Longevity Series-Finding My Why: A Doctor's Journey to Purpose and Its Impact on Health

Written By Adama Diarra, DO, FACP

By Adama Diarra, DO, FACP, Board Certified in Internal Medicine (American Board of Internal Medicine-ABIM)

Introduction: Rediscovering Purpose in Medicine

I embarked on my medical career driven by a genuine desire to help people. The gratification I experience when assisting a patient is profound and beyond words. Understanding my patients deeply to provide tailored care has always been a source of immense pride for me.

However, within the confines of a large healthcare system, I found myself constrained. Administrative burdens and time restrictions inherent in traditional primary care made it challenging to fully address my patients' health concerns. It was disheartening to ask patients to wait until the end of the day so I could devote more time to them—time that came at the expense of my family and colleagues.

I don't harbor resentment toward my former employer; I understand that the survival of most healthcare organizations hinges on reimbursement from insurance companies. This creates a complex ecosystem involving patients, healthcare providers, pharmaceutical companies, and insurers. Unfortunately, it often feels like a tug-of-war between these giants, with patients caught in the middle. Over the past decade, insurers have emerged as dominant players, focusing on profits, while hospital systems strive to stay afloat through efficient billing practices. This shift has led to less time for patient care and more emphasis on coding and documentation.

Confronted with the constraints of the traditional healthcare system, I found it increasingly difficult to justify working longer hours at the expense of my personal and family life, only to deliver care that felt compromised. The administrative burdens and time pressures inherent in the system often diverted my focus from patient care to navigating complex billing processes and insurance reimbursements. Recognizing that this environment was misaligned with my core values and commitment to patient-centered care, I made the pivotal decision to establish my own practice. This transition has allowed me to prioritize meaningful interactions with my patients, free from the encumbrances of excessive administrative tasks, and to practice medicine in a manner that truly reflects my dedication to their well-being.

This journey has reinforced the importance of purpose in my life. Research supports this connection; studies have shown that having a strong sense of purpose is associated with increased longevity and better health outcomes. For instance, a study published in JAMA Network Open found that individuals with a higher sense of purpose had a significantly lower risk of mortality. Similarly, the concept of Ikigai—a Japanese term meaning "a reason for being"—has been linked to longer, healthier lives in Okinawan populations.


The Power of Purpose in Longevity

A growing body of research underscores the profound impact of purpose on health and longevity. A study by Alimujiang et al. (2019) in JAMA Network Open found that individuals with a strong sense of purpose had a significantly lower risk of mortality compared to those without. This association remained even after accounting for other factors like age, gender, and health status. Purpose, it seems, acts as a protective factor, enhancing resilience and promoting healthier behaviors.

In cultures renowned for longevity, such as Okinawa, Japan, the concept of "Ikigai"—one's reason for being—is central. Residents often attribute their long, fulfilling lives to having a clear purpose, whether it's family, community engagement, or personal passions. This cultural emphasis on purpose aligns with findings from the Greater Good Science Center at UC Berkeley, which highlights that a sense of purpose may be more important to our longevity than life satisfaction.

Scientific Evidence Supporting the Link

Beyond the aforementioned studies, additional research supports the association between purpose in life and positive health outcomes:

  • Boyle et al. (2009): Published in Psychosomatic Medicine, this study demonstrated that a greater sense of purpose was linked to a lower risk of Alzheimer's disease and cognitive decline in older adults. 

  • Kim et al. (2013): In a study published in the Journal of Psychosomatic Research, researchers found that a higher purpose in life was associated with a reduced risk of stroke among older adults. 

  • Cohen et al. (2016): A meta-analysis published in Psychosomatic Medicine found that a high sense of purpose in life was associated with a 17% reduced risk of all-cause mortality and cardiovascular events. 

Addressing Critiques and Limitations

While the association between purpose and longevity is compelling, it's essential to consider potential limitations:

  • Causality vs. Correlation: Most studies are observational, making it challenging to establish a direct causal relationship. It's possible that individuals in better health are more likely to report a higher sense of purpose, rather than purpose leading to better health. 

  • Measurement Variability: Different studies use various tools and definitions to assess "purpose," which can lead to inconsistencies in findings. 

  • Cultural Differences: The concept of purpose or Ikigai may vary across cultures, affecting the generalizability of findings. 

  • Potential Confounding Factors: Other variables, such as social support, economic status, and education, might influence both an individual's sense of purpose and health outcomes. 

A study by Sias and Turtle (2022) in medRxiv suggests that the relationship between life purpose and mortality may be influenced by reverse causation, where poor health leads to a lower sense of purpose rather than the other way around. This highlights the need for further research to establish causality. 

While more research is needed to establish causality and understand underlying mechanisms, existing studies consistently show a positive association between a strong sense of purpose and improved health outcomes, including increased longevity. Recognizing and nurturing one's purpose could be a valuable component of strategies aimed at promoting healthy aging.

Discovering Your "Why"

Finding your purpose doesn't require grand gestures. It can be as simple as identifying activities that bring joy and meaning. Engaging in community service, pursuing hobbies, or nurturing relationships can all serve as avenues to a more purposeful life. 

Experts suggest reflecting on questions like:

  • What activities make me lose track of time?

  • What contributions do I want to make to others?

  • What legacy do I wish to leave behind? 

