In one of my first blog posts, Physician: Know thy ikigai? Then Know thy Twitter, I introduced the concept of ikigai..

It can be modeled, roughly, as the confluence of what you love to do, what you have the ability to dowhat the world needs,  and what the world will pay for.

Bill Gates, at a fairly young age, had a clear vision of his personal ikigai: creating software which puts the computer on everyone’s desk in the world.

Although his definition of desks and PCs expanded to include such things as the Internet and mobile devices,  for many years his ikigai remained in place.

The result?   The creation of the powerhouse Microsoft and his own personal wealth.

However in June 2006, less than  a decade after the formation of Bill and Melinda Gates Foundation, Bill Gates exited from Microsoft, actively and radically changing his ikigai: now one focused on the world health, particularly that of children.

Here’s my point.

As a doctor reading this right now, there is a strong chance that in your early 20s you had a very clear ikigai.

It’s likely you had a passion for medicine or some other aspect of healthcare. You had the ability, in terms of both natural intelligence and discipline, to pursue a career in medicine. And finally,  the world certainly needed and compensated good doctors.

Ikigai complete.

However, now – 5, 10 or 20 years later – you may find new a ikigai pulling you forward.

This new ikigai is one your 21 year-old self couldn’t have understood or formulated,  because it wasn’t informed by the human experience of the thousands of patients you may have seen and treated. 

Unfortunately it is pulling against resistance.  You have invested much time and effort in your 21 year-old’s ikigai,  It is difficult to change, to take that leap.

So what’s my advice to all of you physicians out there existing in a tug-of-war between the ikigai of old and the ikigai of today?

Take half an hour, and think like Bill Gates.

If you have a new, clearly defined ikigai, then take the leap.

You only live once. so if you are fortunate in this life to have two ikigais, then embrace it.  

Bill Gates did.