When I took my first job out of fellowship, I had two kids, both in diapers. Between that and starting my first job out of training, it seemed I had no idle time at all. I distinctly recall deciding: I was here to work, not to make friends. (To my work friends: Thank you for being my friend despite my attitude!)

We didn’t decide to make friends in training — it just happened. Our friends got us through grueling hours and stressful times. Someone told me that in their residency, the program provided no food overnight, and there was nowhere to even buy food, so they would scavenge patient trays for snacks, with an unopened pudding or jello being a major score and cause for celebration. Through hardship, the experience brought them together.

Now in medical practice, we’re on our own. While coaching, I frequently hear colleagues who are disconnected and considering another job, inside or outside of medicine, partly because no one is keeping them here.

Making the case for connection

Two in 10 U.S. workers spend a lot of their day lonely, according to Jon Clifton, who wrote Blind Spot: The Global Rise of Unhappiness and How Leaders Missed It. A Harvard Business Review survey of 1,624 workers found that those with a professional degree (physicians and lawyers) were the “loneliest by far,” 25 percent lonelier than those with bachelor’s degrees and 20 percent lonelier than PhDs.

Life without enough connection is awfully hard on us. The NIH estimates that prolonged isolation is comparable to 15 cigarettes/day! Working without friendship affects us in many ways. Disconnected workers have:

• a 313 percent stronger intention to quit
• a 176 percent higher chance of job searching
• a 39 percent higher quit rate than their more connected counterparts

I’m with people all day. Doesn’t that count?

Some clients say their patients are their best friends. Patient care is the ultimate privilege. When in the examination room, the focus is on the patient, and our performance will be graded. We need to be upbeat, warm, patient, thorough, and competent. With a good friend, we can be quiet, messy, crude, and relaxed; the focus is reciprocal. So, patients don’t count for this.

Our days are full of interruptions, questions, and contacts. I don’t count these as meaningful connections, either. If anything, these necessary interactions are just draining. Most of us do our daily tasks in workrooms and hallways, full of distractions, when we most need to focus.

These demands on our time and attention can extinguish any extroverted tendencies. Meanwhile, we’ve lost “physician’s lounge” opportunities, in which we could choose when and how to interact or relax.

So, what’s a busy health care worker to do?

A first step might be to identify and invest in one “Best Friend at Work” (BFAW) as described in the great business management book First Break All the Rules. They include having a BFAW in their top-12 features of a satisfying workplace, according to a survey of 80,000 managers. Best Friends at Work are significantly more likely to:

• engage customers and internal partners
• get more done in less time
• support a safe workplace with fewer accidents and reliability concerns
• innovate and share ideas
• have fun while at work

I believe that health care providers thrive when they have a BFAW who is also a colleague — ideally in the same specialty or work area. Support staff can make wonderful friends and work partners but do not know our struggles in the same way.

Who is your Best Friend at Work?

Some of my clients find it hard to connect with their colleagues. Maybe they’ve been hurt, criticized, or lost trust in their department for some reason. When considering whether you have anyone at work you’d call your BFAW, consider:

A BFAW doesn’t have to be “our people” out of work. I was coaching a physician who felt out of place here because they didn’t hunt, fish, or have other hobbies in common with colleagues. The work you share is plentiful, what you have in common and enough. What a wonderful opportunity it is to befriend people of different generations, backgrounds, and beliefs.

Share your struggles. It was easier when the common foe was an acceptable and worthy adversary: demanding residencies, board exams, etc. Being a little vulnerable, even sharing a secret, when done well is an opening to connection.

Make each other feel better, not worse. There’s a difference between venting to process a challenge vs. gossiping and breeding negativity.

Go out of your way. Many of us are like ships passing in the night. In training, you might run into each other at morning report or on rounds. Put in the effort to see your friend when you can.

Great friendships can be built a few minutes at a time. BFAW’s should respect each other’s time. Connection feels great but falling behind is distressful. I’m reminded of a patient who described the “perfect job” of delivering medical charts all over the clinic and hospital. He had friends everywhere; he stopped by but couldn’t linger.

What’s your plan to make friend connections at work? Give it some thought and attention. If you are looking for a place to start, working with a coach can help.

Erin Maslowski is a physiatrist and physician coach.