Why So Many Doctors Lack Self-confidence, and How to Get It Back

Pamela L. Wible, MD

August 26, 2015

In This Article

A Self-esteem Roller Coaster

A positive employment experience can help physicians who have lost self-esteem during medical training. "When I got my first job out of residency, I was so timid," says Rochelle, a solo family physician. "Every time one of the physicians who owned the practice would talk to me, I would just about jump out of my skin thinking they were going to berate me. One morning the medical director told me he wanted to talk with me during lunch. I was frantic. I could barely breathe when I went to his office at lunch. Do you know what he said? 'I just wanted to let you know that we're all really glad that you're here. We're really impressed with your work. I hope someday you'll consider buying in to the practice.'

"I walked away in shock," Rochelle said. "That was when I realized how damaged I'd been during residency. That practice was where I did my initial healing, learning to trust myself and other doctors again. The broken medical system eventually became too much for me and I decided to open my own practice to provide care for the uninsured and underinsured, and now I feel even better."

Still, some physicians feel that practicing medicine is a self-esteem roller coaster. "My self-esteem depends on the day and time," says Alison, a pediatric neurologist. "There are days when you get a rare diagnosis right and make such a huge difference in a patient's life which makes your self-worth soar. Other days your hospital tells you that you don't see enough patients, bill enough RVUs, and you just can't make that one patient happy which makes your self-esteem plummet."

After Medical School and Residency: Physician Self-destruction

After all of the education and time invested in medicine, many physicians continue to feel injured by the healthcare system. The list of assaults on the physician psyche in modern medical practice is beyond the scope of this article. A great many physicians do suffer, often in isolation, throughout their careers.

Retaliatory culture and institutional bureaucracy shatter physician self-confidence. David, a family physician shares, "I definitely experienced PTSD from medical training and continue to do so periodically from the daily practice of medicine." Others are equally exasperated. "Practice kicked my ass," says Mark, a neurologist. "The demands of insurers, workers' comp, paperwork that did not exist during training, were inescapable and soul-sucking. The call demands were unexpectedly way increased because of hospital policies. For the most part, caring for patients was a refreshing escape and why I went into medicine."

But some patients are not a refreshing escape. "I questioned myself constantly," reveals Yvonne. "I practiced in Manhattan where patients come in to the office already knowing your background and how they think you should treat them. They're incredibly informed and have an ophthalmology friend who second-guesses what you do. The expectation of patients is very high and there's a lot of pressure to meet their expectations in order to compete with the dozen ophthalmologists who work within a few square blocks of you."

"Practice clearly ruined my life and my self-confidence and self-esteem," reports Peter. "As a psychiatrist I was cut out, carved out, and devalued. I overworked and ruined my personal life. Sad. I take responsibility for allowing Medicare, insurance companies, administrators, and patients to take advantage of my fine personality traits and professional skills. I needed role models but they were just as overwhelmed. Professional organizations abandoned us and sat quietly, watching passively as physicians were groveling. Unacceptable. They all should be fired."

"Residency was bad, fellowship was worse, and now at the age of 56 years, I have to keep reminding myself why I am alive," says Michelle, a pediatrician. "I have never felt more worthless in my life. I calculated my hours and realized that I could work 3 jobs: Panera baker, Chick-Fil-A, and house cleaning, and make as much money working as many hours...and would potentially have better self-esteem."

Melissa, an internist, concludes: "I feel like I've completely wasted my life. Many personal sacrifices to become a physician. Nothing to show for it."

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