Physicians have long felt the pull between our natural desire to please our patients and our professional and ethical commitment to provide care that’s in our patient’s best interest.

When a patient requests an antibiotic and we know their viral illness won’t respond to one, we feel torn.  When a patient who can walk without much trouble asks for a disabled placard, we feel conflicted.  The angst of these decisions has intensified with the pressure of online reviews and the arrival of patient satisfaction scores. Honestly and compassionately explaining why we’re refusing a request, in a way that maintains a trusting relationship, requires time – and that’s something we have less of as the years pass.

These types of decisions leave us feeling increasingly burned out.

We’re frustrated that we’re not given the time to fully use the knowledge and skills we worked so hard to acquire. We’re angry that we’re expected to satisfy the conflicting demands of our patients, medical group, the pool of medical resources, and our own sense of professionalism and ethics.   We resent outside interests – insurers, administrators – that interfere with care we feel is necessary. And we feel despair when our dreams of having a satisfying career feel like they’re evaporating.

Doing what pleases patients or administrators if it conflicts with our ethical convictions doesn’t lift our feeling of unease. But when we insist on following our own beliefs, we worry about losing our job or facing a dwindling practice. We feel stuck.

Finding our way out of this will take some thought and courage, but we can regain the sense of authority and integrity we’re so painfully missing.

Take a moment and consider the conflicts you feel in your practice. For those that constitute a simple difference of opinion,  you might decide to take the path of least resistance. But with those issues that are rooted in your sense of ethics, a different tactic is required. Because the person you live with, day in and day out, the one you most need to please – is YOU.

As a physician coach, I’ve seen physicians courageously stand up for what they believe. This act has caused some to leave their positions. Others sparked an uprising that spurred important change. None of these physicians regretted their decision to follow their ethical compass. Those who continued to do what they felt was unethical continued to suffer and became increasingly disillusioned.

With all the changes in medicine, many of us find ourselves straying from the path of service and fulfillment that we thought would define our career. But we each have an ethical compass that advises us when we’re getting off track. If we want to be healthy, engaged, satisfied physicians who provide good care to our patients, we need to dust off our compasses and find our way back to the inspiring path we signed up for.