Focus on Physicians:
Insights, Ideas, and Strategies
Learning the Art of Delegation: A SMART Tool for Physicians
Delegating can be a challenging skill for many physicians to master. The need to maintain control over every detail—especially when you bear ultimate responsibility—can make letting go feel risky.
In this article, we’ll explore which tasks are most suitable for delegation, how this practice can strengthen teamwork, and strategies to make the process efficient and effective. Plus, I’ll share a practical template to help you overcome common barriers, enabling you to maximize your team’s potential.
An earlier version of this article appeared on this website in July 2023.
Delegation can be a challenging skill for many physicians to master, but it’s an integral part of safe and efficient patient care. One reason it’s so hard is that it can often feel risky to let go, especially when you bear responsibility for the outcome. That’s why the most effective delegation is not just about offloading tasks; it’s about empowering your team to work at their best.
Of course, you can’t simply assign a task and hope it all works out. Instead, when you delegate, the goal is to get the same or better result than if you did the task yourself. Defining expectations, educating your team, and fostering a sense of shared purpose will set you up for success.
In this article, we’ll explore how delegation can strengthen teamwork and we’ll look at strategies to make the process both efficient and effective.
SMART Delegation
(Based on the work of Kate Christie of Time Stylers)
You may already know about SMART goal setting, but the SMART Delegation mnemonic is different. It’s designed to help you manage your workload more effectively and make the most of your time.
Using the SMART Delegation template will help you recognize and overcome common barriers that get in the way. By following this workflow, you’ll feel more at ease with the process while supporting your team and maximizing their potential. SMART stands for select, motivate, activate, results, and timeline. Here’s how it works:
Select
Choose the best person for the task. This may be a team member with little experience but a willingness to learn, or it could be someone with years of practice in the same or related field. Be choosy, but consider thinking outside the box. Is there a team member who yearns for more responsibility, is willing to take guidance, and is excited to learn? Even if they are new to your specialty, they might be a good fit.
Motivate
Motivate your team by making it clear why the task is important. This will create buy-in and foster a sense of importance and pride. Remember that motivation is an ongoing process, especially at first. You can think of it as a fly wheel, where each spin of the wheel builds upon the earlier work, creating more momentum and reducing the amount of work needed to keep the wheel in motion. Don’t “set it and forget it.”
Activate
Explain the details of the task so that everyone is clear on what is expected. Be sure to include a checklist if appropriate, and a written guideline that can easily be referred to and updated as needed. Giving your staff permission to be proactive can improve both the quality and the timeliness of care for your patients.
Results
Describe and explain clearly what a good result looks like, and why that matters. People who find their work meaningful are more likely to remain engaged and committed.
Time Line
Set realistic and clear deadlines when starting new protocols and teaching new procedures. It can help to create a series of steps with expected completion dates so that you stay on track.
Delegating Effectively
Delegation is a critical component of effective and efficient practice, but you have to be smart about it. Here are a few important caveats and guidelines that can help to keep your SMART Delegation plan on track.
Trust but verify
Effective delegation requires trust, but it doesn’t mean stepping away entirely. Check in periodically to identify potential problems early, reinforce accountability, and build confidence in your team’s ability to meet expectations.
Acknowledge the learning curve
Learning a new skill can be stressful. What may seem obvious to you may be a big leap for someone else. Do your best to be available, approachable, and patient, especially in the early stages. While it might take a little extra time at first, your support will be well worth the effort in the long run.
Keep communication open
Maintain open lines of communication so your team feels comfortable seeking help with complications or unexpected situations. Instead of simply providing answers, turn their questions into teaching opportunities. Encourage them to brainstorm solutions and come to their own conclusions, while at the same time offering a safety net of support.
Connect with supervisors
It can often help to involve a supervisor to provide an additional layer of support. This empowers your team to seek guidance on minor issues or questions without relying solely on you. At the same time, when you bring supervisors into the workflow, you’ll foster camaraderie by acknowledging their leadership role and building stronger team cohesion.
Provide constructive feedback
Be generous with your praise and constructive criticism. Research shows that when the work environment is supportive, performance tends to improve more quickly than when feedback is mostly negative or nonexistent. And while patience is essential, if someone consistently struggles to meet expectations, consider delegating the task to someone better suited for it. Avoid slipping back into the time-consuming habit of doing everything yourself.
Embrace discomfort
Delegating can feel like relinquishing control, so it’s normal to experience some discomfort at first. Be patient with yourself and your team while setting clear and achievable expectations.
The Ripple Effects of SMART Delegation
When you commit to the principles of SMART delegation, you’re not just easing your workload, you’re fostering a culture of trust, accountability, and growth. With the right people and processes in place, delegation can make you more productive, improve safety, strengthen teamwork, and boost patient satisfaction.
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 coaching discovery session, click the button below.
How Much Does Physician Coaching Cost? What to Know Before You Invest
Coaching is a meaningful investment of your time, attention, energy, and money. Sometimes the cost is covered or subsidized by your organization, but for many physicians, coaching is a personal financial investment.
I believe physicians should be able to understand the cost of coaching before scheduling a consultation. I also think it’s important to know what coaching asks of you beyond the financial transaction. In this article, I’ll cover what physician coaching may include, what can affect the cost, and what questions to ask before signing up.
Coaching is a meaningful investment of your time, attention, and energy. Unless coaching is offered within your medical institution, it may also be an important financial commitment. Sometimes the cost is covered or subsidized by your organization, but for many physicians, coaching requires a personal monetary investment.
I believe physicians should be able to understand the cost of coaching before scheduling a consultation. I also think it’s important to know what coaching asks of you beyond the financial transaction. In this article, I’ll cover what physician coaching may include, what factors can affect the cost of coaching, and what questions to ask before signing up.
What does physician coaching cost?
Physician coaching fees vary widely, and there is no single standard rate. As a general benchmark, professional coaching for physicians usually falls in the range of about $250–$500 per session, whether billed by the individual session or as part of a package.
Executive coaching may be priced higher, particularly when it includes organizational coordination, leadership assessments, 360 reviews, stakeholder interviews, or written reports.
