Top tips for rediscovering your purpose in primary care

In the fast-paced world of medicine, it’s easy for GPs to become consumed by the demands of their roles and lose sight of the very essence that initially drew them to this noble profession

CREDIT: This is an edited version of an article that originally appeared on Medscape

Rediscovering one’s purpose in medicine is a journey of introspection and renewal, allowing individuals to reconnect with their core values, passions, and the profound impact they have on patients’ lives. In this article, we delve into the transformative process of rekindling your sense of purpose in medicine, offering insights and practical strategies to guide you on this voyage of self-discovery.

Reflect on What Led to a Career in Medicine

Many GPs may have never paused to consider the factors that drove them to pursue a career in medicine and what continues to keep them in the field. When asked about this matter, the anticipated response is often “wanting to help people,” yet a recent discussion on Twitter revealed a broader spectrum of answers, both positive and negative.

Some doctors felt that inadequate career guidance during their school years or parental influence directed them towards medicine. Proficiency in scientific subjects played a role, as did the aspiration for a stable, well-paying job. Witnessing severe illness in close family members emerged as another prevalent theme.

Life experiences evolve, and sources of personal significance can also shift. General practitioners might therefore find value in questioning why they remain committed to medicine and what sustains their motivation. It could be those moments of excitement and deeper fulfilment they experienced. Conversely, it could stem from a lack of imagination to pursue an alternative path or simply the necessity to meet financial obligations. Regardless, engaging in this introspective exercise could aid healthcare professionals in comprehending their individual drive and making informed decisions about their careers.

Recognise the Elements of Job Satisfaction

Life often revolves around achieving tangible goals: exam scores, possessions like cars and houses, and so forth. However, there’s a distinction between achievement and self-satisfaction (or self-realisation). True fulfilment arises from being present in the moment and engaging with what holds personal significance, rather than relying solely on material accomplishments and comforts.

As underscored in Kimsey-House et al’s Co-active coaching, “Leading a purpose-driven, mission-oriented, or service-focused life can be intense, occasionally heart-wrenching and draining, yet simultaneously deeply rewarding. The paradox of fulfilment lies in the potential to experience both inner tranquility and external struggles concurrently.”

Various aspects of the medical profession resonate with different healthcare professionals, from cultivating patient relationships to performing intricate, high-stakes procedures. When GPs invest time to explore the core sources of their satisfaction, they gain better self-awareness and can strategically integrate more of these elements into their work. It might be beneficial to recall career moments that were particularly invigorating—what made those instances so significant?

Acknowledge the Influence of Personal Values

Closely tied to fulfilment is the recognition of one’s personal values, which serve as a blueprint for living and self-expression. Individuals with clear, holistic career values tend to prioritize activities that bring them fulfilment and minimise those they perceive as less meaningful or relevant. Common values among healthcare professionals include altruism, proficiency, intellectual stimulation, autonomy, and fairness.

Recognise and Harness Individual Strengths

In the realm of general practice, much emphasis is placed on the pursuit of improvement—whether it pertains to procedural skills, ongoing professional development, reflection on patient feedback, or addressing feelings of anxiety, impostor syndrome, or perfectionism, as well as other challenges common in the medical field.

Externally, there’s persistent pressure to adhere to best practices and adhere to clinical guidelines, with numerous NHS initiatives focusing on both individual and broader-scale service enhancement, such as the NHS long-term plan or the Interim NHS people plan. It’s easy to become ensnared in an ongoing journey of rectifying professional deficiencies.

Less attention is given to what is actually beneficial for the individual practitioner, yet there is evidence that understanding and playing to one’s strengths has a significant positive impact on people’s mental health, wellbeing, and performance, indicating that GPs would likely be happier and perform better at work when working to their strengths. Here are three possible ways in which anyone can get to know their positive qualities:

• ask a trusted friend or family member what they think their strengths are
• spend a moment at the end of each day reflecting on what they did well—what were they expressing or doing at the time?
• undertake a strengths-based questionnaire, such as the VIA Character Strengths Survey21 (a free online tool developed by Professor Martin Seligman and Professor Christopher Peterson, which is based on their influential work in the field of positive psychology).

Be Clear About Finances 

Anecdotally, many clinicians say that they are disillusioned in medicine, but feel trapped because of their financial commitments. Therefore, it is essential for them to spend time getting to know their finances properly, particularly their outgoing expenses and what is needed to maintain them. For this, a full financial audit of a year’s spending can be revealing.

There are various options to consider if finances are a concern, such as extending a mortgage, discussing the possibility of a spouse putting in more hours to accommodate work changes, or cutting back on certain expenses while settling into another career or role. Such changes require time, careful thought, and sometimes difficult conversations, but can be an important step to take. 

Exert Control Over Working Life with Job Crafting

‘Job crafting’ is a process through which an individual alters their job to tailor it to their unique needs and make it more engaging and meaningful for them. Studies have shown that job crafting improves individuals’ wellbeing, motivation, and performance when used in healthcare settings.

Not everyone can have control over their working environment, and most people’s jobs are influenced by external forces or circumstances, such as when working for a large institution or in a training position. However, some clinicians will be able to make beneficial changes, and even small changes can make a difference. 

Recognise and Deal with Burnout

Healthcare professionals are at high risk of burnout, but the very nature of burnout means that people are often poor at spotting the signs and, paradoxically, some people may work even harder as a way of combatting it. Signs of burnout include fatigue, poor concentration, detachment, disengagement, and irritability. The British Medical Association offers a self-assessment questionnaire for clinicians who think they may have symptoms of burnout.

Understand the Psychology Underlying Self-Care

Many doctors report difficulty in implementing self-care. These difficulties include the practical challenges of time or energy constraints, but there is also a tendency for doctors not to prioritise themselves.

Seligman’s theory of wellbeing uses the PERMA; (positiveemotion, engagement, relationships, meaning, accomplishment) model as a way of understanding what makes humans flourish. Within this conceptualisation, people need elements of each category on a regular basis.

Self-care means different things to different people, and self-care, mental health, and relationships with work all go beyond this framework. However, it is an excellent starting block for reviewing the different areas of one’s life and considering what may be missing.

Apply Decision-Making Skills to Life Choices

Practitioners are constantly making good decisions about patients, but how often are they ensuring that they make great decisions about themselves? Potential decisions relate to staying in a particular job, working in the NHS or private sector, staying in the UK or moving abroad—these are all common dilemmas.

There are numerous tools intended to help with decision making. When making key decisions, it is important to talk to people who will listen, but who will not necessarily prescribe what to do. After all, it is not their decision to make.