John Changes the Question
A few weeks ago, I introduced you to John, a fictional physician whose story reflects common themes many physicians wrestle with. He’s a mid-career family physician facing a career dilemma I hear often:
“I’ve never stayed in one job more than x number of years. I feel I need to leave my current one, and I think that means something is wrong with me.”
Rather than telling one linear story, we’re exploring different ways John might sort through the same challenge.
In one version, he recognized the story he was telling himself and how it was shaping his emotions, behaviors, and decisions.
In another, he stepped back as the compassionate, objective observer and looked for patterns, blind spots, and lessons with more self-awareness and less self-criticism.
In another, he learned to have his own back. Difficult discoveries about jobs were not proof he couldn’t trust himself. New information was just that: new information.
This week, John explores something different.
What happens when we stop asking how to escape and start asking what we want to move toward?
His coach walked him through the 5 D’s of Appreciative Inquiry:
Define the affirmative topic
John defined the topic of the day of getting out of this cycle of wanting to leave jobs.
The coach reframed it to more affirmative language - “Maybe you're wanting to consider how to reconnect with meaning and sustainability in your work?” Actually, yes.
Discover The coach focused on the positive moments and stories.
“What parts of medicine still feel meaningful?”
“Long-term patient relationships,” John said. “Complex problem-solving, teaching....being there through hard seasons of my patients..."
“What strengths are you using in those moments?”
“Listening, connecting, clinical judgment, and helping people make sense of hard things. Also to know what to expect”
“What would you genuinely miss if you left?”
John sat quietly. “Actually, a lot.”
Dream The coach asked him to create a vision of a preferred future
“If medicine fit your life and values better in this season, what would look different?”
“More continuity, maybe some teaching, more time for complex thinking, less feeling like I’m in a sprint all day.”
Design The coach asked him to think through innovative ways to move toward the dream.
What steps would need to be taken in your current role to move an inch toward that dream?
What would parts of your role would you want to shift, if any? How would that be possible?
How could you protect more time for meaningful work? What would be required of the organization, the team, and yourself, to move toward that?
Destiny Experiment with the first steps and make changes iteratively.
Several weeks later, John had started to make some progress in small areas to reclaim time. He was also spending less energy trying to escape. More energy getting clear. Using his small amount of agency to move toward the parts of medicine he valued most.
John realized something many physicians discover over time: meaningful work is not frustration-free work. He was beginning to recognize which work was worth enduring and navigating its challenges.
Maybe he stayed. Maybe he adjusted pieces of his current role. Maybe he moved toward something new.
But increasingly, his decisions came more from clarity and intention. He was no longer simply running from discomfort. He was moving toward what mattered.
Reflection:
John changed his question from: "How do I get out?" to "What do I want to move toward?"
- What question are you currently asking yourself about your work? Is there a better question worth asking?
- What would you genuinely miss if your current role disappeared?
- What parts of your work would you want more of?
- What small amount of agency do you have to move an inch toward that?
Responses