Six-month coaching packages typically cost $3000 to $10,000, and more intensive executive or organizational coaching engagements can reach even higher. Group coaching tends to be more budget friendly, but also less personalized.
With these ideas in mind, it is helpful to ask not only, “What does coaching cost?” but also, “What is included in the fee, how much support will I receive, and is this the right kind of coaching for my needs?” For reference, my Mindful Physician Coaching packages and cost are outlined on my FAQ page.
What does physician coaching include?
There are many ways physicians can access coaching. Some coaches offer group programs, on-demand courses, coaching apps, retreats, or organization-sponsored programs. In this article, I’m focusing on private coaching sessions conducted virtually between an individual physician and coach.
Every coach works a little differently, so it’s helpful to ask what is included before you commit. In my Focus-Shift-Balance-Fly coaching program, I offer:
A set number of 50-minute sessions (usually 6 or 12) which are scheduled at your convenience and ideally spaced every 2-4 weeks
Unlimited e-mail access, generally with 24-hour turnaround time
A variety of coaching tools, depending on your individual needs and goals, which may include:
Values exercises
Wheel of Life
Personal vision statement
Positive Intelligence resources
Other customized reflection or planning tools
Other coaches may offer a different structure or set of resources. Some may include assessments, written exercises, between-session support, or additional materials. Others may charge separately for these tools, so it’s worth asking ahead of time what is included in the coaching fee.
In my coaching program, there are no additional charges for the resources or tools we use together.
What affects the cost of physician coaching?
Physician coaching fees can vary widely. The cost may depend on the coach’s experience, training, credentials, niche, and program structure. A short-term coaching package will usually cost less overall than a longer coaching arc, while a more intensive program may include additional support between sessions.
Cost may also vary depending on whether coaching is paid for privately, subsidized by an employer, or sponsored by an organization. Some coaching programs are designed for individuals, while others are built for groups, leadership teams, departments, or institutions.
The most important question is not only, “How much does it cost?” but also, “What am I receiving, and is this the right kind of support for what I need?”
What questions should I ask before investing in coaching?
The questions you ask may depend on why you are seeking coaching. A physician navigating burnout may have different needs than someone considering retirement, leadership development, a career transition, or a challenging workplace situation.
If you are interviewing coaches before signing up, it’s a good idea to prepare your questions ahead of time. Here are some questions to get you started:
What is included in your coaching packages?
How many sessions will I have, and how long do they last?
Is there a defined coaching arc?
Will you help me establish goals?
How do you address accountability?
Is our work confidential?
What happens between sessions?
What kinds of clients do you usually work with?
When do my sessions expire?
What is your refund policy?
Are there any additional fees for assessments, tools, or resources?
These questions can help you understand not only the cost, but also the structure, expectations, and fit.
Why I list my coaching fees publicly
Because coaching is such a meaningful investment of time, money, and attention, I believe physicians should be able to understand the cost before scheduling a consultation.
Some coaches prefer to discuss fees privately, and there can be good reasons for that, especially when programs are customized, organization-sponsored, or designed for groups. My approach is to list my current coaching fees clearly on my FAQ page so that prospective clients can decide whether the structure, investment, and coaching style are aligned with what they are looking for.
Transparency does not replace a good fit conversation, but it helps make that conversation more useful. Spending your hard-earned money is a commitment, and an exchange of energy, and I respect that. When you already understand the basic structure and cost, we can spend our consultation talking about what matters most: where you are now, what you are hoping to change, and whether coaching is the right next step.
If you’re interested in learning more about my coaching program, you can schedule a free consultation by clicking the button below:
Overcoming Disrespect in Medicine: Protecting Physician Dignity
Treating patients with dignity is one of the cornerstones of the medical profession. Most physicians genuinely want their patients to feel safe, heard, and respected. But what happens when physicians are not treated with the same dignity by their colleagues, their healthcare systems or even their patients? It’s a growing problem, and one that often goes unacknowledged.
In this article, I’ll dive into the major shifts that have led to this reality and I’ll share five practical strategies to help you push back against disrespect and reclaim your sense of dignity.
An earlier version of this article appeared on the KevinMD website in August, 2023.
Treating patients with dignity is one of the cornerstones of the medical profession. Most physicians genuinely want their patients to feel safe, heard, and respected. But what happens when physicians are not treated with the same dignity by their colleagues, their healthcare systems or even their patients? It’s a growing problem, and one that often goes unacknowledged.
In this article, I’ll explore the major shifts that have led to this reality and I’ll share five practical strategies to help you push back against disrespect and reclaim your sense of dignity.
The roots of the problem: Disrespect and breakdown in advocacy
In medical school, you may have been taught to expect, and even accept, that patients in distress might occasionally lash out. Years ago, this wasn’t something that happened every day, so it was easier to shake it off, remind yourself it wasn’t personal, and move on. Norms have shifted drastically over the past decade, and today the toll of daily disrespect has an enormous impact on physicians’ wellbeing and sense of agency.
In the worst cases, disrespect can escalate to physical violence. In fact, a recent study found that more than one third of public health workers in the US experience some form of workplace violence. Minority healthcare professionals are frequent targets, but any physician is at risk.
Adding fuel to the fire is the rise of administrative oversight of physicians and their practices by people who may have little experience in direct patient care. These administrators’ reach extends not only to metrics and billing, but into personal and professional decisions that once would have been completely off limits. Stigma, discrimination, job-related threats, and bullying or harassment are aspects of institutional disrespect that may be swept under the carpet by management personnel who work at a distance from patient care.
Of course, when physicians own their practices, they can refuse to engage with patients who are habitually disrespectful. And if staff members fail to maintain civility, they can be dismissed with cause. But employed physicians may have little say as to whether threatening patients can be dismissed from their practices, or disruptive staff terminated.
At the intersection of patient and administrative stress are the widely published patient satisfaction scores. While these scores often have no relevance to patient outcomes, they’ve become yet another pressure point, pushing physicians to prioritize arbitrary expectations over doing their best work.
When coping strategies backfire
Although physicians are tasked with regular training in sensitivity and respect for patients and employees, they get little instruction in how to protect their own dignity. Often, defaulting to earlier norms, physicians are advised to just let it go.
