Creating Action Steps for Process Goals

In a previous article I explained the difference between outcome goals and process goals. Simply put, outcome goals are the big results you want to achieve. And process goals are the small and meaningful steps you take to achieve those larger goals. These are the actions and behaviors that are within your control.

Process goals are typically SMART goals. That means that they are

• Specific

• Measurable,

• Achievable

• Relevant

• Time-bound

So how do you get started with creating your own process goals? In this article, I’ll walk you through the process. As the Chinese philosopher Lao Tzu said, “The journey of a thousand miles begins with one step.” Think of each process goal as one of those single steps.

The template I outline below is a great place to begin. Set a timer for 15 minutes, 30 minutes or an hour, and just start writing. By the time the timer stops, you’ll have created something that you can build on.

Getting Started with Process Goals

1. Get a Notebook: An analogue, hand-written journal tends to work best. That way it doesn’t get lost in the ether of your computer and your on-line life.

 2. Define Your Outcome Goal: Start with a clear understanding of what it is you want to achieve, but be comfortable with the idea that this goal might change. Your outcome goal will guide your process goals and ensure they align with your overall objective.

 3. Break It Down: Identify the smallest and most specific actions that will get you closer to your goal. These should be easily defined and actionable steps that you can incorporate into your daily or weekly routine.

 4. Make it SMART: Ensure your process goals are Specific, Measurable, Achievable, Relevant, and Time-bound. This framework will help you stay focused and track your progress.

 5. Monitor, Reflect, and Adjust:  Review and update your notebook daily. Check off your small process goals as you achieve them, and reflect on the direction you are heading. Be open to making adjustments as needed to either stay on track or to change course.

6. Bonus Step: Create Weekly, Monthly, One Year, Three Year, and Five Year Goals. Write these down in your notebook and refer to them on a specific day every week. These larger outcome goals will often change over time, but they will help you to stay aligned with what matters most to you.

If this all seems a little theoretical, here’s an example of how this process might look.

Outcome Goal: Find a New Job

Process Goals:

• Clarify your values.

• With your values in mind, create a list of 3-5 things that matter most to you when thinking about your ideal job.

• Update your CV and LinkedIn profile to reflect your skills, experiences, interests, and values.

• Decide if there are new skills you’d need for your dream job and create a process goal plan to acquire them.

• Create a list of 3-5 places you’d like to live.

• Contact 3 colleagues in your field who might be able to help you.

• Research and attend relevant events in your specialty over the next 3-6 months to learn about opportunities and meet people who may be interested in working with you.

• Research and identify potential medical practices or institutions that align with your values and professional goals.

  • Identify people who are decision makers for the practice.

  • Check LinkedIn to see if you have any colleagues in common.

  • If so, can you be introduced? An email to your colleague can help get the wheels in motion.

  • If not, send a well-crafted email or direct message, or make a phone call to someone in the practice who might be in a position to invite you for an interview.

• Prepare for interviews by creating your personal elevator pitch

• Develop a list of potential questions you might be asked in an interview, and create a set of answers.

• Practice for interviews with a friend or coach.

Focusing on process goals rather than outcome goals can be transformative. By taking control of the actions within your reach, you’ll create a sustainable path to your own success, reduce stress, and live a life that aligns with your values and your ambitions. You’ll be able to overcome the inertia that might be holding you back, and you’re likely to find some surprises and unexpected opportunities along the way.

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

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My Podcast Interview with Mastek’s Ritwik Batabyal

I enjoyed this conversation with Mastek's Ritwik Batabyal and David Sanchez, RN. It was a great reminder of how integral sophisticated behind-the-scenes technology is to providing optimal health care.

Rightfully, there is a lot of trepidation around the use of AI in healthcare and health technology, but the truth is that it’s already here. By understanding and optimizing the ways that we as physicians use AI, we will ensure that we have a say in the way it changes our landscape and the ways that care is delivered.

Perfectionism, Procrastination, and Fear of Failure

An earlier version of this article originally appeared on Doximity.com in December 2022, where I served as an Op-Med Fellow from 2022-2023.

You probably didn’t become a physician without a healthy dose of perfectionism. From preschool through residency and beyond, many of us have survived, thrived, and been rewarded for our perfectionist tendencies. And when you didn’t hit the mark? You may have felt the sting of your parents’ and teachers’ disappointment. Eventually, you may have learned to define yourself by your perfectionism.

Perfectionism seems to be on the rise, especially among people born in the 1980s and later. Those on the outside may mean well when they assure us that perfectionism is an impossible goal, but the truth is that perfectionism is a prized attribute in our profession. Our patients appreciate it as well. After all, who wants a doctor who is willing to just scrape by?

Paradoxically, perfectionism can keep you from doing your best work. It can also hold you back from living your best life. In this article, I’ll talk about how perfectionism and self criticism often go hand in hand with procrastination. And I’ll give you a few actionable steps that can help you to overcome the self-imposed inertia that perfectionism often creates.

Perfectionism, Procrastination, and Imposter Syndrome

It’s not surprising that perfectionists often suffer from impostor syndrome. If you’re a perfectionist, you may fear that you are simply not good enough and that you will eventually be exposed for all to see. And in fearing that you are not going to meet the high standards you set for yourself, you may subconsciously find ways to procrastinate as a means of avoiding that discomfort.

When you fall prey to imposter syndrome, you may overlook or give up opportunities for growth that could lead you to a more rewarding and exciting professional path. Learning new skills, taking on a leadership role, and discovering a position that is more aligned with your values may all fall by the wayside.

And when you’re uncomfortable with embracing a beginner’s mindset, you may find yourself reluctant to take up hobbies or endeavors that might enrich your life and create new connections.

Perfectionism, Procrastination, and Fear of Success

Another factor holding perfectionist physicians back is, perhaps counter-intuitively, a fear of success. This often arises from fear of change and the unknown. The end result may be the same: procrastination and a failure to act in your own best interests.

Fear of failing to meet your highest standards often manifests in such mundane activities as uncompleted charts, unanswered messages, and unopened emails. This compounds the problem, and can create enormous stress, not to mention nasty messages from administration.

Breaking the Cycle of Procrastination

If you’re having a hard time getting started on a task, big or small, don’t beat yourself up. Chastising yourself for feeling overwhelmed and disorganized may only make the procrastination problem worse by confirming your fear of inadequacy and filling you with anxiety. And thus, the problem comes full circle.

To break the cycle of fear, frustration, and despair, it’s important to recognize that procrastination does not mean that you are incapable or irresponsible. And let’s establish right now that as a busy and caring physician, you are certainly not lazy.

So how can you harness your perfectionism? The key is to focus that superpower on providing excellent patient care. Sometimes that also means treatment plans, operative notes and imaging reports. These are things that truly make a difference, and that people are depending on you to complete. They don’t have to be works of art, but they need to be complete and correct.

Often it’s the non-clinical commitments, stacks of insurance paperwork, and lingering home projects that drain your mental energy. If no one’s life or livelihood depends on it being perfect, allow yourself a little grace. Realize that for many of your routine tasks, perfection is not worth the effort and may not even be possible. For many of these, good and done is good enough. Other times, it might be most efficient to simply delegate. And sometimes, when it’s appropriate, you just have to say no.

