Physician Thriving: Meaning and Purpose – Burnout and Resilience

By Hilary McClafferty, MD, FAAP

Like many of you, my work life has changed significantly over the years. These transitions have reinforced my conviction that a strong sense of meaning and purpose are integral to a sustainable career in medicine.

Take a moment to consider your current feeling of meaning and purpose at work. Where would you fall on an informal scale of 1 -10, with 10 being a high sense of meaning and purpose on most days?

If you fall in the upper range, say 7-10, that is a tremendous accomplishment and a powerful buffer against burnout. What are those things that are bringing you meaning and joy, providing you energy to meet the challenges of the day? Write them down. These are your guideposts.

If you are on the lower end of the scale, say less than 5, when was the last time you did have a strong sense of meaning and purpose at work? What work were you doing? What elements of work resonated with you? What fueled your sense of purpose? Write it down- these are your bread crumbs.

When you think about your prior sense of purpose and direction, what is different now? Changes might include your job, the setting, the people, your support system, technology, time constraints, call schedule, sleep schedule and so on.

Once you have identified some of the differences between then and now, write them down. There are clues here. Can you identify the potential obstacles, speed bumps, or closed doors blocking your way to regaining meaning and purpose in your work life?

The next important question to ask when considering your perceived obstacles is this: Which elements of the situation are actually in your control, and which are not?

Research shows that a strong sense of ‘locus of control’, i.e., an inner ‘can-do’ perspective, is a recognized trait of highly resilient people. (1) It is not that these resilient people don’t recognize the obstacle, it is that they do several things simultaneously including recognizing challenges, maintaining an attitude of realistic optimism and problem solving without fear of failure.

One of the things I’ve observed when talking with some colleagues about burnout is a profound sense of loss of control, a feeling that medicine has changed for the worse and there is little they can do about it. This concerns me because I have seen many colleagues make deep and significant shifts in their outlook, turn events in their favor, seek out new opportunities, connect with broader networks and open doors to solutions not previously considered.

If you need to refuel your sense of meaning in medicine, it may be worthwhile examining an area where you feel stymied, stuck, or stagnant. Take some time to consider these questions:

  • Can you clearly bring to mind a time you felt a strong sense of meaning and purpose at work?
  • Which elements resonated with you then?
  • If you’ve lost your sense of purpose, what is different now?
  • Does the change involve elements that are, in fact, in your control?
  • If so, focus on one small area where you can realistically make a change.
  • Then make it.

Each time you follow the breadcrumbs and act, whether it’s a step towards physical self-care or in seeking out a new job opportunity, you enhance your inner locus of control. Taking that first step, no matter how small, will provide a sense of welcome relief from feeling burned out, off course, and out of control. This allows you to make the next decision from a place of greater strength and can catalyze a positive and healthy cycle of change.


  1. Stress in America: Paying with Our Health. American Psychological Association, 2015


Hilary McClafferty, MD, FAAP, is board certified in pediatrics, pediatric emergency medicine, and integrative medicine. She writes and speaks nationally on physician wellbeing, resiliency, and whole physician wellness. She is a certified physician coach and author of two books: Mind-Body Medicine in Clinical Practice and Integrative Pediatrics: Art, Science, and Clinical Application, and editor of two Special Editions on the use of integrative medicine in practice. She is Founding Director of the Pediatric Integrative Medicine in Residency program, University of Arizona, and Medical Director, Pediatric Emergency Medicine at Tucson Medical Center, Tucson, AZ. Email:  Website:  Twitter: @drmcclafferty

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