Truly happy, yet non-brain dead...
Does such a critter exist?
One often gets the impression that physicians who are not deeply troubled by the current state of medicine are either in deep denial or are in collusion with bad care and general meanness. Lack of dissatisfaction often strikes me as polyannish.
Nonetheless, I think it's important to note that one can be reasonably happy as a physician. One can be happy or unhappy in most lines of work, in fact.
And yes, I have met happy doctors who are both nice and competent. It exists!
Is this specialty dependent? I've heard by now from physicians from practically every specialty and have yet to find one that is burnout-proof, largely due to administrative hassles and general disrespect rather than the practice of medicine itself. ER docs and FPs/IMs are obviously burnt out, but (surprisingly to me) so are plastic surgeons.
Is it character dependent? To a certain extent, yes. Some people are better at brushing aside trivialities, some take them to heart more, as they probably do most non-trivial things. The more you lean towards the latter, the more likely you are to be on the receiving end of unpleasantness in the healthcare industrial complex, as bullies sense your weakness and target you, thus creating a vicious cycle. The more oblivious you are, the more untouchable you become.
You can do some work here towards acknowledging who you are and accepting yourself. You could do a better job of avoiding hostile work places - but you must be purposeful about this, not just go 'wherever', only to be shocked over and over. And you might think more seriously about independent practice, as a kindness to yourself.
Is it dependent on specific circumstances?
Your life as you know it is made up of many factors big and small. One smallish but relatively unchangeable factor is your commute. You might live in a place you love and have a pleasant ten minute commute through tree lined streets. In your Tesla. The beach is five minutes in the other direction and you can go for a jog there most months of the year.
Or, you might be stuck in a place you despise and sit for hours every day in the "rush hour traffic" watching smoke stacks spew their pollutants over the concrete. The beach is several thousand miles away and so is the nearest mountain or tree. Plus, you're spending those hours in your non-Tesla car. Double or triple whammy.
The thing is, if you have some vague notion that things will change for the better, it might surprise you to realise that the beach will always be several thousand miles away. No trees will sprout in your path. This is the way it will stay.
It sounds absurd to say all that, but we have a tendency to live in a state of daydreaming. This includes some magical thinking about sudden improvements in traffic and the appearance of beaches, trees and mountains. If living near any of the above is important to you, you need to MOVE. The mountains won't come to you. Trees won't sprout magically along your commute. You need to go to them. You need to make this happen.
As far as the business of medicine goes, you might be a dull, mediocre doctor, possibly an uncaring one, yet what you offer is what people want, so: success. You might be the best doctor and human being in the entire known universe yet fail to sell your wares. Wrong time, wrong place, and the guy down the street takes insurance and gives out z-packs, opiates - and more!
Don't beat yourself up for not doing well, but see if you can find someone you consider both good and successful, not mediocre or z-packy, and see what aspects of their practice you can adopt. Willingness to take all referrals, and quickly? Maybe you should, maybe you shouldn't, but it's something to consider. Or maybe you should limit your practice to a specific niche? That might be what you really want to do. What's right for you? What will work in your market?
Bright cheery waiting room? Check. Little fountain spa thingies and real plants? Check. Quick responses by e-mail? Check if you're DPC. A wellness program for patients? Check, if you're into it.
Cash practice - some say it's easy. Don't believe them. They're not telling you the whole story. Some say its impossible. It might be impossible in certain geographic areas, but in general it's a lot more doable then the system would have you believe.
Much of your day to day happiness, and much of your success in your work life, boils down to small, concrete circumstances. If you analyze all these factors you can find some you can change. Other things, you might find a way to make peace with.
You can't have it all, but you can probably have more control than you currently have over your life. First, you need to be honest about your preferences and your abilities. You need to be honest with yourself about why you're stuck in a bad workplace. You need to not be deterred by those who say failure is assured, nor be shamed by those who claim insta-success.
Lastly, you really need to reserve yourself a Tesla*.
COI disclosure: None. *I have no affiliation with Tesla or any of its subsidiaries**, and am not paid by them.
**I'm not sure what 'subsidiaries' means but it's an important-sounding word so I stuck it there.