Below, I share some practical tips for tackling a handful of competing priorities and getting stuff done.

1. Medical documentation

We’ll address the elephant in the room first: your medical charts. As charts start to pile up and paperwork is left unfinished, your anxiety levels may rise, and you may find yourself in a spiral of regret and self-flagellation. If you have a system that works for you, kudos and keep it up.

But for the many physicians for whom the EHR and report generation are a major source of stress and procrastination anxiety, it’s important to get a handle on this beast as early as possible in your medical career. Just get the charts and notes done, either immediately during or after the visit (my preference) or at the end of the session.

The fewer times you have to return to a document, the more focused and efficient you will be.

Yes, the notes need to be succinct, truthful, and useful. And personally, I always found that including a brief personal observation reminded me of the issues that were meaningful to my patients when we met the next time. But your notes do not have to be perfectly crafted works of literature. Punctuation, spelling, even virtual voice transcription errors that don’t change the meaning of the sentence can often be safely overlooked.

Consider using “smart phrases” — text blocks that you use frequently that can be automated through your EHR system — as much as possible when appropriate. Look into using an AI assistant for history taking, if you can assure accuracy. The point is not to be sloppy or incomplete, but to include the pertinent details that assure great patient care and communication as efficiently as possible.

To avoid a horrendous backlog, create a block of time once or twice each day to get patient communication, testing review, insurance, and other paperwork done. This is known as task batching. Do it consistently every day (perhaps using the Pomodoro method), and even though you may not finish everything all at once, you’ll have a process for getting it done. Once you start seeing the results of your efforts, your feeling of self-efficacy will increase.

Let your staff know that you will be working on these tasks within these blocks of time. That way you can set expectations and encourage them to direct pertinent issues to you at a time that works best for you. Ultimately, this may create a clearer sense of work flow within the practice and enhance your teamwork.

2. Professional Commitments

When it comes to committees, research, and other professional commitments, take a good long look at what you’ve signed up for. Be sure that the work is meaningful and actionable for you.

Sometimes taking on more responsibilities is the right thing for your professional growth or your career trajectory. If so, it’s important to stay committed. Procrastinating on these commitments can have a seriously negative impact on your future opportunities.

Consider working with an accountability partner who is on the same committee or working on the same project. You can keep each other on task with quick check-ins by text. Simply committing to a plan can often get you halfway there.

But if you find that you just have a hard time saying no, then it’s time to reassess. As writer and time management guru Oliver Burkeman so aptly puts it, if we’re lucky, we only have Four Thousand Weeks. That means that time is a fixed resource. When you say yes to something, you are saying no to something else.

If your commitments exceed your capacity, you will never get everything done. Choose wisely. And remember that saying no doesn’t mean never or not at all. Is there a way to stay involved with something meaningful without diving all the way in?

3. Your Personal Life

Having a life outside of the clinic or hospital helps you to decompress, stretches your brain, and keeps you connected to the outside world. When it comes to family and close friends, your time and attention matter. And of course regular exercise is critical for just about every aspect of your health.

Unlike taking care of patients, the bar is fairly low. Usually no one is depending on you to be the best. Just being present and engaged is often enough. For your home projects, exercise, and other extracurriculars, consider using a Bullet Journal or other daily log.

Experiment with using a real notebook rather than an app. Not only does writing something down tend to create more solid memory retention, it’s easy for virtual to-do lists to disappear into the ether of the internet, never to be seen again. Most importantly, choose what works best for you, and be consistent.

To get started with something new, commit to just five to 10 minutes a few times a week, or set up an introductory lesson for something that interests you. You’ll be surprised how much you can do, and it may motivate you to keep going. If you’re not perfect, all the better. You’ll learn and grow and maybe even find new life passions.

Procrastination and Self Compassion

If you’re a chronic procrastinator, developing self-compassion is important. But being kind to yourself doesn’t mean you can ignore the pressing problems that procrastination has created. That will only add to your stress, and create more trouble in the long run.

When you put off completing charts or making calls, procrastinating can also hurt your patients and your practice. In the worst cases, medical care may be delayed and important notifications missed, with possibly serious ramifications for the people who depend on you.

If the load feels overwhelming, realize that procrastination-born perfectionism can lead to important mental health conditions including depression, anxiety, and eating disorders. Get help from a mental health professional if you need it. And if you are questioning your efforts, your direction, or experiencing burnout, consider meeting with a physician coach.

Remember: your perfectionism is one of your superpowers as a physician. You have high standards, you solve tough problems, and you keep people safe. Leverage this, cherish it, but don’t let it take you down the road of procrastination.

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Mapping Out Your Future: The Power of Process Goals Over Outcome Goals

If you’re a doctor, you’re used to reaching goals. But often those goals are ones that have been chosen for you, or that follow a well-worn template. When it comes to creating and achieving your own personal and meaningful goals, it’s common to feel stuck and uncertain how to move forward with purpose. That’s where process goals come into play.

When the future you envision seems unattainable, it’s possible that the type of goal you’ve chosen is the sticking point. Whether it's landing a new job or position, getting control of your time and energy, achieving a financial milestone, or even taking a dream vacation, the focus is often on the end result. And that can sometimes feel like a heavy lift.

To be clear, it’s important to have an end in mind. However, what if I told you that shifting your focus from the outcome to the process could be the key to your success?

In this article I’ll show you the difference between outcome goals and process goals. I’ll give you some easy-to-understand examples of how this can work for you. And I’ll give you some steps that you can start working on today.

Understanding Outcome Goals vs. Process Goals

Outcome goals are the big results you want to achieve. While these goals provide direction and motivation, they are often beyond your direct control due to a variety of external factors. These might include outside competition, unexpected obstacles, lack of time, and your other obligations. Sometimes the problem is simply a lack of specificity.

Process goals are the steps you take to achieve your outcome goals. They focus on the actions and behaviors that are well within your control.

Process goals are:

• Shorter term (usually less than a week)

• Concrete and realistic       

• Very specific

• Trackable and measurable

• Modifiable

• In alignment with your values

In short, process goals are often SMART goals. For instance, a process goal might be to exercise for 30 minutes a day, enroll in a leadership development course, send one email to request a letter of recommendation weekly for three weeks, or practice the guitar for an hour each week.

When you focus on process goals, you maintain control over your progress, making adjustments as needed, without the pressure of an immediate big and important outcome.

Process goals lead towards an outcome, even though that outcome is not always guaranteed. This is the way you break down a goal that seems unattainable or even audacious and create your own roadmap. In truth, you may not get where you expect to go, but you’ll get somewhere. And you’ll open up more possibilities along the way. Sometimes those other possibilities become the new outcome goal.

The Benefits of Focusing on Process Goals

1. Consistency and Habits: Process goals encourage you to develop consistent habits. By committing to daily or weekly actions, no matter how small, you’ll build a routine that supports long-term progress.

2. Flexibility: Unlike outcome goals, which can be rigid and unforgiving, process goals allow for flexibility. If one approach isn't working, you can modify your actions without feeling like you've failed. Changing direction is a normal and exciting part of the process goal method. By creating small process steps, you’re allowing yourself to experiment with small stakes outcomes.

3. Reduced Stress: Shifting your focus from the end result to the journey reduces stress and anxiety. You’ll become more engaged in the present moment, finding a sense of satisfaction in the process itself. And you’ll feel more in control.