It’s not unusual for doctors, especially women, to attempt to deal with these situations with passivity and even self-deprecation, in a misguided attempt to get along. And regardless of gender, younger physicians who lack strong mentorship may be especially vulnerable to these situations.
Unfortunately, these well-meaning attempts to smooth things over typically have the opposite effect. They can actually embolden the transgressor and do nothing to improve the situation.
This status quo is not sustainable. It leads to burned out physicians, and can hinder patient care. It is incumbent on healthcare systems to work to create safe and respectful environments. But this is not something that can wait for a committee to decide what to do. As a physician, you have more power than you may realize. Here are five ideas that you can implement right now:
How to reclaim your dignity
1. Establish boundaries
Boundaries are essential for maintaining professional relationships and protecting your sense of self. Being a compassionate physician is not the same thing as being a personal friend.
Keep a clear line between work and personal life. This means avoiding interacting with patients or administrators on social media, and being intentional about keeping the two spheres separate.
2. Advocate for a respectful work environment
If you don’t stand up for yourself, who will? Open discussions about mutual respect, whether at meetings or through anonymous feedback systems, can pave the way for change.
Keep in mind that you’re not asking for anything unreasonable. Advocating for policies that address disrespect and burnout can help create a healthier, safer, and more supportive workplace for everyone.
3. Strengthen doctor-patient communication
Good communication is at the heart of any physician-patient relationship. By being empathetic and respectful in your interactions, you can set the tone for civility with both patients and staff.
Stay calm during difficult conversations. Pause, take a deep breath, and step away if needed. Active listening, showing genuine interest in your patients' concerns, and involving them in decision-making can help build trust and respect.
And although the EHR is great tool for communication, keeping EHR messages brief and focused can help to maintain your professional boundaries while still addressing patient concerns. If a message requires more than a couple of minutes of your time, it may be an indication that the patient needs an office visit for more focused care.
4. Don’t accept disrespect
Firmly but politely calling out an incident of disrespect can be a first step towards creating a solution. This can mean simply repeating someone’s words out loud, asking if they meant to say what you heard. If an issue persists or escalates, begin by documenting what’s happening. This is often more effective than simply voicing complaints.
If you feel that your safety or that of your staff is at risk, don’t allow yourself to be talked into accepting a dangerous situation. If you’re employed, your healthcare system bears responsibility. If your concerns are not addressed, sometimes reporting to security or even law enforcement personnel is the best course of action to protect everyone. And don’t overlook the option of engaging an attorney if workplace safety issues are routinely ignored.
5. Take care of yourself
Prioritize your own well-being. Make time for self-care, whether it’s through exercise, meditation, or hobbies to help you recharge emotionally and mentally. Mindfulness practices can give you practical tools that help you to stay present, focused, and composed during difficult encounters, preventing potential escalation.
Make time for your family, friends and loved ones. Don’t take them for granted. By nurturing these ties, you will stay connected to the world outside of your practice.
Reclaiming your dignity as a physician will require commitment and some courage. While it’s crucial to acknowledge the culpability of our healthcare systems, real change depends on strong and consistent advocacy from physicians. Fair or not, no one else is likely to do this work for you. By starting with the steps I’ve outlined, you can begin to build a workplace that’s not only more respectful but also more sustainable. And ultimately everyone, including the patients you care for, will benefit.
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 coaching discovery session, click the button below.
References
Exploring the Five Whys: A Self-Coaching Tool for Meaningful Decisions
The Five Whys is often described as a root cause reflection tool, but in coaching, I think of it less as digging for a cause and more as peeling back the layers.
By asking “why” five times, each “why” gently opens another layer of the decision, creating insight and dimension that often goes way beyond the first question.
Some decisions are not difficult because something is wrong.
They are difficult because something important is happening.
⭐ A new opportunity appears.
⭐ A leadership role opens up.
⭐ A job possibility comes into view.
⭐ A creative project begins calling for attention.
⭐ A chance to learn something new feels both exciting and unsettling.
⭐ A long-held professional identity begins to loosen, and another possibility starts to emerge.
Superficially, the question may seem simple: Should I do this?
But meaningful decisions are rarely only about the visible choice.
They often carry layers of hope, fear, loyalty, identity, responsibility, possibility, and self-permission.
You may tell yourself that you are weighing the practical considerations, and of course those considerations matter. But underneath the logistics, something deeper may be asking to be noticed.
This is where the Five Whys can help.
The Five Whys is often described as a root cause reflection tool, but in coaching, I think of it less as digging for a cause and more as peeling back the layers of a tightly held onion.
By asking “why” five times, each “why” gently opens another layer of the decision, creating insight and dimension that often goes way beyond the first question.
The First Answer Is Rarely the Whole Answer
As an example, when you are considering a meaningful change, it’s easy to feel resistance. Your first response to the question “why does this feel so hard?” may seem like a practical answer.
🧅 “I do not have time.”
🧅 “I am not sure I am ready.”
🧅 “It might be too much.”
🧅 “I do not know if this is the right moment.”
🧅 “I should probably wait.”
🧅 “I need to think about it.”
Those answers may be true. But maybe they’re not be the whole truth.
Underneath “I do not have time,” there might be a question about whether you are allowed to make space for something that matters.
Underneath “I am not ready,” there might be fear of becoming visible.
Underneath “It might be too much,” there could be a longing for a different kind of work.
Underneath “I should probably wait,” is there an old habit of deferring your own growth?
The 5 Whys allows you to stay curious long enough to hear what else is there.
Peeling the Onion
Imagine a physician who is considering applying for a leadership role.
The surface question is: Should I apply?
A 5 Whys reflection might unfold this way:
Why does this decision feel important?
Because I keep thinking about it, even though part of me wants to dismiss it.
Why do I want to dismiss it?
Because I am not sure I am ready, and I worry other people may be more qualified.
Why does that worry feel so strong?
Because stepping into leadership would make me more visible.
Why does visibility feel uncomfortable?
Because I have been most comfortable being seen as dependable, capable, and useful behind the scenes.
Why does this opportunity still matter?
Because I do not only want to function within the culture anymore. I want to help shape it.
At the surface, this looked like a question of readiness. But a few layers down, something more meaningful began to appear.
