It’s supposed to be hard! How to maximize professional satisfaction

By: Tami Dolphens, MPAS, PA-C
Nebraska Home Pediatrics
Creighton University PA Program
Omaha, NE

One of my favorite “non-clinical” conversations to have is the effective utilization of Physician Assistants. 

This conversation has evolved in the last two decades. The two driving forces for change include my role in this world and the world itself.  

I’d like to think my role has evolved for the better, from clinical, to administrative, to academic, and well…don’t forget a jump back to clinical, then back to academic! We are a constantly changing species, both as humans and as professionals.

“It is not the strongest of the species that survives, nor the most intelligent, 

but the one most responsive to change.”  

-Charles Darwin

The conversation usually begins during the last few months of PA School. The title of my lecture has always been Joining the Team

I speak about certification, obtaining a PA license, and the credentialing process. My experience on our State licensing committee allows me to warn the budding professional about disciplinary actions and unprofessional conduct. It also gives me a platform to teach students how to make the most of their careers. My advice has always been to get involved and advocate for yourself. My constant reminder is that you are “joining a team,” your opinion matters, and to please don’t just settle for a “role” that someone thinks is right for you; show up and satisfy your calling.

“How you see your work is more important than your job title.” 

-Angela Duckworth, author of Grit

In order to make the most of your career, your scope of practice should change as your expertise and skillsets advance. Involvement in medical staff and administration can assure that your professional skill sets are being utilized effectively. This utilization can be exercised by writing hospital policy and serving on committees, such as credentials or educational committees. 

Perhaps it includes the uncomfortable idea of applying for a management role within the Organization. But wait, here is the big one…. Step out of your comfort zone and present at Grand Rounds, volunteer to speak in the community, or volunteer to be a preceptor. These activities go beyond your medical training, many professionals do not feel prepared to take something like this on, and it feels scary! Accomplishing something that at first feels scary builds confidence and pride.

This kind of advice works well in a world in which everyone is striving to maximize their professional skillset and provide intellectual challenges. It also works well with professionals who desire to push themselves to the limit and are comfortable feeling a little uncomfortable…  

“What if we live in a world in which comfort is encouraged, fear is avoided, and job security is the objective? What if we cease to advance?”  

These questions are discussed in a book by Ross Douthart, called

 The Decadent Society: How We Became the Victims of Our Own Success 

My narrative has changed over the years. Partly due to reading material like Angela Duckworth’s Grit, and Ross Douthart’s The Decadent Society; but more so as I have evolved as an educator, coach, professional mentor and parent. The way we train PA Students has not deviated much from the original competency-based medical model (or perhaps trending toward a more Biopsychosocial blended model); however, I believe our societal expectations have. The societal expectations of the avoidance of stress and encouraging complacency have become the norm. This pertains to our community and not solely to students. What I see affecting professional satisfaction, and ultimately success, is a desire to avoid uncomfortable situations. Would you agree that the past 12 months have put us all in an uncomfortable situation? 

How is everyone handling this?

“It’s supposed to be hard.”

The year 2020 has taken people out of their comfort zone and placed them on top of a high bar, handed them a set of dumbbells, and told them to do pistol squats. You can be afraid, you can say it’s too hard, or you can give up before you even try out of fear of failing. PA School wasn’t easy, so why would that change once you are finished? If you want to be challenged intellectually or simply want more out of your medical, then go get it. But how?

What makes some tolerate uncertainty better than others? What fosters toughness, courage, and grit? How do we demonstrate resiliency? How do we build confidence? The answer is: Try things that scare you.

When I saw this exercise in action, my mind went immediately to those questions above. This example goes well beyond the year 2020, beyond sports participation, and into our ever-changing profession known to be a Physician Assistant.

You don’t have to be a recently graduated PA student to grow from this column. The beautiful thing about medicine and our profession is the versatility of it all. If we never step out of our comfort zone, and we never try things that scare us, then we never know the pride one feels from success, from overcoming an obstacle, from first being scared, then trying it anyway. As a physician assistant, an educator, a mom, a youth sports coach, and every other hat we wear in our lives, just remember, it is supposed to be hard!


See Tami Dolphens, MPAS, PA-C speak at the GAPA 2021 CME conference in Hilton Head Island SC July 12-16, 2021.

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