4. Enhanced Motivation: Achieving small, manageable goals boosts your motivation and confidence. You’ll be able to track your accomplishments as they happen. Each step forward serves to reinforce your commitment and gradually drive more progress. Sometimes this is referred to as a “fly wheel”. It may take some effort to get the process rolling, but eventually you’ll gain momentum and achieving your goals will become easier.

For more about SMART goals, check out my recent article here. To learn more about how to create action steps to achieve your process goals, see this article. In addition to providing a template to help you get started, the article gives you a practical breakdown of the way this process might work for someone who is seeking a new job or position.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

TechLink Health Podcast on Heart Smart Mindfulness

I often host the TechLink Health podcast, a show devoted to exploring the gamut of new technologies and innovations in health care. I began this journey as a guest on the podcast in 2022. The interview went so well that I was subsequently invited to host.

It’s been a lot of fun, and I always learn so much from our guests. My experience is a great example of what can happen when you take chances and say yes to opportunities that align with your purpose, even when you don’t know exactly what will happen next.

This week I’m re-sharing my first episode. The conversation ranges from insights on maintaining heart health with a busy lifestyle to the role of mindfulness on outcomes in healthcare, and the importance of addressing issues that lead to burnout in physicians and others. We also discussed the ways a creative practice can help physicians and others in healthcare.

If you’re interested in accessing some of the resources we discussed, I’ve linked to them below.

📗 The Bullet Journal Method

📙 Real Change

📲 Insight Timer: The #1 free app for sleep, anxiety and stress

📲 The Waking Up App

📲 Headspace

📲 Calm

📲 Yoga: Down Dog

A version of this article originally appeared on this website in November, 2022

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Define Your Values to Create Your Ideal Life a Physician

Your values are integral to your identity. They are a very personal and multifaceted set of foundational qualities that have the power to provide a guiding light, leading you towards a life that feels in harmony with your true and ideal self. While they are a fundamental aspect of the complex person that you are, external pressures, social circumstances, and even inertia mean that it’s common to live out of sync with your values. But once you give your values a name, the way forward becomes far more clear.

Most of the time we can distill our core values into a set of five or six concepts that give our life meaning and purpose. In this article I’ll guide you through a simple exercise that can help you to get clarity on your own values. From there, you may begin to see patterns of alignment, or perhaps misalignment, in your life.

Through this process of awareness, you’ll find that your decisions become more clear. You’ll begin to feel the confidence to say “yes” to the opportunities that serve your higher purpose. You’ll find a way to energetically reach towards the next foothold, even when it’s challenging. And you’ll feel more certain when you say “no” to those choices that are not the right fit.

First, Define Your Values

The first step is to define your values. This might seem a little contrived, because you may feel as if you know yourself well enough to understand what matters to you. But putting a name to your values, and seeing them written out in black and white, can be surprisingly enlightening. For the purposes of this exercise, a value is a single word that encompasses an idea or belief in a certain way of being in the world. I’ve created a list of values for you to get started with. You can find them here.

Go through the list and circle the values that speak most strongly to you. Don’t overthink it. Your values may change over time, and that’s completely normal. There are no right or wrong, or good or bad, answers.

Once you have circled your top values, write them out. Take a good look at what you have written and see if you can narrow them down into five groups. From there, discover what themes emerge. These are your core values.

Next, Put Your Values into Action

Now, thinking about your core values, consider how you might choose to elevate these values in your daily life. Don’t try to make sweeping changes. Instead, think of small actions or choices that might more completely align your values with your life.

If there is a big disconnect between your values and your life, it might be time to reconsider your path. It is often challenging to get a handle on these ideas and put them into practice. If so, a physician coach can be a great ally. Through coaching, you will generate greater self-awareness and discover options and opportunities that more completely align with your unique set of values.

If you’re not ready for coaching, but want some clarity, consider downloading my free Values Workbook. It’s free when you sign up for my newsletter.

An earlier version of this article appeared on this website in January , 2023.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Setting SMART Goals: A Guide for Physicians

If you’re a physician, you’re no stranger to goal setting. You wouldn’t have gotten to where you are now without setting some very specific and actionable goals.

But once you’ve made it through your training, landed a position in your specialty, and begun the process of living your own life, your goal setting muscle may have atrophied a little. What’s more, no matter where you are now and where you might want to be in the future, there’s no longer a prescribed set of steps to get you there.

If you seek growth or change, creating the map is up to you. Unlike the well-worn trail you may have followed in the past, the direction you will take is based on your own unique talents, interests, and visions. As Joseph Campbell warned, in his book The Power of Myth, “If the path before you is clear, you're probably on someone else's.” And starting this adventure begins with setting goals.

Choosing, planning, and carrying out your own goals can feel daunting. Whether professional, financial, personal, physical, or even spiritual, it can all seem like a lot. Where to start? And what can you expect along the way? As with so many other life skills, it’s likely that no one ever taught you how to set goals.

Fortunately, there’s a template that you can follow that breaks the goal-setting process down into clear and accessible parts. Innovators and movers in the business world have been using this tool for years, and it’s something that can work for physicians as well. In this article, I’ll walk you through the process of setting SMART goals that matter to you.

Defining and setting your goals will pave the way for your ultimate success. For instance, a study of medical students undergoing a surgical clerkship found that those who set clear and specific skill-related goals were more likely to get the outcomes they desired than those who just hoped for the best.  And goal setting may also reduce your cognitive load, meaning that you have exert less mental effort to get the work done.

Writing out your goals by hand is more likely to ensure that you stick to the process compared to typing them into a document or entering them into an app.

Give yourself an uninterrupted stretch of time to really think through the goals that you want to set, and the outcomes you hope to achieve. And then map it out using the SMART template. You may be surprised by what you’re able to achieve, and by what you discover about yourself along the way.

Specific

Get as specific as possible about your goal. As author Jack Canfield puts it, “vague goals produce vague results.”   Define your goal clearly and succinctly. It should be something that you can describe in one to two sentences.  

To make it clearer and more engaging, phrase your goal in positive terminology.  This has the added benefit of making it more likely that you’ll get it done. For example, instead of deciding you want to get out of an unhappy work environment, you might reframe this to a desire to get into a more fulfilling position.

Measurable

You should be able to objectively track your progress, whether that’s a checklist, a habit tracker, a set of numbers, or anything else that gives you a way to measure your efforts towards the goal.

Achievable

Choosing a realistic goal that is within your control is important, since you want to set yourself up for success. Choose a goal that requires a moderate stretch, but that you know is achievable.

The magic of the process is that once you reach that goal, other possibilities that are currently out of reach may open up. In the words of writer Joseph Campbell, “Follow your bliss and the universe will open doors for you where there were only walls.”

Relevant

Get in touch with your core values and ask yourself how this goal aligns with your personal vision. The goal should matter to you, not just to your friends, family, or administrators. It’s great if the goal will make everyone happy, but if it’s not your own, you’ll be less likely to commit to it.

Time-Bound

Unless you set a deadline, or a series of deadlines, you may find it hard to get started. That’s just human nature. When you set and commit to a target date, you’ll be more likely to bring your goal to fruition.