This physician may be standing at the edge of a new professional identity. The real question may not be only, “Am I qualified?” For this physician, the deeper question may be, “Am I willing to be seen in a new way?”
For someone else, the questions may lead in a different direction altogether.
That is the kind of insight that changes the decision-making process in a way that is both meaningful and actionable. Instead of following a predetermined algorithm, you are uncovering a path that is aligned with who you are, and with the life you want to live.
Positive Change Can Still Feel Vulnerable
When you begin to explore change, you may find excitement. But you may also find fear. That does not always mean the opportunity is wrong.
Growth often comes with vulnerability. A positive change may mean:
⭕ Becoming a beginner again
⭕ Stretching into a position of leadership
⭕ Leaving a familiar but constricting role
⭕ Disappointing someone whose plans for you no longer fit
⭕ Allowing yourself to want something you have not admitted out loud
These questions can feel tender, because they are not just logistical questions. They are questions of who you are, and who you are becoming.
What Might Be Underneath?
As you peel back the layers, you may discover different kinds of information.
You may uncover a value:
I want to contribute. I want to grow. I want to create. I want to lead. I want to serve in a new way.
You may uncover a fear:
What if I fail? What if I disappoint people? What if I am judged? What if I am not ready?
You may uncover an old rule:
I should not want more. I should stay where I am needed. I should not take up too much space. I should not change direction after investing so much in this path.
You may uncover an identity shift:
I am no longer only the person who does the work. I may be someone who shapes the work. I may be someone who teaches, leads, creates, builds, or begins again.
You may uncover a longing:
I want my life and work to feel more aligned. I want to make room for something that I have been afraid to make manifest.
The purpose of the Five Whys is not to force change. Instead, it is to create enough openness that the decision can be made from a deeper and more personally resonant place. Once you can see more clearly what is underneath, the next step often becomes easier to discern.
The Takeaway
The Five Whys is not just a problem-solving tool. Used with curiosity and compassion, it becomes a way of opening up a meaningful decision.
Layer by layer, it helps you to move beyond the first, and easiest, answer. It helps you notice the values, fears, loyalties, assumptions, identities, and longings that may be shaping the choice. And often, that is the first step that moves you into a more purposeful and values-driven life.
If you have questions about coaching and how it might work for you, please contact me through the website, or schedule your complimentary 30 minute discovery session.
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.
Doctors are Not Immune From Illness
This is a difficult story for me to tell. It is about facing our humanity and our mortality as physicians. And it’s about the truth that despite our desire to view ourselves as insiders with the keys to the hospital doors, the pact that we have made is one-sided. There is no covenant with the universe, no deal with the devil that if you save others, you yourself will be saved. I saw my physician father fall victim to this implicit belief after he became ill. I witnessed with sorrow his misplaced trust that he would be treated differently, and his difficulty in disengaging from his identity as a physician.with an idea.
An earlier version of this article originally appeared on Doximity.com, where I was a 2022-2023 Op-Med Fellow.
This is a difficult story for me to tell. It is about facing our humanity and our mortality as physicians. And it’s about the truth that despite our desire to view ourselves as insiders with the keys to the hospital doors, the pact that we have made is one-sided.
There is no covenant with the universe, no deal with the devil that if you save others, you yourself will be saved. I saw my physician father fall victim to this implicit belief after he became ill. I witnessed with sorrow his misplaced trust that he would be treated differently, and his difficulty in disengaging from his identity as a physician.
I’ll start by telling you about my father before his illness. He was a brilliant physician and researcher, an immigrant and outsider who worked his way up to the highest position in his specialty. He taught and inspired generations of medical students, residents, and fellows from around the globe. He was described to me years later by one of his former fellows as “a god.” He saved, mended, and assisted in the conception of countless lives through his innovative therapy and research.
My father was a humble man in many ways. But he refused to submit to becoming a patient, and that’s what was ultimately his undoing.
My father’s family history was riddled with heart disease and early death. His mother died of a heart attack at the age of 45. Most of his siblings died young. But he was a vigorous and proud man, and even when he suffered an unexpected and frightening episode of hypertensive heart failure after returning home from a conference, he refused to see a cardiologist.
I will never know what kept him from seeking help, but I believe that he was afraid of what he might learn. That all the years of work and sacrifice might eventually catch up with him. That he needed someone or something else to become physically whole again. That his health, and thus his independence, might be irretrievably changed. That he, like those he cared for and those he loved, was mortal and vulnerable.
Truth be told, he refused to even go to the ER for evaluation. Instead, he sent my mother, a physician herself, out to the pharmacy for a dose of furosemide in the middle of the night. It was she who made the diagnosis, with her stethoscope and her blood pressure cuff.
To us, his children, this somehow did not appear inappropriate or unusual. Our parents were true medical do-it-yourselfers. They always seemed to have everything under control, so why should this be any different?
Yet I recognized that something was off. At the time I was a medical student out of state, and during my calls home my dad regularly assured me that his blood pressure was a perfect 120/70 on a low dose of medication. I thought he was misleading me, but from hundreds of miles away, there was nothing I could do about it but believe him.
It should have come as no surprise that my father suffered a terrible hypertensive stroke several years later. It was severely disabling, and despite appropriate care, there was no hope of recovery. I will never forget finding him in the radiology department of the hospital, a local facility far from his world-renowned academic medical center, where no one knew him. Slumped in his wheelchair in a faded hospital gown, he was shivering, weeping, and demoralized.
This was the unraveling of the deal that he believed he had made. No longer the professor, the department chief, the innovator, he was simply the stroke in Room 402. He had gone from a man of the world to a random patient, unacknowledged and unremarkable.
Plaintive pleas for water, request for assistance to the bathroom, and upkeep of simple hygiene were addressed by staff with disinterest, although he received timely care. Instead of being acknowledged as a respected and dignified physician, he felt like an outsider, just another task for the busy staff who had no time or reason to think any more of him.
After my father returned home, there was a brief period of hope and even optimism that things might improve, despite the devastation recorded on his imaging studies. But what little recovery he made was unimpressive and ultimately gave him no freedom or chance of independence.
