One way to understand the possibilities for solving the US health care crisis is to take a better look at how people make career decisions.

I have a lot of doctors in my family and lots of friends who are doctors, so I'm reasonably familiar with the careers of doctors, and I'm astounded that we're not talking about paying less for health care.

Why do doctors need to make so much money? The non-financial rewards for being a doctor are larger than almost any other profession. Except teaching.

There's a reason we pay an almost non-living wage to teachers: It's rewarding and meaningful and you do not need tons of schooling to do it.

So okay, there's a shortage of teachers, but not by a lot. Because the trend today is to do meaningful work and work with civic duty. Teach for America is one of the most popular choices for college grads. So the salaries can't be that out of whack for the job.

Also, the Institute for the Study of Labor says, “When teachers were offered cash rewards for good performance (measured by factors like grades and parental feedback) student scores on national exams significantly declined.” So I don't think paying more to people with meaningful work actually gets a more meaningful performance from them. Read more

I never watch American Idol, or other talent shows. I think I got my fill of them in the 1970s, watching year after year of the mind-numbing Miss American pageant. But there was too much hoop-la with Susan Boyle on Britain’s Got Talent, so I had to see what I was missing. I ended up watching her audition fifty times. Because every time I'm feeling slow or unmotivated or depressed, the clip cheers me up.

Last night she sang in the semi-finals, and what struck me most while watching her is how much we can learn about our own careers from watching Susan Boyle's. For example.

Everyone loves to be a shepherd of talent.

The act of finding a mentor is actually the act of showing someone you have talent and they can help you find it. It's very, very hard to land in the limelight on your own. So many studies of success — from Fortune 500 executives to startup entrepreneurs — all show that a key factor is finding people to help you navigate a system that requires many more skills than any one, single person could have.

If you ever wonder what you bring to someone who is mentoring you, look at the faces of the three judges when they realize (after four or five notes) that Susan is phenomenal. The joy on their faces is contagious. That's a big reason people like to watch that video clip: the moment when you see someone is very talented is so rewarding. It's a moment full of excitement and promise and you get to be a part of it because the person is asking you for help.

This is why mentoring is magical and electrifying to both sides. And seeing the moment on Britain's Got Talent reminds me that I should continuously seek out mentors and show them I perform well with the help they give me. Read more

The best way to get control of your career and stability in your life is to be great at what you do. Superstars are not out of work right now. Really. Even in finance. If you have an amazing track record in your field of work, you'll have a job. And if you need to change jobs, or adjust what you're doing, you'll be able to do it if you're great at what you do.

Here are five steps to follow:

1. Aim to be great at something that matters in the world.
The process of being great is long and hard. It requires you to try a lot of stuff to figure out the intersection of your gifts and what the world will pay for.

It's hard to be great at something you have to stop doing. But that's the reality you face if you are going to be a star performer. It's about self-discipline. When I was in graduate school, my writing professor was reviewing my writing, and he announced to the class, “She writes the best sex scenes I have ever read. Week after week she surprises me with her wry, funny, salacious approach.”

I had to look up the word salacious to make sure it was good.

Then I had to stop writing about sex. Because it was clear to me that being great at writing literary sex is too narrow. The greatness is so small it doesn't matter. Greatness needs context that has value.

2. Expect that being great will entail many levels of disappointment.
So I got a job in a marketing department in a Fortune 100 company where we spent lots of time talking about whether HTML accommodates a proper em dash. Read more

This is a guest post from Jamie Varon. She’s 23 years old. Her blog is called intersected.

Not too long ago, I started a new job, in which I moved my self from point A (college town) to point B (Bay Area). This was supposed to be my career launch. It took me about two weeks to admit to myself that I was unhappy. So I quit.

I had the security of knowing I could go back to my parents’ house to live. (Which, by the way, is such a good idea that 65% of new grads do it.) Here are five reasons why I am sure it was a smart decision to quit my job after just two weeks:

1. Your job performance will be terrible if you hate your job.

If you hate your job from the beginning, then you will never fully dedicate yourself. In fact, you’ll resent both the company and yourself for staying at a job that you knew you didn’t like early on.