Once you’ve identified your goal, break it down into “micro goals” that you can complete within a very short period of time. This progress of completing will help propel you forward, keeping the momentum going.

Don’t forget to celebrate your wins, even the small ones. Calling a friend, going out for dinner, savoring a cookie, listening to music, or even taking a walk are all ways to honor the effort that you’re putting into the process.

Goal setting is naturally tied to effective use of your time. Looking at a big goal can seem daunting, but simply devoting ten to fifteen minutes several days per week can move you forward.

If you struggle with time management, I have a number of articles available on the website that may be helpful. They focus on issues that are specifically relevant to physicians and medical practice. If you’re looking for more guidance, my Four Week Focus Shift course is a self-guided way to find focus for the goals that matter. I also offer 3 and 6 month Time Management coaching packages for physicians.

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

References

Campbell, J., & Moyers, B. (2011). The Power of Myth. Anchor.

Doran, G.T. (1981) There’s a SMART Way to Write Management’s Goals and Objectives. Journal of Management Review, 70, 35-36.

Etkin, J. (2019). Time in relation to goals. Current Opinion in Psychology, 26, 32–36. https://doi.org/10.1016/j.copsyc.2018.04.013

Gardner, A. K., Diesen, D. L., Hogg, D. C., & Huerta, S. (2016). The impact of goal setting and goal orientation on performance during a clerkship surgical skills training program. ˜the œAmerican Journal of Surgery, 211(2), 321–325. https://doi.org/10.1016/j.amjsurg.2015.07.028

Locke, Edwin & Latham, Gary. (2002). Building a Practically Useful Theory of Goal Setting and Task Motivation: A 35Year Odyssey. American Psychologist. 57. 705-717. 10.1037/0003-066X.57.9.705.

Nebel, S., Schneider, S., Schledjewski, J., & Rey, G. D. (2016). Goal-Setting in educational video games. Simulation & Gaming, 48(1), 98–130. https://doi.org/10.1177/1046878116680869

Oscarsson M, Carlbring P, Andersson G, Rozental A. A large-scale experiment on New Year's resolutions: Approach-oriented goals are more successful than avoidance-oriented goals. PLoS One. 2020 Dec 9;15(12):e0234097. doi: 10.1371/journal.pone.0234097. PMID: 33296385; PMCID: PMC7725288.

Van Der Weel, F. R., & Van Der Meer, A. L. H. (2024). Handwriting but not typewriting leads to widespread brain connectivity: a high-density EEG study with implications for the classroom. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1219945

Optimizing Patient Flow: Time-Saving Tactics for Physicians

One of the biggest pain-points for physicians is the paucity of time allowed for patient visits in the office. Unless you own and manage your practice, it’s likely that someone else controls your schedule.

Despite these constraints, there are some fairly simple things that you can do to optimize the time that you have available.

By focusing your attention on taking care of your patients, empowering your staff to manage routine tasks, and automating some of your EHR processes, you may be able to free up valuable time. Over the course of the work day, these small gains can improve your ability to care for your patients, reduce your wait times, and end the day feeling more in control of your time and attention.

 Pre-visit Information Collection

• Assign your medical assistant (MA) to briefly gather basic symptoms, including duration and intensity, before you enter the room. This has the added benefit of making the MA a valued part of the care team.

• Have your MA ask patients to list their top three questions and concerns. This way, you can start with pertinent issues, and be aware of any unexpected concerns. This won’t eliminate the “by-the-ways” doorknob questions, but it can help.

• Review these issues before walking into the room so you are prepared and can direct the conversation appropriately.

Standardization and Checklists:

• Develop simple checklists for common diagnoses to help guide your patients through symptom description, potential treatments, and follow-up steps. This documentation may also help when it comes to pre-authorization.

• Use protocol and instruction lists for routine procedures, common surgeries, or testing to streamline the process and maintain consistency.

Efficient Communication Techniques:

• Make use of the Teach-Back Method to confirm patient understanding quickly by having them repeat back information about their diagnosis or treatment plan. It might take an extra minute or so, but you’re likely to save time in the long run by addressing misunderstandings at the outset.

• Implement closed-loop communication techniques to ensure tasks like tests ordered or referrals made are understood. In closed-loop communication, the person receiving information repeats it back to make sure the message is understood correctly, and the sender confirms to “close the loop.”

Technology and Tools:

• Utilize EMR templates and macros for common visit types to expedite documentation

• Recommend or create patient education resources to reduce time spent on common issues, reduce post-visit in-box messages and focus more on specific concerns.

Delegate Simple Tasks:

• Delegate routine prescription refills and diagnostic test orders to nursing staff or MAs to free up time for complex decision-making.

• Assign follow-up tasks, such as checking if a patient has completed a test or started a medication, to designated team members.

Optimize Scheduling Practices:

• If possible, incorporate short buffer times every couple of hours to handle any overflow or unexpected delays.

• Whenever feasible, schedule patients with similar needs in consecutive slots to minimize mental switch costs and preparation time.

Structured Patient Interactions:

• If possible, sit down facing the patient to create an impression of focus and interest.

• Begin each visit by asking the patient what they aim to achieve during the appointment, directing the conversation efficiently. This also lets the patient know that you are focused on their needs, and can help to build trust. Over time, that may also reduce unnecessary messages to your inbox.

While you may not be able to fully control your schedule, putting these strategies into play can significantly free up some of the limited time you have with each patient. As a result, you’ll enhance both patient satisfaction and the quality of your care. And ultimately, your own satisfaction may improve.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Five Simple Ways Busy Physicians Can Save Time

Time is a precious commodity, but there’s only so much of it to go around. Your patients, your administrators, your family, your community—everyone wants some of it. With just 24 hours in a day, it may seem that there simply isn’t time to give everyone what they need, let alone take care of your own needs.

The reality is that, especially if you work in primary care, you might actually need 27 full working hours each day to get everything done that’s expected of you. And that’s before taking care of yourself, your personal relationships, and those who depend on you.

Ironically, despite your many years of school, training, and continuing education, you were probably never taught time management. Somehow it was just expected of you. Yet as the demands of medical practice have continued to rise, administrative burdens have increased and managing time is now critical to simply getting through the day.

Unfortunately, there is no way to magically manifest more time. You might be tempted, or even encouraged, to multitask. But it’s important to realize that you can truly only do one thing well at a time. In fact, an Australian study found a nearly two-fold risk of errors with multi-tasking.

As a Physician Coach with additional certification in Time Management Coaching, it’s been my experience that when you improve your time management skills, you’ll experience greater control and clarity over the direction of your life. You’ll strengthen your own well-being. And you’ll create the margin that you need to pursue your passions and reach the goals that matter to you.

Time management doesn’t have to be complicated or convoluted. Simply starting small can lead to big improvements.

In this article, I’ll tell you about five simple ways to reclaim wasted time. These are battle-tested strategies that served me well over many years as a busy cardiologist, and have helped many of my clients as well.

1.       Organize your physical and virtual workspaces.

Make it easy to find all the tools you need for your daily routine. Don’t forget to put them back in place at the end of the day to avoid having to hunt for what you need the next morning. As simple as it sounds, an organized workspace helps to set the stage for a well-ordered day.

Keep your computer files tidy as well, and organize your “smart phrases” in your EHR. Take advantage of any available technical support at work to make things run more efficiently. Developing a system that makes sense to you means less friction in your daily routine.