He had been beloved by his patients and revered by his colleagues, but after the first brief flurry of visitors, the world moved on and he was mostly forgotten.
He desperately wanted to return to work, to reclaim his identity, to be of service. He was unable to drive himself, so after much anguished pleading, my mother agreed to take him for a visit to his hospital and research lab. He found himself disoriented, lost, and humiliated, subjected to the well-meaning pity of his former staff.
It was clear to everyone that his days as a physician were over, and he retreated to his home. Only a sole colleague regularly came by to see him for the next seven years of progressive decline that preceded his death.
From my father’s devastating story, I learned several hard but ultimately sustaining truths. These lessons have informed my life and my practice of medicine. I believe they not only made me a better physician but also allowed me greater freedom to explore and discover the world outside of our profession.
Although I’d like to believe otherwise, the crucial lesson I learned was that being a physician does not provide us with a teflon shield. As physicians, we spend tens of thousands of hours learning our profession, honing our skills, giving up much of our 20s and 30s in service to our calling. Most of the time, we offer this sacrifice willingly, knowing that by doing so we will be worthy of our patients’ and colleagues’ trust. Even after training, the climb never ends. We may lose untold hours of sleep, delay time with family, forgo relationships and other passions. We take on the weight of our patients’ illness, fear, even their anger at the whims of fate.
Surely the scales must somehow balance out for us in the end, a karmic destiny in this life. That is the deal that I believe my father made.
The truth is that physicians are human, no matter how invincible we may feel. My father’s sad journey taught me that. But if we need any further proof, COVID-19 has shown us that nobody is beyond the reach of sickness and death. I believe that it’s important to live life with that understanding.
The time to act is now. Even with the best preventive practices, there are no guarantees, but taking straightforward measures have the power to extend and improve the quality of the life we have. Waiting until retirement to take preventive care seriously may mean waiting too late. Through my father’s suffering, I was able to appreciate the importance of taking the earliest risk factors seriously.
My father’s story also taught me that eventually, most of us will leave the fraternity of medical practice, whether we do so willingly or not. We must take the reins and be the driver of our own lives; otherwise we will one day find ourselves separated and bewildered, without a North Star to follow. Nothing is promised. And there is no time to waste.
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.
As a physician coach, I will work with you to explore what’s possible and create a plan that aligns with your personal values and aspirations. Schedule your exploratory conversation with me by clicking the button below.
Burnout is an Expression of Grief, Not a Lack of Compassion
“The wound is the place where the light enters you.”- Rumi
With over 60% of physicians surveyed reporting burnout in 2021, it’s an epidemic in our profession.
Burnout is not a personal failing or a psychological illness. Rather, burnout is a response to chronic workplace-related stress.
But burnout is not a failure of compassion. In fact, burnout may be a natural reaction to the recognition that you are unable to provide the compassionate care that your patients need.
An earlier version of this article appeared on the KevinMD website in June, 2023
In 2025, more than 40 percent of physicians surveyed reported at least one symptom of burnout. As bad as this sounds, it was an improvement over the pandemic era, when over 60 percent of physicians experienced one or more manifestations of burnout. Yet despite this meaningful improvement, the problem remains substantial. It’s no wonder that the word “burnout” has become nearly synonymous with the state of health care.
Before we go any further, it’s important to understand that burnout is not a personal failing, and it doesn’t mean that you lack compassion or empathy. The World Health Organization (WHO) defines burnout as an occupational phenomenon that develops in response to chronic workplace-related stress.
Despite the systems that create the conditions for burnout, physicians are often made to feel responsible for the problem. You may be encouraged to be more resilient, more efficient, more mindful, more adaptable. Those things may help at the individual level, but by definition, burnout is not a weakness or a psychological illness.
Burnout can affect your life in many different ways, but the WHO makes clear that burnout “should not be applied to describe experiences in other areas of life.” This is an important distinction, because it shifts the responsibility for burnout to the workplace.
Burnout is not a failure of compassion
If you’re feeling burned out, it doesn’t mean that you don’t care. In many cases, it can mean the opposite. Burnout may arise from the painful recognition that you are no longer able to provide the kind of thoughtful, connected, compassionate care your patients need, or the kind of care you entered medicine to provide.
This is why, in a very real sense, burnout may mirror grief.
Both burnout and grief are responses to loss. Grief is not only about death. You may grieve the loss of time, purpose, identity, autonomy, connection, or the way you once imagined your work would be. And like burnout, grief can show up as exhaustion, irritability, numbness, difficulty concentrating, and a sense of disconnection from life as it once felt.
For physicians, burnout may represent grief for the doctor-patient relationship you thought you would have. Grief for the time you no longer have with patients. Grief for the ability to think deeply, listen fully, and practice medicine in a way that feels whole.
The role of moral distress
Moral distress is closely related to burnout, but is a different condition. It describes the anguish that arises when you know what your patients need, but are constrained by systems, policies, staffing shortages, financial pressures, or administrative demands that prevent you from acting in alignment with that knowledge.
Over time, that repeated gap between what you believe is right and what you are able to do can become profoundly demoralizing.
The added pain of mistrust
It’s impossible to discuss burnout and moral distress without acknowledging the role of mistrust. Social media, misinformation, political polarization, and other societal forces have changed the way many patients encounter medical expertise.
For doctors who entered medicine with a deep commitment to service, science, and the healing relationship, it can be profoundly painful to face unfounded suspicion and doubt, or to be treated as part of a system that patients no longer believe has their best interests at heart.
Burnout versus compassion fatigue
Burnout and moral distress are different from compassion fatigue.
Compassion fatigue is often described as emotional withdrawal or a reduced capacity to respond to the suffering of others, often after repeated exposure to trauma, illness, or death.
High-acuity environments often trigger situational compassion fatigue in physicians. The early days of the COVID-19 pandemic were a powerful example, particularly for clinicians working in emergency departments, ICUs, and other settings where suffering and loss were relentless.
Compassion fatigue does not mean a physician is uncaring. It means they are overwhelmed and in need of relief.
We might consider burnout and moral distress as forms of disenfranchised grief. But they are not compassion fatigue. In fact, equating burnout with a lack of compassion may be another heavy-handed way of placing the blame on physicians while deflecting it from the systems that created the problem.
