Is your doctor happy? Are you happy with your doctor?

Are you frustrated with your last visit to the doctor? Did it feel rushed? Have you waited a long time to be seen? Was it difficult to get an appointment? Did the doctor put his or her face behind a computer screen instead of talking to you?

Up to 70% of patients are dissatisfied with their doctor. It turns out doctors are just as fed up.

Before the pandemic, 75% of physicians reported being at least somewhat happy in their work. By 2023, that number had dropped to 48% questionnaire from Medscape.

Having dissatisfied doctors is a problem for patients.

Why does this happen? Why does it matter? And what are the solutions?

What is happiness?

Merriam-Webster attempts to succinctly define happiness as a state of well-being and contentment. Arthur Brooks PhDthe celebrated social scientist, professor at Harvard, and Atlantic Ocean columnist, delves deeper into the macro elements that underlie the true complexity of happiness. His framework articulates happiness not as a fleeting feeling, but as a complex synthesis of pleasure, satisfaction, and purpose.

Enjoy transcends mere pleasure and includes shared experiences of positive events that bring richness to life. It can be temporarily pleasant to drink too much. But we enjoy it and remember sharing a champagne toast with our closest friends and family after the birth of our child. Satisfaction comes from the long-lasting satisfaction of striving for a goal and achieving it. For example, the arduous process of building a business offers a more lasting sense of happiness than the chance windfall of a lottery ticket. Goal is derived from meaning – a fundamental sense of why we exist and why we do what we do. Arthur Brooks summarizes this vividly as: what were you born for and what are you willing to die for?

This is the architecture of happiness, and it is crumbling for doctors.

Why isn’t your doctor happy?

The calling of medicine, no matter how noble, takes its toll. Doctors deal daily with the most serious manifestations of human frailty: cancer, paralysis and terminal illness, to name a few. For the surgeon, even flawless execution of an intervention is no guarantee of a favorable result. Yet it is these outcomes that dictate their perceptions: a hero when success follows, a villain when complications arise. In today’s flat communications landscape, a doctor may have to see his or her name smeared – fairly or unfairly – through Google reviews and social media comments. And this ruthless game of surgical roulette is played during 50- to 80-hour work weeks. The emotional toll becomes clear.

Some physicians have lost their joy, satisfaction and, most tragically, their sense of purpose.

Burnout has become endemic. Administrative work, which is cited as the main cause, consumes most of our working hours. The same Medscape study found that two-thirds of a doctor’s day is now spent on charting and bureaucratic tasks.

Moreover, 80% of doctors are too now working by hospitals, institutions that are themselves consolidating at an alarming rate. Physicians, reduced to middle managers in sprawling bureaucracies, bear responsibility for patient outcomes while having increasingly less control over the healthcare process. Erosion of physician autonomy is the most important factor affecting job satisfaction, according to a 2018 study study by the Council of State Neurological Surgeons. Additionally, physician compensation is on a dried-out trajectory; adjusted for inflation, this has fallen by 29% since 2001.

Much of what doctors do has now unfortunately become transactional.

While enjoying the timeless holiday classic Rudolph the red-nosed reindeer with my family this season, I was struck by the poignant juxtaposition. In the film, the elves happily sing their cheerful refrain, “We are Santa’s elves, we are Santa’s elves,” as they work diligently in the workshop, making toys to delight children around the world. This is in stark contrast to the doctors who have become the proverbial elves of healthcare, toiling under the vast rule of administrative entities. They once worked for Santa Claus. They now work for Mattel. The noble art of healing, once based on the ethos of human connection and the relief of suffering, has been overshadowed by the cold calculation of productivity quotas, the Sisyphean task of electronic documentation and the incessant demands of administrative oversight – all paradoxically to demanded reduced compensation.

In short, doctors have become commodities.

Why do you care if your doctor is satisfied?

Extensive research has shown that physician burnout compromises the quality of care and patient outcomes. We need to attract and retain the best and brightest people in medicine, but the current trajectory is unsustainable. Physicians are the cornerstones of clinical care teams, especially in hospitals. A discouraged clinical leader invariably fosters a toxic environment, to the detriment of everyone involved. The cold and distant doctor does not inspire comfort and trust in the family of a sick patient.

This crisis is compounded by a demographic reality: According to the American Association of Medical Colleges, 42% of practicing physicians are over the age of 55. Meanwhile, 61% of medical students are considering a career outside of clinical practice, viewing medical school as a stepping stone to other healthcare fields.

The most competitive fields in medicine are those with higher incomes, fewer hours and the opportunity to earn income outside of an insurance or government payment matrix.

This is not a feasible future for patients.

How do we get happier doctors?

Of course, there are some pragmatic solutions to help stop the bleeding. Cut the red tape that stifles efficiency. Limit the overreach of insurance companies to the sanctity of patient care. Improve the usability of electronic health records, reduce documentation burden, improve compensation, etc. This will improve things for patients and physicians. The newly created Department of Government Efficiency will hopefully bend the arc of change in that direction. However, while these reforms are necessary and helpful, they are situational solutions to job satisfaction.

True happiness is much more difficult. It is a much more complex and deeply internal undertaking. It is neither easy to achieve nor sustained without constant effort. The simple yet challenging truth is this; happiness is an individual responsibility; the only person who can make a doctor happy is the doctor himself.

This means that we must reject with firm conviction the seductive lure of victimhood and the tacit relinquishment of personal agency. Instead, they must embrace ownership – of their profession, their purpose and, most importantly, their own happiness. The stakes are not just personal; Patients expect that they will work on their happiness. Doctors must adopt the habits of happiness as so eloquently described by Arthur Brooks: to trust, family, friendsAnd purposeful, sanctifying work.

Building on the holiday theme, this ethos finds poignant expression in the timeless lesson of It’s a great life. George Bailey, the film’s protagonist, embodies the human condition: his dissatisfaction stems from a relentless pursuit of unattainable ambitions: the next train whistle, boat horn, or airplane sound signals an adventure that forever eludes him. It is only when he gains the clarity to see the profound impact of his seemingly ordinary life – his family, his friendships, his community – that true happiness becomes manifest. His perspective shifts, and with it his joy becomes transparent in his contentment. The culmination of this revelation is etched in cinematic history as one of the most iconic celebrations of human purpose and connection.

It takes work to have a happy holiday.