2.       Commit to only touching each piece of paper or emailonce.

Block time to tackle your virtual and real-life inbox, and complete whatever task is required before moving on to the next. Even a 5- 10 minute block can make a difference. Delete (or recycle) whatever is unnecessary, and organize your virtual and real-life inboxes.

Chances are you get dozens if not hundreds of emails daily along with piles of paper. Most of it is likely unnecessary and distracting, but other documents are time-sensitive and important. Organize your inbox so that your attention is focused on those more critical communications, and let the others drop into a secondary file or forward them on to someone who can take care of them.

3.     Get your charting done before moving on to the next patient.

When you do your charts as you go, you’ll remember the details that you need to make the note accurate, and you’ll be less likely to forget to include things like orders, refills, and instructions. Patients will appreciate it, and you may have fewer requests for clarification after the appointment. I learned this early on, and it made all the difference.

Consider using AI to help with your notes if a good system is available. A scribe (or virtual scribe) can also be a valuable asset. It can be a little tricky to get up to speed with your charting, but I promise it will save you time and aggravation if you can manage to do it efficiently. The next tip will help with this.

4.       Automate and delegate your common phrases and tasks.

Use smart phrases in your EMR for common scenarios. And do your best to stay out of the weeds by delegating administrative tasks to your office staff whenever possible. Make it easy for them to know what you need. Smart phrases can be helpful here as well. And when you empower your staff this way, they may feel more connected and engaged.

5.      Streamline Team Communications

Efficient communication with nurses, assistants, and other team members can significantly reduce time spent on back-and-forth clarifications and miscommunications. Establish clear, direct, and respectful communication. Take the time to create protocols to handle common situations that don’t need your direct input. This proactive approach can foster teamwork, reduce errors, and keep your patients happy.

If you’re like most physicians, you are probably pulled in many different directions at once. It should go without saying that healthcare systems need to step up and reduce the burden on physicians. In fact, there is growing recognition that the current demands on physicians are unsustainable. But meanwhile, if you can create a little more margin in your day, you may find that you reduce your stress and have a little more time to devote to your patients.

An earlier version of this article appeared on this site in October 2022.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

References

Hodkinson A, Zhou A, Johnson J et al. (2022) Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis BMJ

Porter, J., Boyd, C., Skandari, M.R. et al. (2022). Revisiting the Time Needed to Provide Adult Primary Care. J Gen Intern Med (2022)

Westbrook JI, Raban MZ, Walter SR, et al. (2018) Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Quality & Safety

Stop Being So Hard on Yourself: Five Reasons To Celebrate Physicians

If you’re like many physicians, it may be easy to lose sight of your value. Healthcare today faces unprecedented challenges and stressors, and it’s sometimes hard not to take it personally.

Physicians in particular are some of the worst at self-flagellation. It’s common to feel frustrated and disappointed when you feel as if you haven’t lived up to your own ideals, or those that are imposed on you. Some days it can seem as if being a doctor is a thankless task. Doctor’s Day comes once a year, but your work is never done. So I’d like to share five reasons that you deserve to be appreciated and celebrated every day.

You Want to Do Good in the World

Medical practice is a field that naturally attracts individuals who are both highly intelligent as well as driven by a desire to impact the world positively. But wanting to do good and actually doing the work are two very different things. You do the work. Although your efforts may not always be acknowledged, your actions, big and small, directly affect the health and well-being of your patients and your community.

You Do Hard Things Every Day

Physicians face an array of challenges daily, from navigating complex medical and social issues to making life-saving decisions under pressure. On top of that, societal, economic, and administrative pressures may add levels of frustration that test your empathy and determination. The work of a physician requires an extraordinary level of resilience and fortitude, especially when, despite your best efforts, things don’t always turn out as you’d hoped or expected. It is no exaggeration to say that this level of commitment and grit far exceeds that of most other professions.

You Are Passionate About Your Work

Passion is the lifeblood of innovation and motivation. Physicians often pursue their profession because of a deep-seated passion for healing and discovery. This enthusiasm is often what spurs you to continually learn, grow, and push the boundaries of what is medically possible. Even on days where you feel less than enthusiastic, your years of focus and commitment drive you to do your best work.

You Come from All Walks of Life

Each physician comes to the profession with a unique array of backgrounds and experiences. Whether you come from a rural town or a large urban community, from a US metroplex or a country thousands of miles away, each physician carries a distinctive set of perspectives and skills. This diversity enhances your ability to connect with and care for a wide range of patients with a rich mix of cultures and viewpoints.

You Are a Change-Maker

Physicians are often at the forefront of change, not only in their clinics or hospitals but also in the broader context. Collectively, you have the power to initiate significant health policy reforms, improve patient care standards, and lead community health initiatives. What you do makes a difference in ways, big and small, that ripple out into the world.

As a doctor, you are not just a healthcare provider or a widget in a faceless system. You are a resilient, passionate, and dedicated professional committed to making the world a better place, one patient at a time. Most importantly, the work you do matters.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

My Podcast Interview with Digital Diagnostic’s John Bertrand

Artificial intelligence is making its way into healthcare at a rapid pace. By harnessing its benefits while at the same time recognizing its limitations, we have an opportunity to improve and expand access to care for a wide range of people.

This was a thought-provoking podcast conversation with John Bertrand of Digital Diagnostics about the practical and potentially life-changing uses of AI for early detection of diabetic retinopathy. The beauty of the process is the fact that it can be used virtually anywhere, and does not require a highly skilled technician to acquire the data.

Getting Unstuck: How a Simple Mind Shift Can Move Your Life Forward

If you’re a physician, you’re probably juggling patient care, administrative tasks, and personal responsibilities like a boss. But when you feel the need for something beyond the daily routine, it can feel daunting.

Whether it’s getting up to speed with a new procedure, launching a research study, trying to get some time for self-care, or considering making a complete change of practice or location, it’s easy to feel like you’re stuck in an endless loop, unable to break free.

In my practice as a physician coach, I frequently encounter these common challenges. It can seem overwhelming from the inside looking out. But there is a way through, and it begins with understanding why you feel stuck.

In this article, I’ll explore common reasons that physicians feel immobilized, and I’ll offer you some strategies that will get you moving forward with purpose.

Break the Cycle of Repetition

Doing the same thing over and over, expecting different results, is not only the classic definition of insanity but it’s also a common trap. Whether it's procrastinating on completing notes, avoiding difficult conversations, or never saying no, these habits can perpetuate your feelings of frustration and stagnation.

Routine can be comforting, since you know what to expect, but it may also be a barrier to growth. When you’re caught up in an endless cycle of repetitive tasks, it’s easy to lose sight of what matters the most to you.

Strategy: Starting small can open up a crack that allows you to see a little more light. As simple as it sounds, begin by introducing small changes in your routine. This could mean taking a different route to work, setting aside just 10 minutes a day to walk or stretch, or incorporating new learning into your practice. Sometimes, the smallest adjustments can lead to significant shifts in perspective and outcomes.

Spring Free of the Inaction Trap

If you don’t take action, you will not get yourself unstuck. It’s that simple. But the fear of making the wrong decision often squashes the potential for change. That doesn’t mean it’s not important to think through your decisions. Be thoughtful and judicious, but don’t get stuck in an infinite cycle of analysis. Realize that taking action can mean taking the smallest of steps.