As a coach, I have found that many physicians experiencing burnout are not at all indifferent to their patients. Instead, they are grieving the loss of connection with them. They are grieving the intrusion of RVU pressure, excessive clerical work, inbox burden, staffing shortages, and the constant demand to do more with less. They are grieving the gap between the care they want to give and the care the system allows them to provide.
A call to action
National organizations and many health care systems are beginning to take note, and as supportive processes are put in place, rates of burnout are gradually improving. But there is much work to be done.
In the words of the poet Rumi, “the wound is the place where the light enters you.”
If you’re experiencing burnout or moral distress, it’s important to recognize it for the wound that it is, have compassion for yourself, and create a plan to move forward.
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As a physician coach, I will work with you to explore what’s possible and create a plan that aligns with your personal values and aspirations. Schedule your exploratory conversation with me by clicking the button below.
Retirement Planning for Physicians: Meet Your Future Self
No matter where you are in your professional arc, the “future self” exercise is a powerful tool for envisioning and then creating a meaningful retirement. In this article, we’ll explore how you can use this exercise to develop and align your retirement plans with your personal values, dreams, and aspirations.
An earlier version of this article appeared on this website in December 2024
For many physicians, the idea of retirement may feel distant, daunting, or even unattainable. Although physicians on average are exiting the profession nearly a decade earlier than in years past, it’s not surprising that the thought of leaving may still seem frankly overwhelming.
After so many years of dedicating your life to others’ health and well-being, what does a fulfilling retirement look like for you?
The truth is that retirement is different for each of us. Some people happily move out of the profession and take a new path, never looking back. Others repurpose some of the skills they’ve acquired and dedicate that to teaching, mentoring, volunteering, or creative work.
Yet many physicians mourn the life they’ve given up, struggling deeply with the loss of identity, structure, and purpose that can come with leaving clinical life behind.
No matter where you are in your professional arc, the “future self” exercise is a powerful tool for envisioning and creating a meaningful retirement. In this article, we’ll explore how you can use this exercise to develop and align your retirement plans with your personal values, dreams, and aspirations.
Planning for Retirement with the Future Self Exercise
It can be difficult to imagine yourself many years into the future. Instead, a one-to-five-year time line might feel more tangible. That’s partly because needs, priorities, and dreams often change over time. If you think back to the person you were ten years ago, it’s possible that version of you feels very different from your current self.
Research on the “future self” confirms that we often perceive this unknown version as an “other.” And yet, thinking about your future self as someone you care about can foster a sense of compassion, responsibility, and intentionality.
If you’re contemplating retirement, the future you may already feel a bit more knowable. And in this context, the future self exercise can be especially useful and actionable.
This exercise can help you design your goals both by creating self-awareness and clarity, but also through aligning your current actions with your long-term hopes and dreams. You can’t control the future, but you can take ownership of your direction during this major life transition.
Your Step-by-Step Guide to the Future Self Exercise
Step 1: Set the Stage
Choose a quiet, comfortable space where you can reflect without interruption.
Have a journal or notepad ready so you can capture your thoughts as they arise.
Step 2: Imagine your ideal retirement.
Close your eyes and picture yourself 1-5 years into retirement.
Questions to consider:
What does your day look like?
Where are you living?
Who are you spending time with?
What activities bring you joy, energy, or fulfillment?
Step 3: Consider your impact
Staying with the image of your future self, ask:
What am I proud of accomplishing since retiring?
How am I continuing to make a difference or live meaningfully?
What feels most satisfying about this phase of life?
Step 4: Identify values and priorities
Still holding the future in your mind’s eye, reflect on:
What matters most to me in this phase of life?
What are the values I hope to embody?
How do I want to feel in my daily life?
What do I want more of—and what am I ready to release?
Step 5: Nurture relationships and connections
Sitting with your future self, consider:
Who are the friends, family members, colleagues, or communities I care about?
What relationships do I want to develop or deepen?
How am I creating a life that keeps me connected and supported?
Step 6: Carry your strengths forward
Ask yourself:
What strengths and skills from my life as a physician do I use in this next phase of life?
How might I use those strengths in new or meaningful ways?
Howwill I continue to learn, grow, and stay engaged?
Step 7: Write a letter to your future self
It can be helpful to write a letter to your future self, describing your hopes, goals, and dreams for this next chapter.
Seal it and set a date to read it in the future. Create a reminder on your phone or calendar so you don’t forget. This simple act can help you stay connected to the life you are beginning to imagine and create.
Translating Your Vision into Action
Once you’ve completed the process, take a look at what you’ve written. Highlight any recurring themes, patterns, or ideas that stand out. Then begin to identify actionable goals that can help you move toward the retirement you want to live. Here are some ideas to get you started:
🎯 Financial goals: You may want to enlist a trusted advisor to help you clarify and refine your financial goals. Having a thoughtful plan can help you enjoy retirement with less worry about money, savings, or long-term security.
🎯 Lifestyle goals: Begin to define your ideal balance between relaxation, hobbies, health, creativity, and productivity. Physicians often overlook their own well-being when life gets busy, but the pre-retirement years are an important time to make your health a priority so you can fully enjoy the next phase when it arrives.
🎯 Relationship goals: Consider who you want to share your time with, and in what ways. It’s never too soon to strengthen relationships and cultivate friendships, even if that starts with a brief text, phone call, coffee invitation, or email to keep the lines of communication open.
🎯 Legacy goals: Explore ways to contribute to your community or profession. This might include teaching, mentoring, volunteering, writing, advocacy, creative work, or something entirely different. You don’t need to make a commitment before you’re ready, but this can be a good time to explore areas of interest you may not have had time for during your working life.
It’s Never Too Soon to Start
Although your goals and plans may change over time, the Future Self exercise can be a powerful way to strengthen your vision and jump-start your planning. It’s never too early to begin taking small steps now to integrate elements of your future self into your current life.
When your life and identity have been shaped by your profession, it’s natural to feel overwhelmed and unmoored by the decision to retire. But retirement can also be an opportunity to redesign your life in a way that aligns with your values, passions, relationships, and aspirations. The Future Self exercise offers a practical and meaningful way to gain clarity and begin shaping this next chapter with intention.
