Presently, two-thirds of all physicians are demoralized and experiencing a less than satisfied work experience for a number of reasons other than it being “our fault” (please do not let them call it “burnout”). The future of finding happiness in practicing primary care medicine does not appear to be promising.

The combination of more complicated medical problems in addition to an increased volume of older patients on the horizon and less experienced providers to service them (shortages projected now due to fewer PCP in training and experienced PCPs retiring earlier) seems on the surface to be prescription for challenges for not only patients but for PCPs as a whole.

There are a number of ways that policymakers, hospital administrators, and other employers who see this now are reacting to it, but due to limited autonomy for most physicians, our destiny will be out of our control.

From those in training through your future “career zones,” you have the power to be happier.

Here are just a few suggested ideas within each zone.

Zone 0

Maintain or start good health habits, including sleep. Continue this in the future.

Learn as much as you can for as long as you can regarding electives in medical school. Just try to do your best and work as hard as possible in your residency. Once you get into practice, it will be more difficult.

Start laying the groundwork for your FAAM team (financial planner, attorney, accountant, and mentor).

Watch that initial contract term and restrictive covenants, which may go away soon for your employer.

Max out your retirement funding, putting away as much as you can.

Zone 1: early career — your first real job-saver

An indentured servant (pay off your medical school debt). Perhaps other opportunities give you loan forgiveness so you can have different options.

Start family, college and retirement savings to the max

Zone 2: mid-career

First decision time for most: “Is this as good as it gets?” Where are you in your analysis at this crossroad?

For most, family, college, and retirement savings continue

Zone 3: “pretire”

Planning your off-ramp. Some retire early here, sometimes by choice or force due to restrictive covenants, which will probably soon be eliminated from contracts.

Zone 4: retirement

Make it “semi”-clinical, admin, volunteer, hobby, social networking. Let’s call it semi-retirement. Develop some of these before this zone. You are now a spender instead of a saver!

If you do not continue to focus on your physical and mental health, you may not have to worry about your money outlasting your life!

Finally, I recognize that some present physicians will find that they have made the wrong choice and may choose to leave the profession.
Some will choose to stay and be unhappy and complain all the time.

I hope most that stay will choose to stay and be happier and more fulfilled knowing that you have done the best for yourself, your family, and your patients by trying to improve your situation within the system that you presently work or venture outside that system if needed.

Change is hard, and I know many individual considerations need to take place before making decisions. However, I would ask you to perhaps take a new of thinking by finally putting yourself at the front of the line.

I am reminded of a Beatles song called “Misery.”

A line at the start goes: “The world is treating me bad … misery.”

For those who stay, you will have to decide if you want to be a victim or not.

It is not selfish to be happy and put yourself first. You will be a better person for all those around you that matter. “Do no harm” should first apply to you.

Paul R. Ehrmann is a family physician.