Strategy: Embrace the concept of ‘progress, not perfection.' Understand that inaction is a decision in itself, and it can be more harmful to your wellbeing and your future opportunities than making an imperfect decision. Start with very small, manageable actions that align with your goals and gradually increase the stakes as you build confidence.

Unaddressed Issues

Not dealing with problems as they arise means that they are given free rein to accumulate. Eventually these unresolved issues may begin to feel overwhelming. And as a consequence, this drag on your energy will make it harder to move forward. Whether it's patient care issues, administrative challenges, or personal matters, avoiding problems doesn't make them disappear.

Strategy: Commit to a proactive approach. Tackle important issues as they arise. You don’t need to solve every pressing problem on the fly. But by putting it in its place, it won’t be overlooked. That could mean delegating, scheduling committed time to address the issue, or even saying no. This not only prevents important issues from escalating but also builds a habit of facing challenges with purposeful action.

The Burden of Incomplete Tasks

Like unresolved issues, incomplete notes and tasks can be a significant source of mental load, leading to a feeling of being perpetually behind and unable to move forward. This is a very common issue for physicians, and one of the most important ones to get a handle on quickly. Your own well-being as well as your patients’ care depends on it.

Strategy: Get those notes done. Use templates, smart phrases, and any other resources available to you to make your notes concise, accurate, and useful. Prioritize and delegate the other tasks crowding your in-box. Addressing each task once and moving on, keeping your responses brief and succinct will help you get through your list. Consider adopting time management techniques, such as the Pomodoro Technique or time-blocking, to efficiently tackle your workload.

The Value Dilemma

Objectively, you probably know you’re valued. Despite the turmoil that many physicians face every day, your patients need you, and the work you do makes a difference.

But it’s easy to undervalue yourself, undermining your self-confidence. You’re not alone. Not believing in one’s own value is a common issue that affects how many doctors perceive their abilities and their worth. And as a result, you may miss opportunities, fail to stand up for yourself, put up with toxic working conditions, or take on projects that go against your won best interests.   

Strategy: Practice self-reflection and affirmation. Remind yourself of your achievements and the unique value you bring to your patients and the medical field. Journaling can be a very useful exercise. Keep a folder or a box with notes from patients and others who express appreciation and give yourself a few moments to revisit this when you’re feeling down.

Seek feedback from peers and mentors when you need it and consider engaging with a coach to build self-confidence and set achievable and meaningful goals.

Conforming to Expectations

Playing to other people's narratives is a common trap that can lead you down a path that doesn't align with your values or aspirations, leaving you feeling stuck in an unfulfilling or ill-fitting role. This is another theme that plays out for so many physicians. It often begins with family expectations, and it may eventually become a way of life.

Strategy: Define your own success. Take time to reflect on what success means to you, independent of anyone else’s expectations. Setting personal and professional goals based on your values and aspirations will ensure that your actions align with who you are and how you want to live your life.

Moving Forward

Feeling stuck doesn’t have to be a way of life. By understanding the underlying reasons and adopting targeted strategies, you can navigate your way out of the quicksand of stagnation.

Take the time to understand your value and remind yourself of the resilience that got you this far. Think of change as a catalyst. Create and then begin to implement a plan to take action, one step after another. Remind yourself that fulfillment is a process that can lead to unexpected growth and opportunities.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

My Podcast Interview with AI Pioneer Dennis Cogan of Caresyntax

It’s no secret that artificial intelligence (AI) is rapidly becoming a powerful tool in healthcare and medical science.

As a TechLink Insights podcast host, I enjoyed this very forward-thinking and inspiring conversation with Dennis Kogan of Caresyntax, a company pioneering the use of AI in surgical practice.

It’s normal to feel uneasy about these new technologies. But AI is already here, and it’s up to physicians and others in healthcare to guide its implementation and develop reasonable safety rails to protect our patients. Having met with a number of pioneers in this space through the podcast, I believe that the future looks bright for innovations in care when AI is applied thoughtfully and collaboratively.

Why Should Healthcare Systems Invest in Coaching?

Changes in the administration of medical care have accelerated at a frenetic pace over the past decade, amplified by changes in practice ownership, healthcare law and COVID-19. With a few exceptions, the time of the solo practitioner, or even the single-specialty group practice, is well past. A recent report from Avalere Health noted that by January 2022, nearly three quarters of all US physicians were employed by hospitals or corporations, with a 19 percent increase over the preceding 3 years.

This consolidation of care comes with important benefits, including cost savings, ease of quantification and other metrics, and streamlining of care. Yet whether they intended to or not, large healthcare systems have also taken on an enormous responsibility for the satisfaction and well-being of their employed physicians.

Although healthcare administrators are a diverse group, and many have some background as healthcare professionals, they may not fully understand or embrace the qualities that lead individuals to pursue the life of a physician.

In general, physicians are highly intelligent, extremely motivated individuals. That’s individual with a capital I. Physicians are typically empathetic yet driven perfectionists. Many see their profession as a personal calling. While admirable, this may put them at risk for exploitation, since physicians with this mindset may find it difficult to say “no” to added responsibilities.

Recognizing these character traits makes it all the more concerning that in a recent survey, nearly half of physicians reported burnout in 2022, compared to about 25 percent in 2000. COVID is partially to blame, but so are systemic changes in healthcare, including less autonomy and greater documentation demands.  

Clearly, our healthcare systems bear a substantial responsibility for the amelioration and reform of many of these underlying factors. This includes workload, clerical and documentation burdens, and leadership culture.

How can coaching help?

Coaching is not the answer to burnout, but it’s an important tool. A study from the Mayo Clinic found that after 6 coaching sessions by credentialed coaches, the rate of burnout decreased by over 17 percent. In the control group, burnout actually increased by nearly 5%. And rates of emotional exhaustion dropped by nearly 20% in the coached group but increased 10% in controls.

Beyond addressing burnout, coaching can help physicians navigate the challenges of daily practice. Discovering the underlying causes of inefficiencies and working through time management practices with coaches may help physicians stay more organized and reduce wasted time. This in turn can improve quality of life for physicians as well as foster patient engagement, staff satisfaction, and timeliness of medical records.

Burned out, dissatisfied, and disconnected physicians are more likely to leave healthcare, which is expensive and disruptive for the system. According to the American Medical Association, it may cost anywhere from $500,000 to $1 million to replace one physician. And burned-out physicians may increase healthcare costs and decrease patient satisfaction. Ultimately this results in lost revenue and loss of social currency. More importantly, quality of care may also suffer and medical errors increase.

As hospital and healthcare systems navigate the years ahead, retaining high quality, satisfied, and engaged physicians will become increasingly important. An investment in coaching is a tangibly supportive and mutually beneficial use of resources.

Coaching alone won’t solve the problems facing healthcare. But when used as part of a comprehensive strategy to enhance physician well-being and streamline efficiency, coaching may ultimately improve patient care and satisfaction, enhance teamwork, and foster a happier, healthier medical staff.

An earlier version of this article originally appeared on this site in August 2022.