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.
Dealing with Regret: Discovering Growth and Self Compassion
When you’re a physician, it can sometimes feel as if the weight of the world is on your shoulders. Despite years of training and experience, dealing with the unexpected is part of the job.
Complex decisions with no easy solution, challenging interactions with patients and family, and outcomes that don’t always turn out as planned: these are unavoidable facts of life for most physicians.
Although you may thrive on the challenge of the unexpected, seemingly lost opportunities or unanticipated consequences may lead to feelings of regret that can haunt you when you least expect it.
This is completely normal, but coming to terms with regret can be difficult. What can make it especially painful is the fact that this aspect of professional life is rarely discussed out in the open.
In this article, we’ll talk about regret, what it can teach you, and how it might help you to become an even more effective physician.
An earlier version of this article appeared on this website in October 2024.
When you’re a physician, it can sometimes feel as if the weight of the world is on your shoulders. Despite years of training and experience, you can’t always predict a complication or an outcome. And you can never be certain how an individual or family is going to react, even when you believe you are offering good news. Dealing with the unpredictable is part of the job.
Although you may thrive on the challenge of difficult decisions and complex interactions, the shadow of lost opportunities or unanticipated consequences can sometimes lead to feelings of regret. These painful reminders may haunt you when you least expect them.
This is all completely normal, but coming to terms with regret can be difficult. What can make it especially distressing is the fact that this aspect of professional life is rarely discussed out in the open.
In this article, we’ll talk about regret, what it can teach you, and how it might help you to become an even more effective physician.
Regret is normal, and it’s a sign of compassion
Although it can feel crushing in the moment, regret is not a weakness or a marker of failure. Instead, it can be helpful to reframe regret as evidence that you are compassionate and invested in the outcome of your decisions. Whether that’s the well-being of your patients, the strength of your relationships, or the integrity of your work, you wouldn't feel regret if your work didn’t matter.
Learning from regret
When you recognize regret in this way, you can break the cycle of rumination and open yourself up to the multitude of lessons it holds, including opportunities for reflection and discovery.
Perhaps the lesson is learning to slow down, to listen more closely to your patient or their family, to take an extra breath before responding to a difficult conversation. Maybe it’s resolving to take a more active role, or advocating more effectively when faced with challenging situations. Or it could be a recommitment to ongoing learning and professional development.
It’s important to acknowledge that although the past cannot be changed, it can inform the future. If you can reframe a complication or a poor interaction as a catalyst for growth, it can help you to build strengths that will offer a way forward.
Here are some questions to ask yourself that might help to create mental space for new ideas:
Are there ways that you can mitigate the consequences, even now?
What would have needed to happen for things to have turned out differently?
What actions are within your control?
What resources might you need that were not available to you then?
How might you respond next time you’re faced with this situation?
The importance of self-compassion
As a physician, perfectionism is probably one of your driving forces. But at the same time, you may hold yourself to impossibly high standards.
Although you may never have been taught this in training, at some point in your career, you will very likely make a decision that, in hindsight, turns out to be wrong. Other times, some outcomes or reactions will simply be beyond your control.
Self-compassion means treating yourself with the same kindness and understanding that you would offer a colleague or friend. And at the same time, caring for yourself helps you to stay present and capable of providing the best care for your patients.
Of course, regret can sometimes feel overwhelming, despite your best efforts to overcome it. When this happens, professional help in the form of a counselor or a coach can be sustaining.
Turning regret into action
It’s important not only to acknowledge regret, but to turn your reflections into action. Use your hard-earned awareness to make adjustments, both big and small, that will help you navigate future challenges with more confidence and clarity. Depending on the source of your regret, it might mean
Taking a course
Learning or perfecting a skill
Seeking feedback or support from a trusted colleague, coach, or mentor
Implementing measurable changes in a process or procedure
Practicing mindful communication
Setting clearer boundaries
Reaching out to a mental health professional
Moving forward from regret is about progress, not perfection. It's about using each experience to inform your next steps without getting stuck in the past.
Discovering resilience and growth
Learning from regret will strengthen your resilience and shape your compassion for colleagues who may find themselves mired in similar situations. By being intentional rather than dwelling on self-blame, you will build a toolbox of strategies that will support you through the inevitable challenges that arise in the future.
Regret is a seldom-acknowledged part of the life of a physician. With time and practice, it can become a guide, pointing you towards opportunities for personal growth and a deeper connection with the values that first led you to find your place in the medical profession.
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 Should You Expect From Physician Coaching?
If you’re considering investing in physician coaching, you probably want to know what you will actually have to show for it when your coaching arc is complete.
Will there be a written plan? Goals? Metrics? Accountability? Practical strategies? Or will coaching mainly consist of talking through problems and reflecting on what comes up?
These are reasonable questions, and they’re the questions that prospective clients often ask me.
If you’re considering investing in physician coaching, you probably want to know what you will actually have to show for it when your coaching arc is complete.
Will there be a written plan? Goals? Metrics? Accountability? Practical strategies? Or will coaching mainly consist of talking through problems and reflecting on what comes up?
These are reasonable questions, and they’re the questions that prospective clients often ask me.
Here’s what you should know: Good coaching creates space for reflection. Sometimes that’s exactly what’s needed to get unstuck. But coaching can also help you set goals, develop an action plan, or navigate difficult circumstances and conversations.
Having a safe place to think out loud with a compassionate, objective coach can lead to important breakthroughs and meaningful change. Coaching may help you recognize and reframe habitual patterns involving perfectionism, imposter syndrome, procrastination, or over-responsibility. That shift in perspective can change how you approach both your work and your life.
And when you are looking for something more concrete, coaching can help you translate your insight and vision into clearer decisions, more intentional actions, and purposeful changes in the way you work and live.
What might a successful three-month coaching arc look like?
There is no single definition of success because each physician brings different goals and circumstances.
One physician may want to establish clearer limits around an expanding workload. Another may be exploring leadership opportunities. Someone else may be considering a career transition, developing a medical education project, or trying to protect more time and energy for life outside medicine.
