled training system. I would have liked to re-train in plastics even before I left residency, but that was just not possible as I hadn’t initially pursued plastics from first year medical school as is now mandatory. I also enjoyed orthopedics and started pursuing that from Day 1 medical school but as fortune sometimes does, I couldn’t do ortho because of a spine problem. Discovering this too late, I was by default a family doctor. I enjoy most of being a family doctor and am good at it but my heart is still a surgeon. I’m not in agony, just unfulfilled.
Brilliant comment, Ernest. And thank you for echoing and building on what Andris said.
I did not know about your surgical background. I started in surgery but was able to change in 2nd year, unheard of at that time (silly student). I realized quickly that I had made a mistake. I was able to change again into family medicine. The only reason they let me change was because I had started with 5 years of funding. The programs accepting me got ‘free’ funding, so they were happy to accept.
I agree that allowing people to retrain would help. But it would disrupt the planners’ designs. We are citizens of Lowry (from the Giver book).
Thanks for posting!
Cheers
As to the designs of central planners.
The trouble is that medical widgets aren’t doing and will not be doing , what the central planners think that they should be doing or will be doing within their concocted byzantine health care system …they don’t have the foggiest idea of the actual conditions of the coal face “private hells” that each of the medical widgets will attempt to function in and how each will adapt in order to survive….they have no idea of the innumerable ingenious escape plans that the en trapped medical widgets will devise.
The hubristic central planners are so arrogant that they think that they can plan the lives of their medical widgets from the first days of medical schools to their demise ( no pension plan, work being a coal face widget’s pension plan) even as they suppress their incomes and worsen their work environments …the solution of trapped Soviet enslaved widgets was easy…. “ we pretend to work and they pretend to pay us”… which led to the ultimate collapse of the Soviet central planners’ utopic socialist universe.
“ The best laid plans of mice and men often go awry…” ( To a mouse …Robert Burns).
Well said indeed