“Choose a job you love, and you will never have to work a day in your life.” (Confucius)

Approximately one third of our lives is spent at work. Therefore, regardless of one's area of work, job satisfaction is essential for wellbeing and quality of life. Job satisfaction is the extent to which workers feel self-motivated and satisfied with their job, and results from a combination of various psychological, physiological and environmental factors. The core elements contributing to satisfaction and motivation at work are remuneration and working conditions, especially salary and a healthy workplace environment; work-life balance, which ensures that a worker can spend quality time with their family; respect and recognition in the workplace; job security; and challenges and career growth. The importance of job satisfaction can be seen not only from the employee's but also from the employer's perspective, as it results in increased efficiency, commitment, profits and retention.

As an example, a 2022 international ranking of the best workplaces revealed the top three to be DHL Express (transportation), Hilton (hospitality) and Cisco (information technology) (https://greatplacetowork.me/2022-worlds-best-workplaces/), while in Portugal, in a similar ranking, the top workplaces in 2022 were Cisco Portugal (information technology), AbbVie (research/pharmaceuticals) and Janssen Portugal (pharmaceuticals) (https://viveurope.com/best-workplaces-in-portugal/).

What about healthcare and doctors, especially cardiologists?

Among physicians, job satisfaction and motivation are important factors determining the quality and performance of healthcare and helping to avoid burnout. However, various factors can have a negative influence on physicians’ satisfaction, including inadequate remuneration, suboptimal working conditions, excessive administrative burden, difficulty in balancing work with family life, and long working hours.1 The COVID-19 pandemic created additional challenges for doctors already struggling with these problems, especially increased working hours and administrative tasks, which worsened their perception.2

Semedo et al. performed an online survey, the results of which are published in this issue of the Journal,3 on the work of medical members of the Portuguese Society of Cardiology (SPC), comparing the period before and during the COVID-19 pandemic, studying factors related to their job satisfaction, work motivation and burnout. Sector of activity was the only variable distinguishing the participants: cardiologists working in the private sector worked fewer weekly hours during the pandemic, while those in the public sector worked more and expressed greater desire to reduce their working hours, compared to those working in private medicine or in both sectors. There were no significant differences between sectors regarding work motivation, while job satisfaction was higher in the private sector. Moreover, job satisfaction negatively predicted burnout. The authors conclude that during the COVID-19 pandemic working conditions among cardiologists deteriorated, especially in the public sector, which may have contributed to lower levels of satisfaction, also reported by those working in both public and private sectors. Despite the small study sample and the low rate of response (only around 12%) among SPC members, these results are worthy of attention.

It is important to highlight that the study was performed during the COVID-19 pandemic, which increased emotional demands due to deterioration in working conditions, especially in the public sector. A follow-up of this sample or an additional study in the same population in the post-pandemic period would provide a broader perspective on this issue.

As shown in the present work as well as in previous studies, most physicians report lower satisfaction with their working conditions and would like to reduce their working hours, especially in the public sector.4,5 Interestingly, physicians working in both sectors (those with a greater number of working hours per week), reported less desire to reduce this number compared to those working only in the public sector. As the authors discussed in their paper, the better working conditions, better balance between effort and reward and higher income in the Portuguese private sector may explain this fact. Low satisfaction with sleep quality, anxiety, depression and lack of involvement in sports and other leisure activities were frequently reported and should also be taken into consideration. Hospital administrators and policy makers should therefore assess the effects of their rules, policies and procedures on physicians’ stress levels and quality of life and make efforts to implement strategies to improve working conditions that have a positive influence on health professionals’ job satisfaction. Such a strategy would have a greater impact in the public sector, positively influencing performance and work outcomes.

Nowadays, especially among young doctors, job satisfaction, quality of life and work-family balance are important factors to consider when making professional choices. It is not by chance that cardiology is not currently among the top choices of medical specialty in Portugal. Although I believe that cardiology remains the best specialty, the environment in which we work should not be a stressor; if it is, we will quickly go from being doctors to being patients. Being a cardiologist may be a real risk factor, but just as in cardiovascular disease, early detection and prevention can make all the difference, and we should all contribute.