I get it: You have this desire to prove to yourself that you are capable of sticking it out. Or you’re worried that this makes you a complete failure and you have given up. So what? You learn from your failure. You learn from that mistake. You’ll end up quitting at some point soon, so why draw it out? Read more

Here’s a post for all the people who are trying to be artists. It is not a friendly post. I do not think that people who want to create art need to get paid to do it. Do you get paid to have sex? No. Same thing. You love it, but you just do it after work. And sometimes, if you are driven mad by it, you leave work in the middle of the day for it.

Treat art the same way, and you will stay sane. Really. Here are five things I would nag you about if you were talking with me about your burgeoning career as an artist:

1. You cannot do art if you are starving.
The starving artist routine is total bullshit. I know because I did it. Once you know that you are not going to make rent, you can’t really make art. Because your sense of self-preservation insists that your brain focus on the possibility that you will be out on the street. Your brain cannot stop solving that problem long enough to solve the problem of what is truth and beauty.

Here are some things I did while I was becoming a writer: I ate only bagels because I didn’t have enough money for anything else and then I got anemic and had to go to the doctor but I didn’t have health insurance so I had to lie and say I did in order to get the iron pills I needed so that I didn’t pass out from exhaustion the moment I woke up in the morning. Believe me, I was not making great art during this period. Read more

A recession is typically a good time for graduate schools. Their application pool goes up because people see them as safe shelter from the storm. The scariest part of a down economy is the idea of having no income. Of course, graduate school does not solve for that. But graduate school does solve the second most scary thing about a bad economy: lack of a learning curve.

The more desperate you are for a job, the more likely you are to take a job that doesn’t teach you what you want to learn. And then you get to that job and you think, “Grad school could solve this problem.” But in fact, grad school creates larger, and more insurmountable problems. And some the problems you’re trying to solve with grad school might not be problems at all.

1. Grad school pointlessly delays adulthood.
The best thing you can do for yourself is take time to figure out who you are and where you fit in the world. No one teaches you that in school. You need to do it yourself. Grad school is a way to delay this process, rather than move you forward, according to Thomas Benton of the Chronicle of Higher Education. So instead of dodging tough questions by going back to school, try being lost. It’s normal, and honest, and you will end up with more self-knowledge and less debt than your grad-school counterparts, and in many cases, you will be similarly qualified for your next big job. Read more

There is no other way to figure out where you belong than to make time to do it and give yourself space to fail, give yourself time to be lost. If you think you have to get it right the first time, you won’t have the space really to investigate, and you’ll convince yourself that something is right when it’s not. And then you’ll have a quarterlife crisis when you realize that you lied to yourself so you could feel stable instead of investigating. Here's how to avoid that outcome.

1. Take time to figure out what you love to do.

When I graduated from college, I was shocked to find out that I just spent 18 years getting an education and the only jobs offered to me sucked. Everything was some version of creating a new filing system for someone who is important.

Often bad situations bring on our most creative solutions. And this was one of those times: I asked myself, “What do I want to do most in the world, if I could do anything?” I decided it was to play volleyball, so I went to Los Angeles to figure out how to play on the professional beach circuit. Read more

At its core, meaningful work is helping people. But that makes you think you need to save children dying in Africa. But, really, you can push papers for multinational conglomerates and feel like you’re doing good for the world. Here’s how:

1. Take care of yourself—have the basics covered.
The most important thing about making meaningful work is that if you are always worried about paying rent, it’s very hard to add goodness back to the rest of the world. Giving back to the world requires a sense of personal well-being and stability that only people who have a roof over their head can manage.

Back when I was doing what most of you would call meaningful work, I was totally preoccupied with budgeting my meager salary to make sure I didn’t run out of money at the end of the month. At the end of that stint, when I landed in the hospital for a kidney infection, it turned out I was severely anemic, and I’m sure it was because I had such a poor diet from making so little money.

So before you worry about meaningful work, you need to be able to support yourself. Your first job in life is to figure out how to do that. It takes a while. You actually have to figure out what you are good at and what you like doing. This doesn’t mean you have to dedicate your life to that work. But it means that you are learning and growing, and someone values the level of skill you have to pay you a wage with which you can support yourself, and others you might need to support.

