By Dr. Josh Daily, WCI ColumnistAs physicians, we dedicate years to training for a career that is intellectually stimulating and deeply meaningful. Yet, many of us find ourselves disillusioned, burned out, or simply dissatisfied with our work. When I first chose my job as a pediatric cardiologist, I made many of the same mistakes that most physicians make—we optimize for salary, prestige, or job security but rarely consider the research-backed factors that actually contribute to long-term flourishing.
Through my work directing a medical student course, Personal and Professional Financial Essentials for Physicians, I’ve helped future doctors navigate job selection. In doing so, I delved into the broader research on human flourishing, and what I found surprised me: we rarely prioritize the things that actually matter.
Let’s explore the key drivers of long-term happiness at work—backed by research—and apply them to how physicians should select and design their jobs.
What Actually Leads to Happiness at Work
Studies on human flourishing reveal that true and lasting well-being is derived from:
- High-quality relationships
- Autonomy and control
- Purpose and meaning
- Mastery and growth
- Work-life balance
Surprisingly, external rewards like salary and status contribute far less than we think—and they are highly subject to hedonic adaptation, meaning we quickly adjust to financial gains and return to a baseline level of happiness.
So, if money and prestige don’t drive long-term career satisfaction, what does?
#1 High-Quality Relationships
The Harvard Study on Adult Development (The Good Life) found that nothing predicts long-term happiness better than strong relationships. This applies both to our work relationships and those outside of work.
At work, physicians who feel connected, valued, and supported by colleagues experience greater resilience to stress and report higher job satisfaction. Outside of work, a demanding job can either strengthen or weaken our relationships with spouses, children, and friends. If work consistently pulls us away from meaningful relationships, our well-being suffers.
Practical takeaways:
- Prioritize work environments where you enjoy and respect your colleagues.
- Avoid toxic cultures, even if the job is prestigious or well-paying.
- Choose a job that allows you to be present for important relationships outside of work.
#2 Autonomy and Control
Autonomy—the ability to make meaningful decisions about your work—is one of the strongest predictors of job satisfaction.
Physicians often undervalue autonomy when choosing a job, opting instead for higher salaries or institutional prestige. However, having control over your schedule, patient load, and practice environment is far more valuable in the long run. Moreover, a lack of autonomy is one of the leading contributors to physician burnout.
For some, this may mean owning a practice rather than being an employed physician. That said, available data suggest that job satisfaction levels between private practice and employed physicians are similar since each comes with its own trade-offs. Additionally, owning a practice does not always equate to greater control over your life, as administrative, financial, and time demands can offset the perceived autonomy.
Beyond work, control over your life matters even more. If your income allows you to buy back time (by outsourcing chores, reducing clinical hours, or working part-time), your well-being improves.
Practical takeaways:
- Seek roles that allow flexible scheduling, control over patient care, and decision-making autonomy.
- Use financial leverage to gain control over your time, rather than just maximizing income for consumption.
#3 Purpose and Meaning
Work that aligns with your values and contributes to something bigger than yourself leads to greater fulfillment. Medicine is inherently meaningful, but administrative burdens and misalignment with values can erode that sense of purpose.
Research by Amy Wrzesniewski on “job crafting” shows that employees who reshape their work to align with their strengths and values report higher job satisfaction. Meanwhile, physicians who feel disconnected from why they entered medicine are at higher risk of burnout.
Practical takeaways:
- If your job feels unfulfilling, reframe your work’s purpose—mentorship, education, or leadership roles can restore meaning. For me, becoming a fellowship program director and teaching a financial course to medical students has been deeply fulfilling and has increased my enjoyment at work.
- Seek out work that aligns with your personal mission, rather than just chasing the highest salary.
#4 Mastery and Growth
We are happiest when developing expertise and growing in our careers. Flow Theory suggests that engaging in challenging work that stretches but doesn’t overwhelm us leads to deep satisfaction.
That means physicians who keep learning, improving, and developing new skills tend to be more fulfilled than those who stagnate. The craftsman mentality—striving for excellence in your field—increases job satisfaction, and if you become one of the most highly skilled physicians in your specialty, you can leverage that to negotiate for positions that provide the things that truly matter: autonomy, meaning, and strong relationships.
Practical takeaways:
- Continually invest in your clinical expertise, leadership, or a niche skill to gain career leverage.
- If you feel stagnant, seek new challenges through teaching, research, or professional development.
#5 Work-Life Balance and Time Affluence
Burnout is strongly linked to low job control, excessive workload, and lack of recovery periods. Physicians often undervalue time affluence—the ability to spend time on meaningful activities—despite strong evidence that prioritizing time over money leads to greater happiness. Work-life balance allows you to protect your most important relationships and activities, and for most physicians, time affluence matters more than financial affluence.
Practical takeaways:
- Prioritize jobs that allow for time flexibility rather than just income maximization.
- Design your work to allow for recovery, personal pursuits, and relationships.
More information here:
The Radiologist Next Door Takes a Year Off
What We Can Learn About Work-Life Balance and Retirement from the French
What About External Rewards (Salary and Status)?
While money and prestige contribute to well-being, they matter far less than the factors above. Interestingly, a recent Medscape survey found that 48% of respondents believed more money would reduce their burnout. This suggests either that they intended to use the additional income to enhance their relationships, autonomy, sense of meaning, and work-life balance or that this is a case of affective forecasting error—where people consistently mispredict what will truly make them happy.
- Salary: Research by Killingsworth et al shows that money increases happiness at all income levels. However, most of this relationship is driven by how individuals use their income to gain control over their lives—not just to buy more things.
- Status: Recognition is valuable, but prestige alone doesn’t sustain fulfillment.
- Hedonic adaptation: Most external rewards only lead to short-term happiness.
More information here:
It’s a Lifestyle, Not a Vacation
The Bottom Line
To flourish at work, physicians should rethink how they select and design their jobs:
- Foster strong relationships in and outside of work.
- Maximize autonomy to control your life.
- Prioritize meaning over money.
- Continually grow to achieve mastery and gain leverage.
- Value time affluence over financial affluence.
By aligning our work with these research-backed principles of human flourishing, we can design careers that sustain happiness and well-being rather than chasing goals that ultimately leave us unfulfilled.
How is your work-life balance? Have you done anything special to design your work so it’ll make you happier overall? Is that something you’d consider? Why or why not?
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