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If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

What if You Don’t Know What You Want Next: A Physician’s Guide to Finding Direction

As a physician, you've dedicated years of your life to the practice of medicine. You spend the better part of your waking hours staying current on the latest research, honing your skills, serving your patients with compassion and care, and collaborating with your colleagues and staff.

But, like many doctors, there may come a time in your professional trajectory when you feel a need for change and a yearning for something different. Maybe you feel stuck, unfulfilled, or underappreciated. Or perhaps you simply crave a change of scenery.

In this article, I’ll give you some strategies that will help you to gain clarity and direction when you’re not sure what you want next.

Sometimes the direction to take is crystal clear, but it can often be difficult to envision what that change should or could look like. From medical school to residency and beyond, your path up to this point has probably been clearly marked. As you reached one milestone, the next was likely in view.

It can be comforting to know where you are going next, but it’s not uncommon to find yourself longing for a shift in your professional life that doesn’t conform to the well-worn trail. Whether you're considering changing the way you practice, adjusting your working hours, exploring opportunities outside of clinical medicine, or even contemplating retirement, the uncertainty can be daunting.

Change is often uncomfortable and unsettling, especially when you’re blazing your own path. It's essential to remember that this feeling of ambiguity is a natural part of any career evolution. It’s easy to get stuck at this point, instead of recognizing that this period of contemplation is the first step in a new direction.

Although it’s important to think things through, I’m a firm believer in the adage that action creates clarity. Action however, does not have to mean commitment or a big shift. Giving yourself time and space to actively explore what is possible can make your next steps more clear.

If you’re feeling like you’ve come to a standstill, here are some ideas that can help pull you out of the rut and find some serious traction that will move you forward.

1. Reflect on Your Values and Goals

Take some time to reflect on what truly matters to you, both personally and professionally. What are your core values? Have you identified specific long-term personal and career goals?

Understanding what drives you and what you hope to achieve can provide valuable insight into the direction you should take. If you’re unclear on how to express your personal values, my Values Workbook can help.

2. Assess Your Skills and Interests

Consider your strengths, skills, and areas of interest outside of medicine. Are there particular aspects of your current practice that you enjoy the most? Are there skills you possess that you haven't had the opportunity to fully utilize? Or maybe you’re curious about acquiring new expertise.

Exploring these ideas can help you identify potential career paths that align with your strengths and interests. Don’t be afraid to consider possibilities that may not obviously relate to the practice of medicine. Simply asking yourself what lights you up may spark new ideas and connections. One exercise that can help you discover these connections is a mind map.

3. Seek Guidance and Support

Reach out to mentors and trusted colleagues. You might also choose to work with a coach. Sometimes, an outside perspective can provide valuable insights and help you see possibilities that you may not have considered on your own. While a coach will not tell you what to do next, a coach will help you uncover your own answers. That’s because coaching is a supportive process designed to accelerate your capacity to explore your options and take effective action.

4. Explore Your Options

If you're unsure about the specific direction you want to take, make some time to explore different opportunities and try out new experiences. This could involve taking a course or attending a meeting focused on anything that interests you, volunteering, traveling, or joining an organization or group that resonates with you.

These explorations don’t have to have an obvious connection to the practice of medicine. Experimenting with a variety of options can help you clarify your priorities and identify what intrigues and inspires you.

5. Embrace Flexibility and Adaptability

Your path doesn't have to follow a linear trajectory. It's okay to pivot, change direction, or investigate new opportunities at any stage of your life. Be true to yourself, but keep in mind that it’s always a good idea not to burn any bridges along the way.

When you embrace flexibility, you’ll often find unexpected and even surprising opportunities that may otherwise have gone unnoticed.

6. Take Small Steps

Thinking about a professional change can feel overwhelming, especially for physicians. More than most other professions, we often feel defined by the work that we do.

Remember that you don't have to have all the answers right away. Break down your goals into smaller, manageable steps, and focus on taking action consistently. Simply commit to just one small step at a time.

7. Practice Self-Compassion

Be kind to yourself as you navigate this process. It's normal to feel uncertain or indecisive when you’re facing an important change. Practice self-compassion and remind yourself that it's okay not to have all the answers immediately.

Trust in your abilities and know that by putting in the work, you will find your way forward.

As a physician, you have proven that you are resourceful, intelligent, compassionate, and hard working. By taking the time to reflect on your values and goals, seeking guidance and support, exploring and creating your options and opportunities, and embracing flexibility, you will stay open to possibilities, and you will find your way.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Dressing to Inspire Confidence: My Kevin MD Podcast Conversation

On my recent podcast appearance with Kevin Pho, M.D., we talked about the way the clothes you wear can impact the way that you're perceived by your patients, your colleagues, and your staff.

For instance, are your administrators wearing scrubs? Probably not, because they understand the language and the power of clothing and presentation.

There is research on the way that physicians, especially women, are judged by the clothes that they wear. And whether we like it or not, clothing is an important signifier of professionalism to patients and family.

You don't have to be uncomfortable, feel restricted, or spend big bucks for a professional wardrobe. I'll tell you more in the article on the KevinMD website and on the podcast, including simple ways to incorporate professional attire.

Art, Meditation, and Medical Practice: Johannes Vermeer's The Geographer

Art therapy is often used to help to restore a sense of well being in people who are suffering from psychological stress or turmoil. We can experience similar benefits, while at the same time developing a deeper appreciation of our patients as fellow complex human beings, though the mindful experience of art.

Girl with Pearl Earring by Johannes Vermeer, ca.1665; credit Mauritshuis, The Hague

Johannes Vermeer was a Dutch painter in the 1600s. He is particularly known for his interior scenes that depict everyday life in his world. The Girl with a Pearl Earring is probably the most famous of his works. In 1999, a book by the same name, exploring the fictional life of the girl depicted, was published. In 2003, it was made into a movie.

 Sadly, Vermeer was not well recognized or appreciated during his lifetime, and he struggled financially. Vermeer died at the age of 43, leaving his wife with 11 children to care for. The cause of death is unclear, but it was said that stress played a role. Today, only 34 of Vermeer’s paintings are known to exist.  

As a physician, a fine art photographer, and a teacher of mindfulness, I am drawn to Vermeer’s paintings because of his strong connection to his subjects, and his emphasis on their humanity.

Johannes Vermeer, The Geographer, ca: 1669; Image credit Städel Museum, Frankfurt am Main

As a photographer, Vermeer's The Geographer calls to me for its almost photographic frame of reference. This is not surprising, given Vermeer's use of the camera obscura, an early form of photographic projection that creates an image on a wall. As in an un-posed photograph capturing a moment in time, The Geographer appears to be unaware of the painter, and engrossed in his thoughts.  

Vermeer uses the light and shadowing to shape the space of the gentleman's study, creating a strong left-to-right diagonal perspective. Diagonals are important in art, because they often suggest action and energy.

Your eye might first notice the illuminated face of the man, then it may travel from left to right as the line of the light echoes the diagonal of his desk, the movement of the shadow behind the cabinet and even the pattern of tapestry that is draped over the table. The instrument he casually holds in his hand repeats this same diagonal and intentional feeling. 

The Geographer's face is illuminated in much the same way as the globe above him, and his Japanese style robe tells a story of a man who has a wide and diverse experience of life.  