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The market crash is going to mean a new era of banking, but it is also bringing along with it a few new ideas about how to manage one’s career. This is not the first sector to experience catastrophe, but it might be the wealthiest one. And we can all learn a little about managing our careers from watching what happens with the super-rich.

1. Use the downturn to figure out where you stand.
Wall Street ticks with rainmakers and math geniuses. Usually these guys (almost always guys) are tough to come by. Everyone wants them, everyone knows where they are and where they are going, and they are so powerful that they usually come and go in teams. So you can probably guess that recruiting this talent is extremely difficult.

I have a friend who specializes in headhunting finance talent, and he reports that it is unprecedented that these guys would all be fired, flailing individually, and available to the next taker. So in this downswing, where investment banking layoffs are fast and furious, the management at the places that can still hire finance talent (true banks, and other corporations that have so much money that they could be a bank, like GE or Harvard University) are finally enjoying a buyer’s market.

My friend’s phone is ringing all day with hiring managers scared that they’re missing out on a shopping binge, all of them simmering in a sick feeling that their competitors might be getting a good deal this week.

There’s a saying on the trading floor that up or down doesn’t matter, because as long as there is volatility, you can make money. And it turns out that this is true of recruiting, too.

So, if your sector is tanking, test your star power. There will be a feeding frenzy for top-talent. Learn where you stand by calling a headhunter. If he or she will work with you, you have star power, or at least you’re at the top of your game.

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You can tell if you are avoiding personal growth in your career because you are not feeling challenged. You can tell if you are not feeling challenged if you are not scared. Being scared is what makes life interesting. You should be scared that you are going to fail at something because if you are not then you are not trying hard to do something difficult.

Most people think they are challenging themselves, but most people are avoiding personal growth on some level. There are many paths to personal-growth avoidance. Here are five ways people do it in their career.

1. You aim to be a generalist.
The best way to see what you're great at is to specialize. Pick a type of work that suits your personality, then pick a field that is a specialty within that. Usually you will pick wrong. So what? Keep trying. When I was trying to figure out what I was great at, I wrote a lame novel, I pitched stupid articles to Marie Claire and I got dumped as a feature writer for an alternative Weekly. This is how I learned that I should be writing career advice. The process of becoming a specialist is finding out what makes you special. How could you not want to know that?

2. You are consumed with getting a book deal.
Ninety percent of you do not need a book deal. What are you going to do with that? A book will not make you rich. It will probably drive you nuts because a book is very hard to write. If you have so many good ideas, put them in blog posts. The ideas get out faster and you get more feedback. A book is good to promote something. But you need to know what you're promoting. Maybe a company, maybe a project, maybe you want to build a community. But in most cases, a book is not the most time-effective way to meet that goal. So in fact, people who are focusing on the need to get a book deal are avoiding figuring out what they really want. A book is a means to an end, not an end. Uncovering your real goals is what personal development is about.

3. You have never had a long-term relationship.
If you have never been in a relationship for more than nine months, then you have not let anyone really see you. Nine months is how long it takes for that crazy, being in love feeling to wear off. (There should be a link here, but it would be to my therapist, who told me in last week's session.) So after getting through nine months the clouds dissipate and you start to see your true self reflected back to you from someone who knows you well. Before that, it's pretty easy to cover up your true self. You can manage personal development much more effectively if you are looking at yourself through someone else's eyes. It always feels different because you can't hide from the stuff that you wish would go away.

4. You lack strong opinions.
The only thing you get to do in this world is choose what a good life is and then aim for it. But that requires being opinionated. Every day you are choosing what's a good life for you. If you are scared to have opinions because you're scared of being wrong, then how are you making choices? If you can't think of stuff you have strong opinions on, you are probably living someone else's vision for a good life. Not your own. Being wrong is way better than not having opinions. At least if you're wrong you are trying.

5. You think career advice is stupid.
We read the most about stuff we know the most about. It's not optimal, but it's how we are. Do you read about how to make tutus from materials other than tulle? See? That's my point. It may be an interesting topic, if you knew anything to start with. So it's a good bet that the people who read career advice are very consciously navigating their personal development through their career. And people who think it's stupid to read career advice are ignoring the fact that adult life is about getting smarter and smarter answers to the question: What should I be doing?