What Do Doctors Find Meaningful about Their Work?

Although medical practice has always been difficult and the risk for burnout close at hand, most practitioners have found that the joys and satisfaction of their work have prevailed over the challenges, enabling them to sustain a lifelong commitment to service. Thirteen years ago, we began to conduct workshops to help practitioners reflect on their own experiences in practice and discover and explicitly identify what it is about the practice of medicine that is meaningful to them. We believed that with a clear understanding of what nourished and sustained them, clinicians could attend more consciously and intentionally to enhancing that which was meaningful and attenuating that which was depleting.

Over the ensuing years, the question of meaning in medical practice has acquired greater urgency (1). Rapid changes in the structure and process of health care have altered doctors' roles, prerogatives, and financial compensation and have left many doctors feeling besieged (2). Their attention increasingly has been given over to the business of medicine and to bureaucratic procedures that do not contribute directly to improving health. A growing number of physicians are leaving practice prematurely through early retirement and disability (3, 4). The opportunity to recognize and reconnect with what is most meaningful about practice may be remoralizing to doctors and may help them advocate for their needs more clearly. Such an understanding may also help the leaders and managers of health care organizations access professional roles and clinical processes that allow physicians to maintain their vitality.

Physician satisfaction has been linked to physician relationships, collegial interactions, physicians' personal sense of competence, and (in an inverse manner) bureaucratic aspects of the practice environment (5-11). With few exceptions (12, 13), this research has been based on survey results. To complement and deepen insights from this research, we …