Doctors' Happiness a Disadvantage?

Many doctors say they are unhappy in their work. But according to Todd Kashdan, PhD, a psychology professor at George Mason University in Fairfax, VA, that may not be such a bad thing.

“ The way we think when we're happy is very different from when we are mildly unhappy," Kashdan said in an interview. He is the co-author of a new book “The Upside of Your Dark Side.”

Being somewhat unhappy makes people better at responding to details, facilitates analytical thinking and reduces stereotypic thinking, Kashan said.

Those are skills which are fundamentally important to physicians, said Kashdan, who also is a senior scientist at the university’s Center for the Advancement of Well-Being.

Surveys have shown that many physicians are unhappy with various aspects of their practices. For example, 47 percent of a sample of physicians in 6 states found their work "extremely stressful" a joint Rand Corporation/American Medical Association study found last year. And only 32 percent of family physicians said they would chose that medical specialty again, the American Academy of Family Physicians reports.

Kashdan argues that physicians can make some of their negative feelings about work—such as anxiety--help them do their jobs better.

For example, a doctor who is "mildly anxious or worried will ask additional questions,” he explained. “That's why novice physicians often are better at diagnoses than veterans." In fact, he added, patients may be better off choosing the somber doctor who probes with insightful open-ended questions, than the sunny physician they feel more drawn to.

A persistent positive, mindless attitude of turn-that-frown-upside-down doesn't help make doctors better at practicing medicine. But expressing real emotions like anger can, he explained.

"Anger forces a person to face the world and face friction rather than avoid it-- a person needs that in their repertoire," he added.

Being quarrelsome or expressing some candor often is needed in medical settings, Kashdan said. "It's worth it to argue with people to get the best possible course of action, to get the best possible outcome," he said.

Doctors shouldn’t try to be Patch Adams, the real-life pediatrician who inspired a film. Adams has worn a clown suit to cheer his patients on hospital tours. Playfulness has its place, but Kashdan thinks it is helpful "to mirror the emotions that the patient is offering.” That can mean commiserating with them and sharing their sorrow rather than trying to change their mood.

Physicians have an opportunity to lead when they also commiserate with their office staffs' stress, he added. Office staff should be trained to do the same with patients, Kashdan said.

When a person at the desk fails to connect with a patient's stress, it increases the likelihood of poor interaction with the doctor and possible loss of a patient.

Being emotionally adaptive, differentiating feelings, listening to intuition, and paying attention to gut reactions are an important part of experiencing a whole life, Kashdan said.

"The question is what emotional mindset brings out the best possible problem solving when you are working with people," he added.

But doctors, like everyone seeking a work/life balance, need to be able to distinguish between emotions appropriate in medical situations and ones they need to show at home.

"When you get home that quarrelsomeness is extremely unhelpful," Kashdan explains. It is better, he said, to take the time to understand. "In a medical setting, there is less time and it's better to deviate from politeness and be candid."

The upside of the dark side happens because "The building blocks of a well-lived life are moments," he added. Sometimes these "choice points” require deviation from being kind or being selfless.

"Eighty to 90 percent of people say their reason for being alive is being happy. That's problematic because so many things are outside our control," Kashdan explained. "Instead of aiming for this almost impossible control of outcome, how can we maximize the best possible outcomes in the situations we're in?"