Why we make ourselves miserable at work (and how to stop it)

Editor's note: This story was updated on February 8, 2018.

Dan Diamond, Executive Editor

I knew a great doctor who was a terrible CEO. Let's call him Dr. Bob.

Dr. Bob had all the special attributes of the best clinicians. Warm bedside manner. Keen, questioning mind. Terrific outcomes, and deeply loyal patients.

But he wasn't a businessman. And—by his own admission—he wasn't particularly good at being an administrator.

After a few years of struggling to run an organization, Dr. Bob was subtly pushed out and returned to seeing patients himself, rather than telling other doctors how to do it.

Sitting in his office one day, I asked him why he became an administrator, when he so clearly wasn't wired for it. Dr. Bob reflected for a minute.

"When I first decided to be a doctor, life became a series of achievements," he finally told me. "The best college, then the best med school. Then a top residency."

"I'd spent years treating the same patients, and felt overdue for the next challenge," he added, with a pained, twisted smile. "And that job seemed like the natural next step."

Why we choose jobs that make us unhappy

I thought about Dr. Bob this weekend, after reading a new column from Arthur Brooks: "Rising to your level of misery at work."

The president of the conservative American Enterprise Institute, Brooks has carved out an unusual side-gig as a high-profile columnist for the New York Times, writing about happiness and social science.

And in his latest column, Brooks describes a problem that's all-too-common: Happy, successful workers being pushed into management roles that leave them dissatisfied.

I bet you've seen it in your organization. I know I've seen it across the industry, through interviews and observation.

Good doctors become bad administrators. Superstar nurses become overwhelmed managers. Even talented reporters become frustrated editors.

"Ambitious, hard-working, well-trained professionals are lifted by superiors to levels of increasing prestige and responsibility," Brooks writes. "This is fun and exciting—until it isn’t."

Staying engaged in work, and becoming a happy manager

When pushing promotions, every incentive is dangled in front of staffers: More pay, more respect. Better titles.

And like Dr. Bob, many staffers crave new responsibilities. According to the Advisory Board Survey Solutions 2015 benchmark of thousands of health care workers, two-thirds of respondents wanted to be promoted within their units or departments. More than 47% of employed and closely affiliated physicians agree or strongly agree with “I am interested in physician leadership opportunities at this organization."

But clearly, some of those staffers end up having second thoughts. Most managers are apathetic or actively disengaged. And what does it mean to be engaged in your work, when as a manager, you're trying to engage others in their jobs?

We discussed this on the most recent episode of the Weekly Briefing, where my colleagues Rivka Friedman and Rob Lazerow—incredible researchers who have been repeatedly promoted and now run their own teams—talked about the challenge of managing high performers, while trying to find pleasure in their demanding roles too.


(You can hear us start debating work-life balance around the 19:00 mark, and jump to the 28:30 mark to hear Rivka and Rob's tips.)

"This is a job," Rivka says she reminds her team of achievers, "but what in it makes [your] job joyful? And which tasks keep your job as joyful as possible?"

Rob added some advice he heard from Advisory Board Company founder David Bradley, and now passes on to his own staff: "Find the parts of [your] job where you find the most fulfillment and where you're the best, and run to those."

Brooks has his own prescription: Think beyond yourself, and on how your job affects others.

As Brooks writes,

    I believe that service reduces stress and raises satisfaction because it displaces the object of attention from oneself. When I am working for myself, any disappointing outcome is a stressful, unpleasant reflection on me. When I am serving, on the other hand, the work is always intrinsically valuable because of its intention. Adopting a service mind-set guarantees some measure of success.

Given that the Daily Briefing's readers are health care leaders, who already have a service-oriented mindset, I might go one step further.

Something we've found in our interviews is that many of the happiest hospital CEOs spend a disproportionate amount of time in the wards, shadowing frontline staff and meeting with families. And something I've anecdotally learned over the years is that the most engaged clinician researchers are the ones who find time to still see patients, too.

It's easy to become a manager who walls himself off—especially if your office allows for it. But focusing only on your own career isn't empowering. It's isolating.

Learn more: How to combat clinician burnout

More than half of physicians and nurses feel “burned out” from today’s health care environment, which can increase clinician turnover and negatively impact patient experience and quality outcomes. While the drivers of burnout can vary for physicians and nurses, there are opportunities to mitigate burnout for both clinician groups.

Join our upcoming webconference to learn how to recognize clinician burnout at your organization, and embed key strategies to mitigate burnout while engaging your clinicians.

Register Here


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