By exploring these questions, individuals can align daily actions with deeper values, fostering a sense of fulfillment that supports both mental and physical health.

Incorporating Purpose into Daily Life

Incorporating purpose into daily routines can be achieved through:

  • Mindfulness Practices: Regular meditation or journaling can help clarify intentions and values.

  • Goal Setting: Establishing short-term and long-term goals aligned with personal values provides direction and motivation.

  • Community Engagement: Participating in group activities or volunteer work fosters connection and a sense of contribution. 

Introducing "Dreamlining" for Personal Fulfillment

A concept that has profoundly influenced my journey is "dreamlining," introduced by Tim Ferriss in his book The 4-Hour Workweek. While originally designed for entrepreneurial pursuits, I've adapted dreamlining to focus on personal fulfillment. This approach involves identifying dreams across three categories: 

  • Having: Tangible experiences or possessions you desire.

  • Being: Skills or qualities you wish to develop.

  • Doing: Activities or experiences you want to engage in. 

For example, my dreamline included: The Blog of Author Tim Ferriss

  • Having: The experience of watching my favorite soccer team play in their home stadium in England.

  • Being: Conversationally fluent in Spanish within a year.

  • Doing: Training for and completing a half marathon; volunteering to coach youth soccer; helping a complete stranger in a meaningful way. 

These goals, while diverse, shared a common thread: they were unattainable within the constraints of my traditional primary care due to time and energy limitations. By embracing dreamlining, I was able to structure these aspirations into actionable steps with defined timelines, transforming them from distant wishes into achievable objectives. 

For instance, to learn Spanish, I enrolled in a local language course and dedicated 30 minutes daily to practice. Training for the half marathon involved a 12-week running plan, gradually increasing my endurance. Planning the trip to England required budgeting and coordinating schedules, but the anticipation added to the excitement. Volunteering as a soccer coach connected me with the community and allowed me to share my passion. Helping a stranger became a mindset, staying open to opportunities to make a positive impact.

By breaking down these dreams into manageable tasks and setting realistic timelines, dreamlining empowered me to pursue a more fulfilling life aligned with my values and passions.


Conclusion

Integrating a sense of purpose into daily life not only enriches personal well-being but also contributes to a longer, more satisfying journey. My own path back to purpose has demonstrated that aligning actions with deeper meaning fosters profound personal and professional fulfillment. This alignment enhances not just the quantity of life, measured in years, but also the quality, reflected in satisfaction and the absence of regret.​

The French phrase raison d'être, meaning "reason for being," encapsulates this concept beautifully. Without such a guiding purpose, one may merely exist rather than truly live. Embracing your raison d'être can transform existence into a life of intention and fulfillment.


References:

Alimujiang, A., Wiensch, A., Boss, J., Fleischer, N. L., Mondul, A. M., McLean, K., Mukherjee, B., & Pearce, C. L. (2019). Association between life purpose and mortality among US adults older than 50 years. JAMA Network Open, 2(5), e194270. https://doi.org/10.1001/jamanetworkopen.2019.4270 ResearchGate+2MDPI+2PubMed+2

Boyle, P. A., Buchman, A. S., Barnes, L. L., & Bennett, D. A. (2010). Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons. Archives of General Psychiatry, 67(3), 304–310. https://doi.org/10.1001/archgenpsychiatry.2009.208 PubMed Central

Cohen, R., Bavishi, C., & Rozanski, A. (2016). Purpose in life and its relationship to all-cause mortality and cardiovascular events: A meta-analysis. Psychosomatic Medicine, 78(2), 122–133. https://doi.org/10.1097/PSY.0000000000000274 Oxford Academic+2PubMed+2MIDUS - Midlife in the United States+2

Ferriss, T. (n.d.). Dreamline calculator by Tim Ferriss. Coda. https://coda.io/@atc/dreamline-calculator-by-tim-ferriss

Ferriss, T. (n.d.). Ideal lifestyle costing. The Blog of Author Tim Ferriss. https://tim.blog/lifestyle-costing/ A-Z Quotes+11The Blog of Author Tim Ferriss+11Seattle Anxiety Specialists+11

Kim, E. S., Sun, J. K., Park, N., & Peterson, C. (2013). Purpose in life and reduced incidence of stroke in older adults: 'The Health and Retirement Study'. Journal of Psychosomatic Research, 74(5), 427–432. https://doi.org/10.1016/j.jpsychores.2013.01.013 PubMed

Sias, R., & Turtle, H. J. (2022). Why does purpose in life predict mortality in older adults? medRxiv. https://doi.org/10.1101/2022.03.13.22272312

Sone, T., Nakaya, N., Ohmori, K., Shimazu, T., Higashiguchi, M., Kakizaki, M., Kikuchi, N., Kuriyama, S., & Tsuji, I. (2008). Sense of life worth living (ikigai) and mortality in Japan: Ohsaki study. Psychosomatic Medicine, 70(6), 709–715. https://doi.org/10.1097/PSY.0b013e31817e7e64 Fujita Health University+1CoLab+1

Suttie, J. (2024, November 20). To live longer, find your purpose in life. Greater Good Science Center. https://greatergood.berkeley.edu/article/item/to_live_longer_find_your_purpose_in_life

Smith, J. A. (2018, January 10). How to find your purpose in life. Greater Good Science Center. https://greatergood.berkeley.edu/article/item/how_to_find_your_purpose_in_life