The colors in this painting serve to unify the composition and create a soft sense of boundary in which this man lives and works. The gorgeous oranges and blues, as complementary colors, create a lush and intimate feeling. We see them in his robe, the tapestry, the small chair in the background, and in the shade of the light entering the room.  

In color theory, blue evokes the mind, reflection, serenity, and the intellectual, while yellow is a color of creativity and confidence. The orange speaks of passion, but perhaps of frustration as well. And the soft brown conjures nature and quiet. 

The variety of textures in the textiles and furniture elevates the sense of intimacy and deepens the richness of these colors. There is a sense of balance between the foreground and the background, holding The Geographer in the middle of the painting, and setting him firmly in the world.

Experiencing art mindfully

Art can be a way to access mindful exploration. Sometimes this is called slow looking. You don’t have to be an expert in art or a mindfulness practitioner. Even just a few minutes with a work of art can allow your mind to clear and give you space to create a sense of connection to another human being. The Geographer is a perfect stepping off point for this kind of exploration.

To drop into a meditative mindset, allow the experience of Vermeer’s painting to guide you into a sense of tranquility and space. Notice your breath as you spend time with this work of art, paying attention to your slow inhales and exhales. Feel your body loosen, even just a little.

Of course, you don’t have to turn to the Old Masters to experience the meditative power of art. If you’ve ever lost yourself in a song, you know that to be true. Abstract art, photography, sculpture—all can be portals to mindful exploration.

This post contains Amazon affiliate links. I may earn a small commission when you click on the links, at no additional cost to you. These commissions help to support the website.

An earlier version of this article originally appeared on this site in July 2022.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

My Podcast Interview with Tax Expert Alexis Gallati, MBA

I really enjoyed my conversation with Alexis Gallati, EA, MBA, MS Tax, CTS for TechLink Health. This was such a practical and well explained deep dive into tax strategies for physicians.

Alexis is married to a surgeon, so she has seen firsthand how little education most of us have in financial strategies, and how this lack of knowledge can hurt us and leave us vulnerable to bad advice.

This podcast addressed financial strategies related to side gigs, managing independent practices and more. Alexis is an engaging speaker and shares a wealth of practical insight.

From Conflict to Collaboration: Overcoming Challenges with Your Staff

As a cardiologist in practice for nearly 30 years, I was fortunate to work with a fantastic team of nurses, medical assistants, and office staff. I give much of the credit to our no-nonsense in-house nurse manager. But not all physicians are so lucky. And even one bad apple can make going to work a miserable experience.

Although medical training involves teamwork, it’s uncommon for physicians to learn managerial or business skills during medical school or residency. If you’re learning on the job, getting off on the right foot can impact your experience at work for years to come.

Until my practice was acquired by a larger organization, I served as chairman of our Human Resources (HR) committee for a number of years. So if you’re a physician dealing with challenging staff members, I’ve got some expert tips and insight to help you get to the other side of this common problem.

First, a little perspective. In years past, most physicians owned their practices. So in these situations, the physician or a trusted administrator typically did the hiring and firing. And the staff understood that keeping up good relations with their physician-employers was vital to maintaining happy employment. Now that most physicians are themselves employees, the relationships have become more muddied. And the truth is that depending on your organization, you may or may not have much say in the way the practice is run.

Be that as it may, as a physician, your leadership is crucial to maintaining a good working environment. Whether it is implicitly stated or not, your staff should understand that their job is to support the work that you do. And ultimately, that means providing optimal care and a supportive experience for your patients.

Whether you’re employed or not, your patients depend on you for your expertise and your care. Your employment status is irrelevant to them, and they view your staff as an extension and a reflection of you. That means that if the practice feels chaotic and uncomfortable, your patients are likely to feel unsafe and unwelcome.

It’s likely that most of your staff will appreciate a physician who is kind, principled, and clear. Most people who work in healthcare take pride in their jobs and care about the people they serve. But unfortunately, you can also expect to encounter some difficult folks along the way.

To maintain your sanity, your ability to provide care for your patients, and your role as a team leader, it’s important to have a clear plan for dealing with troublemakers.

Some people may be negative or disruptive, others may be passive-aggressive, and some may simply be incompetent. You may even encounter employees who delight in getting you upset. Regardless of the type of difficult staff member you are dealing with, rule number one is this: do your best to remain calm, cool, and professional at all times.

When dealing with the inevitable conflicts and other tough situations at work, here are some important things to keep in mind.

• Don’t make it personal

Although it can be tempting to let your emotions take over, the minute you make it personal, the problem becomes about you. This can be very difficult if not impossible to turn around. By keeping it professional, you have a much better chance of remaining above the fray.

• Consider involving HR:

If you have access to an HR staff member or administrator, and you feel reasonably confident that they will support you, it’s best to involve them early on in a difficult situation. This can help to protect you from accusations of harassment or favoritism.

When you try to go it alone, especially as a new physician, there’s a good chance you will end up making some important missteps. Never underestimate the power of a passive-aggressive or disgruntled employee to undermine your reputation. In the worst cases, this could mean the loss of your own job.

• Document everything

Documentation is not necessarily to get the employee in trouble. You’re documenting in order to protect yourself.

Be sure to include the specific behavior that is causing the problem, the date and time of the incident, and any steps that you have taken to address the problem. It’s a good idea to make a note of any witnesses as well.

• Try to understand the root cause of the behavior

Although your practice’s administration is likely responsible for managing the employee and their disruptive behavior, getting a handle on the behavior and its root cause may be helpful. Once you understand this, you may start to develop a plan to turn things around.

For example, if a staff member is negative and disruptive, it may be because they are feeling overwhelmed or undervalued. That doesn’t mean that you need to acquiesce to their demands or accept the behavior. But understanding what might be contributing will make it feel less personal. It may also give you insight into the path forward. And armed with this information, you may be able to work more collaboratively with your administration.

• Be direct and honest. 

If your administration takes a hands-off approach, it may be left up to you to manage the issues. This is often the case for minor procedural problems, lack of education, and misunderstandings.

When you address the problem with the staff member, be clear, calm, and truthful. Avoid being confrontational or accusatory. Instead, focus on the specific behavior or issue that is causing the problem and how it is impacting the workplace.

Consider having a trusted colleague or nurse present for the discussion. That will help to protect you from any undue accusations.

• Be prepared to offer a solution

It may be necessary to work directly with the staff member to resolve the problem. For example, if a staff member is struggling with a particular task, it may be up to you to provide them with additional training or support.

Set clear expectations and provide regular feedback. Sometimes these individuals become the most loyal employees, if they understand that you are on their side.

• Be supportive and encouraging

The process works both ways. By contributing to a work environment where your staff members feel valued and supported, you are more likely to be listened to and treated with respect.

• Be fair and consistent

Treat each of your staff members fairly and consistently. Avoid favoritism and keep your personal life separate. When you spend most of your life at work, it may be tempting to see your staff as friends. This is a pitfall that many early career physicians fall into. Over time this can create divisions and expectations that will only make things more difficult for you.

As a physician, you have the right to expect a positive and productive working environment. If a staff member is making it challenging for you and others to do your jobs, it’s critical to take the necessary steps to address the problem. Whether that means involving administration, providing additional training opportunities, or even terminating the employee, embodying a calm and professional leadership style will help to ensure a safe and supportive environment for you, your staff, and your patients.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

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