How to go from career frustration to fulfilment

Most people choose a career in health care for various reasons and it’s a field that offers both personal fulfilment and practical advantages. Why is there an increasing number of reported stress and burnout among HCPs? Is it a far-fetched idea to find fulfilment in the primary care profession?

If you are drawn to healthcare, it is likely because you genuinely want to make a positive impact on people’s lives. Whether it’s caring for patients, promoting wellness, or saving lives, the desire to help others is a powerful motivator. The prospect of directly impacting the well-being of patients is not just a profession but a calling—a calling that can compel you to devote your time, energy, and expertise towards this noble cause.

Bear in mind, healthcare extends beyond the clinical boundaries. It encompasses a variety of roles and responsibilities that contribute to the overall ecosystem of the healthcare workforce. A subsection of this ecosystem exists in primary care, from research scientists to public health professionals, to administrative managers, the spectrum of opportunities within primary care is as vast as it is impactful. Despite this, it seems a lot of primary care professionals find it hard to achieve fulfilment in primary care as it is today.

What are some of the frustrations that are common in primary care?

There are 3 causes of frustration that you can address. The patient-facing factors, the conflict of individual values and mindset and the organisational structural challenges of primary care.

Patient-facing Factors

You may be feeling frustrated because of prolonged engagement with challenging consultations. You’ve trained to provide holistic care, considering not just the medical aspects but also the psychological and social elements. However, you may still be unprepared for the many different challenging interactions that occur regularly in primary care. Challenging scenarios could stem from mismatched doctor-patient agenda, patients with a list, diagnostic uncertainty, appointment allocation, specialist referral wait times, the new “urgent lists” in primary care etc. Challenging patient interactions are the rule rather than the excerption. This time consumption, when happening on a large scale and in a protracted manner can put a strain on your wellbeing, leading to frustrations, stress and burnout. For example, the nature of certain conditions that present in primary care may lead to repeat visits which can exert a significant drain on your resources and availability to see other patients. The lack of time creates a challenge in primary care that is shared by many.

Similarly, when you are given limited time to see patients, and there’s a lack of resources, especially evident after COVID-19 when everyone came back needing referrals, the support that wasn’t readily available. Dealing with complex medical cases while patients are on a waiting list can also contribute to frustration, leaving you feeling like you’re constantly in a losing situation. This can eventually lead to stress buildup and burnout.

Individual values and mindset related factors

The second aspect that can contribute to frustration is your mindset. You may be feeling unfulfilled because you’re not able to use all your skills to help people as you would like. Some primary care professionals may hold a fixed mindset regarding patient engagement, believing that patients are solely responsible for their own health outcomes and that their efforts to educate or empower patients are futile. This mindset can lead to frustration when you feel that your attempts to promote patient engagement are met with resistance or apathy.

Similarly, a fixed mindset can lead to frustration when faced with challenges or setbacks, this can lead to perceiving obstacles as evidence of your inherent limitations rather than opportunities for growth. You may have realised that following a predefined work plan doesn’t suit you. You may have even ventured to explore other options, outside clinical practice like software engineering or statistics but ultimately, but then you find that you need to work with people to feel fulfilled. This highlights the deep motivations for choosing a career in primary care. People are at the centre of career fulfilment as a health care professional.

Furthermore you may have thought that being a primary care clinician means you become personally responsible for the care of subset of the population from cradle to grave. Unfortunately, you may find the “employee role” limiting in terms of time and resources to achieve this level of personalised healthcare. This can certainly lead to frustration and an internal conflict.

Some inherent behavioural attributes may predispose you to frustrations in your career. Where you are on the neurodiversity spectrum versus neurotypical behaviours and preferences may also play a role. For example Masking, and Double Empathy are neurodivergent traits that could lead to frustrations and burnout in a career in primary care. Read more here. Also, personality traits are also recognised factors that help you explore why you act the way you do. If your personality is mostly introverted, you may find making connections with others difficult to establish, or finding that trusted co-worker etc. It can make working with colleagues, and some patients, really tough and leave you feeling quite disillusioned or frustrated in your given role.

