Over the last few years, the global pandemic has highlighted many of the long-standing issues within medicine. With all of this negativity, you might think that medicine is a dying career or that all physicians are burned out and miserable. Not so fast. There are still many physicians who lead happy and fulfilling lives and love their jobs.
Let’s talk about physician happiness and what you can do to enjoy a fulfilling career as a future doctor.
Despite what the media might have you believe, the data suggests that most physicians are actually pretty happy.
Approximately 60% of physicians report feeling happy outside of work and 73% report that they would choose medicine again. Although this shouldn’t be used as an excuse not to address the issues within medicine and medical education, the situation is not as grim as some people make it out to be.
According to Medscape’s 2020 Physician Lifestyle and Happiness Report, the specialties with the greatest proportion of happy physicians were rheumatology at number one followed by general surgery, public health & preventive medicine, allergy & immunology, and orthopedics. The bottom five were neurology, critical care, internal medicine, gastroenterology, and endocrinology.
In 2019, the top 5 happiest specialties were rheumatology first, followed by otolaryngology, endocrinology, pediatrics, and general surgery and the bottom five were neurology, infectious disease, cardiology, pathology, and oncology.
Despite rheumatology remaining in the top position and neurology remaining in the bottom position, there is minimal overlap between the two years. Endocrinology, despite being a top 5 specialty in 2019, found itself in the bottom five in that same list in 2020. Although significant year-to-year changes are possible, it’s more likely that these are limitations of the study which uses survey data and self-reporting. So if specialty choice is not a reliable factor, what actually influences physician happiness?
To start, many people are drawn to medicine due to the desire to help others. It should come as no surprise then that relationships are an important factor when it comes to physician happiness.
According to research, approximately 27% of physicians report patient gratitude and relationships as the most rewarding part of their job, and 23% report knowing that they’re making the world a better place as the most rewarding part. Moreover, a 2022 study found that patient connection and visible impact are common traits among happy physicians.
As a doctor, you have the ability to significantly improve the quality of life of your patients. Not only is this often tremendously satisfying, but it also provides you with something that’s difficult to find–purpose. When you feel like you’re working for a larger purpose, you’re more likely to enjoy your work and are more resilient to setbacks and challenging times.
In addition to relationships with patients, relationships with peers and colleagues have also been shown to be an important factor when it comes to physician happiness. If we look at Maslow’s Hierarchy of Needs, connection and belonging are universal human needs–and doctors are no exception. Having a sense of community, connection, and belonging as a physician is key to having a happy career.
Although intrinsic factors such as purpose and meaning are incredibly important for happiness, extrinsic factors such as money still play a role. Approximately 10% of physicians report making good money at a job that they like as the most rewarding part of their job and 28% report insufficient compensation as a major source of burnout.
According to Medscape’s Physician Compensation report, the top 5 highest-paid specialties in 2022 were plastic surgery, orthopedics, cardiology, otolaryngology, and urology. The bottom five were public health and preventive medicine, pediatrics, family medicine, endocrinology, and infectious disease.
Your perception of your compensation is perhaps even more important than total compensation. If you feel that there is a mismatch between the work that you do and the salary that you earn, you are more likely to feel unhappy. The top five specialties with the largest percentage of doctors that feel fairly compensated are public health and preventive medicine, oncology, plastic surgery, psychiatry, and dermatology.
Although total compensation factors into the perception of your pay being fair, it’s clear from the top 5 that how you earn your salary also plays a role. Despite being in the bottom five for total compensation, public health and preventive medicine ranks number one in terms of feeling fairly compensated.
This brings us to our next factor that influences physician happiness which is work-life balance.
According to research, approximately 55% of doctors would take a salary reduction to have better work-life balance with the median physician willing to give up between $20,000 and $50,000 per year to achieve it.
Work-life balance is influenced by various factors including the number of hours worked and how predictable or unpredictable the work hours are, which is largely a function of being on call. This is why specialties such as dermatology tend to rank highly in terms of work-life balance. Dermatologists typically don’t take call and work fewer hours per week than most other physicians.
That being said, other factors such as the amount of time spent with patients versus the time spent charting and doing other administrative work also influence physician happiness.
One interesting finding is that the use of medical scribes can significantly improve physician satisfaction. This makes sense as they decrease the amount of time that physicians spend charting and give them more time with patients–both of which are major contributors to the next point which is burnout.
Burnout has been a popular topic in medicine in recent years and can negatively impact a physician’s happiness. According to the literature, issues such as too much charting and paperwork, too many hours at work, lack of respect, insufficient compensation, and lack of autonomy are major sources of burnout.
The top 5 specialties with the highest levels of burnout are emergency medicine, critical care, OB/GYN, infectious disease, and family medicine, and the top 5 specialties with the least are public health and preventive medicine, dermatology, pathology, oncology, and orthopedics.
It should be noted, however, that burnout is an issue that affects every specialty. Although these are the specialties with the highest rates of burnout, you’re likely to find physicians who are burned out no matter what specialty you’re looking at. Similarly, you’re bound to find physicians who are enthusiastic and enjoy their job in every specialty as well.
Regardless, mitigating burnout is an important part of maintaining happiness as a physician.
Should This Data Influence Your Choice of Specialty?
So how should this data influence your choice of specialty? Should everyone go into dermatology or preventive medicine? Of course not.
At the end of the day, there are multiple factors that you should consider when choosing your specialty. If you’re on the fence, knowing what specialties tend to be the happiest on average may help sway your decision; however, it should not be a primary consideration.
Instead of looking at other people’s happiness, it’s much more important to examine your own. Find a specialty that you enjoy and speaks to your strengths instead of just choosing the one that you feel is the happiest.
Two factors that people often don’t consider with these lists are sampling and self-selection biases. This data represents only a very small sample of the larger doctor population and it may not be entirely representative. And just because 60% of general surgeons in that sample report being happy doesn’t mean that 60% of doctors would be happy becoming general surgeons. These are doctors who have already chosen their specialties. It’s a subtle, but important distinction.
In addition, lifestyle factors such as compensation, hours worked, and administrative burden are highly variable. It’s entirely possible to carve out your own niche and create the lifestyle that you want no matter what specialty you choose. As Plastic Surgeon Dr. Goldman said in his interview on the Kevin Jubbal, M.D. YouTube channel, “what you do with your specialty is more important than what specialty you choose.”
That being said, don’t fall into the trap I’ve seen many succumb to. I’ve come across dozens of residents and even attending physicians who wanted to do a different specialty, like dermatology or plastic surgery, but ultimately had to compromise to something less competitive because they weren’t strong enough for the specialty they truly desired.
If you think you’re not the smartest and that you’re doomed, stop right there. Your ability to crush your MCAT, USMLE, and have dozens of research articles is less a function of your intelligence and more a function of proper preparation, constantly improving, and putting in the work. Having a stellar medical school or residency application and crushing the interviews is no different.
At Med School Insiders, our mission is to empower a generation of happier, healthier, and more effective future doctors. From medical school or residency application help to crushing your MCAT or USMLE, we’ve got your back. And our results speak for themselves. We’ve become the fastest-growing company in this space with the highest satisfaction ratings. See for yourself and learn more at MedSchoolInsiders.com.
If you enjoyed this article, be sure to check out our piece on the Best Doctor Lifestyle Specialties.