Less-obvious Habits Can Significantly Impact Physician Lifestyle and Happiness

A recent article published by Medscape examined lifestyle habits and happiness among physicians and surgeons. Some of the results came as no surprise: We all know we should exercise regularly and eat healthful foods. Some of the other findings—such as those about number of friends, belief systems, and introversion—aren’t covered as often. In this article, I’d like to dive more deeply into the less-covered aspects of physician happiness.

Reciprocity of roles and relationships

A healthy social life and friendships are important factors in a physician’s overall happiness. From “The 8 PRACTICEs of Highly Successful Surgeons,” research and methodology that I have developed, R stands for Reciprocity of Roles and Relationships. All relationships require give and take. I believe this impacts a high percentage of physicians, especially those who report having fewer than four to six close friends (Fig. 1).

For 12 or more years, our time is heavily invested in becoming a doctor (four years premed, four years in medical school, three to five years of residency, and often one or more years of fellowship). To whom did you get closest during your training? The camaraderie that develops during those years can be profound. However, due to a variety of factors, such as time constraints and employment opportunities, few of us stay in close proximity or communication with friends, as everyone moves on to other opportunities.

Although quality time is more important than quantity, both are required to develop and maintain friendships. But there are limited opportunities to find this time, even in our first few years of practice. A high percentage of surgeons will not stay in their first practice location. In addition, many physicians are already struggling to manage time with their spouses and families (82 percent of physicians in the Medscape survey said they are married or living with a partner). The timing of starting a family can also impact friendships. Many people who begin their professional careers in their 20s have children in their late 20s and early 30s, ages when surgeons are still in training. Many surgeons, therefore, may face added challenges, including:

  • choosing to delay pregnancy, which may increase risk
  • managing pregnancy early in a career and training
  • trying to move a young family to a new location and start new friendships

These factors likely make it difficult to develop and maintain friendships. In retrospect, I wish I had been more proactive in keeping up with my friends at each level of my training.

Consider trying to strengthen your relationships or start new ones. A simple message to a friend when you are busy can help. Perhaps the 21 percent of respondents with seven friends or more could share some helpful tips.

Based upon the eight practices, we should be exploring small gives and takes to nurture friendships, and we should ask the same of friends or potential new acquaintances. We also can take small steps to rekindle old friendships, because it is never too late to start using these principles.

What ideas do you have? How can you develop or improve quality friendships? What additional research and education could our specialty do on this topic?

Belief systems

According to the Medscape study, 73 percent of physicians have religious or spiritual beliefs (Fig. 2), and 76 percent of those respondents said their beliefs helped them cope with work stress. Belief and spirituality often correlate with our ability to understand our purpose, our passion or “why,” and our values. Any healthy way of decreasing job stressors is important.

How can you nurture your spiritual beliefs? Consider exploring why you went into surgery in the first place and/or what you still enjoy about being a surgeon. How does one restore passion and/or purpose? What ideas do you have? How can you create more of what you enjoy?

Introversion versus extroversion

The Medscape survey respondents were asked to rate themselves on a seven-point scale measuring introversion to extroversion. Overall, 12 percent rated themselves as very introverted, 14 percent rated themselves as very extroverted, and the remaining respondents selected the three intermediate ratings (Fig. 3).


Figs. 1–3 Medscape recently released its Physician Lifestyle & Happiness Report 2018 on lifestyle habits and happiness among physicians and surgeons. Orthopaedic surgeons can benefit knowing where they rank and taking the time to self-reflect and then self-manage themselves differently to help offset some of the natural pressures of working within stressful, demanding, competitive, and emotionally taxing environments.
Courtesy of Medscape

The survey did not elucidate how introversion versus extroversion might impact happiness, and there is no clear answer in the psychology literature as to which personality type is happier. Several studies show a correlation between extroversion and happiness, but others argue that the methods are biased. Experience suggests that the combination of introverts and extroverts is highly effective in teams and partnerships because of the strength of integrated personality types.

How can you leverage the personality types of your team members to be more effective? Consider asking what your colleagues and team members would consider happiness, then look for ways to help them achieve it. What ideas do you have? Whether an introvert or extrovert, how can you create more happiness?

Editor’s note: This article concludes a two-part series on physician happiness. The first article, “Physician Happiness Cannot Be Ignored,” appeared in the June issue.

Jeffrey M. Smith, MD, is an orthopaedic traumatologist in San Diego, a volunteer for the AAOS Communities in Motion, and a surgeon coach who advocates for physician well-being.


  1. Peckham C: Medscape physician lifestyle and happiness report 2018. Published online January 10, 2018. Accessed on May 29, 2018, from https://www.medscape.com/slideshow/2018-lifestyle-happiness-6009320?mkt_tok=eyJpIjoiTm1JNU9USmlZamcxTTJFeSIsInQiOiJKZnJwdnU2V2xMTENEajFYemU4WGhEa2xUMjRra2x6VUxCNGo5aEZudUJLVlV0cEVQRnNIQXBMRkY1b2FxTzc4OE1sYW4zd1V5WEc0RGdrNFp4TTM3NkJWOU1qWkp5WlwvaGRXV1d1NDEycGRoN0lleE5IZVJNQTRvVjBGQmMzTzAifQ%3D%3D.