You can explore the 4-colour personality identifier to give you an idea where in the team dynamics you may be more suited for. In this activity you have these cards with personality description statements written on in. These were grossly categorised into 4 subheadings: Sensing, Intuition, Thinking and Feeling types. They are subsequently mapped to certain job roles. We had this done at work and were broken up into sets with a dozen staff each so that everyone would have a go. When it was your teams turn, you move around and exchange cards with descriptions that do not fit your understanding of your self for the ones that do. The rule is that you must collect something in return and when you are satisfied, you stop exchanging. At the end of the session you get a pretty good sense of the colour the majority of your cards are.

After this, you then aggregate people with similar colours into one place and further explore what roles they are already performing in the organisation to see how they apply their personality to a joint activity. For example, Yellow colour are the more extroverted personalities with sunny dispositions. If you are planning a staff away day, they are excellent meeting activity generators but may not necessarily look for all the details like the budget, car parking details etc.

If you find you are largely performing a role that does not match your personality, you may be prone to experience more frustrations at work compared to your peers.

Organisational Factors

The third aspect is the organisational culture. There is a lot of workplace culture variation between general practices. The ones that work well are where people have a supportive and friendly culture. Where everyone actually comes in to help out and and take breaks regularly, especially together. It makes a real difference to get to know the people you work with on a deeper level, especially when you come to learn that they share your values and passion for success.

Staff turnover can be detrimental for morale and sustainability of a practice. Managers, team leads and partners have the difficult task of developing strategies to maximise retention especially in deprived areas in the country. Feeling of being overworked, lack of autonomy, fair pay or lack of support from management are few reasons that lead to staff turnover.

Furthermore, new entrants into the GP career / team may feel a lack of agency or confidence to contribute to building a practice. This can stem from a lack of awareness of the practice values, mission and vision. They have “no skin in the game”. The new staff pool are now likely to be from the millennial generational category. Surveys suggest the millennials are more in favour of understanding that the wider societal concerns like climate-improving practices, hybrid working, work-life balance and mental health support should be imbedded into the workplace and when these are lacking it may lead to frustration and burnout. Read the article about workplace culture here.

Also, the experience of discrimination, bullying, sexual harassment or assault could contribute to feelings of frustration and loss of fulfilment in your career.

How to achieve a fulfilling career in primary care.

Overcoming these frustrations and finding fulfilment in a primary care career can be challenging but not impossible. Here are some suggestions:

Mindset Shift: Adopt a mindset that focuses on what you can control rather than dwelling on the limitations of the system. This may involve accepting the constraints of time and resources while finding creative ways to make the most out of each patient interaction. If you are considering other options outside of traditional medicine or general practice, explore more fulfilling ways to leverage your skills and help people without feeling constantly overwhelmed. Explore a portforlio career, hybrid working etc. Having a growth mindset will help you beyond the frustrating external boundaries and help you acknowledge and celebrate every step forward, that is contributing to your growth and development, no matter how small,

Effective Communication: Effective communication is essential for a successful career in general practice. Build trust with your patients and colleagues by only speaking the truth and continuously improving your skills. Read, reflect and write about topics that interest you to deepen your understanding of the field. Enhance your communication skills to better understand patients’ needs and expectations. Actively listen to their concerns, validate their feelings, and involve them in decision-making processes to foster a sense of partnership in their care.

Advocacy: Advocate for changes within the healthcare system to improve resources, access to specialty care, and support for primary care providers. See our article on 8 ways to promote change through health advocacy. Engage with professional associations, policy-makers, and community organisations to address systemic issues affecting primary care. These type of conversations can relieve uncertainty and perhaps give you an opportunity to effect a positive change.

Self-Care: Prioritise self-care to prevent burnout and maintain resilience in the face of challenges. Set boundaries, take regular breaks, engage in activities that bring you joy outside of work, and seek support from colleagues, mentors, coaches or mental health professionals when needed. See our article on how to recognise and deal with burnout.

Professional Development: Pursue ongoing professional development opportunities to expand your skills and knowledge in areas that align with your interests and goals. This could involve attending conferences, participating in training programs, or seeking mentorship from experienced colleagues.

Explore Alternative Roles: Consider exploring alternative roles within primary care or adjacent fields that allow you to leverage your skills and make a meaningful impact in different ways. This could include roles in healthcare administration, medical education, research, community outreach, coaching, entrepreneurship or finance.

By adopting a proactive approach, cultivating resilience, and exploring opportunities for growth and innovation, you can navigate the challenges of primary care and build a fulfilling career that aligns with your values and aspirations. Best wishes.