Does Happiness = Acceptance? The Key Question for Today's Physician

Greg A. Hood, MD

Disclosures

December 02, 2015

In This Article

Happier Doctors = Healthier Patients

Measures of global well-being and contentment ought to be calculated as another vital sign. Indeed, such a vital sign may not only help physicians and patients understand the status and goals of a medical case but would also apply to personal "life reviews." Such an understanding could help with the global expense of healthcare and management of our economy, both on a macro and individual level.

If we're truly going to create a system of "accountable care," then this type of new perspective has to happen within healthcare. If this scale of happiness is charted in a box against level of health (whether personal or professional), one may find greater economies of efficiency as well as substantially different directions in the way in which decisions are made with regard to both personal health and personal finances.

Looking to the extremes, a patient or a doctor who scores very low on happiness ratings may be among those most likely to benefit from attention and intervention. Obviously, additional screenings and resources for depression and other mental health issues would be very important in this group, regardless of whether the subject is a physician or a layperson. Sharpening our abilities to detect these cases could save lives, and do so with more timely and efficiently deployed resources.

Primary care physicians, for example, expend an inordinate amount of effort on patients with chronic medical conditions like type 2 diabetes, even though many of these patients seem perfectly content to accept the medical consequences of their lifestyle choices. I'm not saying that we should resign these patients to their fate. Rather, let's recognize that until they're sufficiently motivated about their conditions or have personally experienced a crisis brought on by their condition, we're going to routinely expend substantial resources to no effect because of the chasm that exists between their physician's unhappiness and distress about their health and their own (contented) perceptions.

Those people who score poorly on health but high on happiness may be a robust area for research and reconsideration. Oncologists and patients alike both frequently bemoan the rates at which treatments are embarked upon that render the patient much sicker, for only marginal gains in duration of survival. If a patient is content in their life, their faith, and their understanding of what's happening to them, do we do them a service by shifting this balance?

However, this position within the paradigm isn't solely occupied by such patients. Somewhat analogously, when this paradigm is applied to a physician's own life circumstances, there may be doctors who really don't mind long-term financial instability from having started their career later than other professionals, the "cancer" of out-of-control spending, and insufficient attention to developing a "healthy" retirement—or, similarly, those who don't care that their own physical health is subsumed by career demands.

In the "U-bend" article, economists identified four main factors associated with happiness: gender, personality, external circumstances, and age. While women were generally happier, they were also more prone to depression at some time in their life. Whether this is an individual fluctuation of moods across one's life, or a subset of women are more depressed than most across the population, hasn't been ascertained. The economists' studies even found differences in health—susceptibility to viruses and wound healing, as examples—based on happiness.

The question then becomes how much of this is amenable to policy change and happiness interventions, and how much is a matter of resilience?

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