The first step is to clarify the personal values that matter most to you. The next is to imagine what success would look like in concrete terms, while recognizing that the destination is not set in stone. Goals and circumstances may change over time, while your core values can serve as important guideposts.
What happens during the first month of coaching?
As with most aspects of coaching, this looks different for each person. But the first several sessions usually focus on clarifying three things:
⭐ What is creating the most pressure right now?
⭐ What broader patterns may be contributing to the problem?
⭐ What would make coaching feel worthwhile?
Using my Focus-Shift-Balance-Fly framework, this is where we begin with Focus.
We work toward clarity before rushing into solutions. And we begin to notice the patterns, assumptions, and habits that may be contributing to the challenge.
As clarity develops, we begin the early stages of Shift—moving from reacting to circumstances toward making intentional choices about how to respond, and what else to explore.
An immediate challenge can then become an opportunity to develop skills and perspectives that apply far beyond a single workplace issue.
What should happen after each coaching session?
A coaching session does not need to generate pages of homework to be useful. Sometimes a worksheet, journal prompt, or other strategic exercise can help create momentum. But more paperwork is not always the best answer for an already overloaded physician.
No matter what form it takes, each session should lead to discovery and a defined next step that takes place outside of the coaching conversation.
Depending on the topic, that might include:
✅ A brief action plan
✅ A script or outline for a difficult conversation
✅ A decision-making framework
✅ A calendar or weekly planning experiment
✅ A boundary statement
✅ A list of information to gather
✅ A measurable step on a career project
✅ A reflection question designed to uncover a recurring pattern
There’s no one-size-fits-all action plan. That’s what makes coaching such a human-centered and personalized process.
What should be different after three months of coaching?
Three months is not enough time to redesign an entire career. But it is enough time to create meaningful momentum that extends into the future.
Depending on the focus of the coaching, a physician may have:
🔺Greater clarity about priorities
🔺A more functional calendar or planning system
🔺Better-defined work boundaries
🔺More confidence approaching difficult conversations
🔺A repeatable process for making values-based decisions
🔺Visible progress on a career project
🔺Greater awareness of patterns such as over-responsibility, perfectionism, or avoidance
🔺A clearer understanding of what a sustainable medical career would require
At this stage, you have begun experimenting with what is possible, making intentional adjustments, and designing your life in a way that better honors your values.
Rather than simply reacting to demands, you are beginning to create systems, habits, and choices that support the future you want to build.
Most importantly, you have more than insight. You are moving forward with greater confidence, intention, and alignment.
Coaching is structured, but not rigid
Coaching is not a standardized productivity program. It’s designed to support you as an individual, with all of the complexity that implies.
A strategy that works well for one physician may be unrealistic for another, even when the problems seem similar. That could be due to professional responsibilities, family needs, personal values, or organizational culture.
As a coach, my role is to create a space where you are empowered to clarify your own goals, uncover the obstacles, examine patterns, develop practical strategies, and receive the support and accountability that serve you best.
You remain the expert on your own life, values, and circumstances. And through coaching, you will renew and refine your own vision, creating your own future.
If you have questions about coaching and how it might work for you, please contact me through the website, or schedule your complimentary 30 minute discovery session.
Art, Mindfulness, and Medical Practice: Wu Zhen’s The Fisherman
As a photographer, a physician, and a Visual Thinking Strategies facilitator, I believe that visual art is a portal through which we may discover find powerful connections with people from all walks of life.
For physicians and others in healthcare, art provides a framework to build understanding and create greater trust, even when we have no background in the artistic process or history. When we spend time with a work of art, we’re offered a chance to explore what the world might mean to somebody from a different time, place, or culture.
In this article, I’ll explore Wu Zhen’s The Fisherman, and the lessons it offers for medical practice.
An earlier version of this article appeared on this website in September, 2024
As a photographer, a physician, and a Visual Thinking Strategies facilitator, I believe that visual art is a portal through which we may discover find powerful connections with people from all walks of life.
For physicians and others in healthcare, art provides a framework to build understanding and create greater trust, even when we have no background in the artistic process or history. When we spend time with a work of art, we’re offered a chance to explore what the world might mean to somebody from a different time, place, or culture.
Art is also a meaningful way to access mindfulness. It only takes a few minutes of focused attention to gain a greater and more subtly shaded experience.
Think of the way that you listen to music. It may be simply background noise or entertainment, but there are times that the experience offers an unexpected way to connect the dots that have been accumulating in your subconscious mind.
In a previous article, I shared the very contemporary insights and connections that we can access by spending time with Vermeer’s The Geographer, painted in the 1600s. In this article, I’ll explore an even older work of art: Wu Zhen’s The Fisherman.
Wu Zhen, The Fisherman (attribution: Wu Zhen, Public domain, via Wikimedia Commons)
Wu Zhen was a painter in 14th century China. In his lifetime, he was not really acknowledged or recognized as an important artist. But about a hundred years later, he was identified as one of the four Great Masters of the Yuan. As a result, his work became a powerful point of reference for many subsequent artists, and that continues to this day.
When Wu Zhen was painting, his country was in chaos as a result of the Mongol takeover. Despite (or perhaps because of) this turmoil, there was tremendous cultural growth underway. At the time, there was a very influential and industrious scholar class that was highly visible in public life. For the middle class, that was an elite realm of life considered worthy of aspiration.
But there was also an idealized, simpler and more rural lifestyle. Although Wu Zhen was educated and could well have lived comfortably as a scholar, he chose to take his life in this slower direction, away from the turmoil and conflict that was part of life in the city.
Through his work, he sought to capture and distill the essence of his subject with line, shade, and pattern. Many of his works, like this one, included a poem written in calligraphy, which is translated by the Metropolitan Museum of Art as:
Red leaves west of the village reflect evening rays,
Yellow reeds on a sandy bank cast early moon shadows.
Lightly stirring his oar,
Thinking of returning home,
He puts aside his fishing pole, and will catch
no more.
So Wu Zhen lived this very simple rural lifestyle, yet was a man of great intellect.
At the same time, in the cities, other Chinese artists were creating more literal portraiture. But it was understood that there was a difference between this precise way of working compared with the ethereal and intellectual work of artists like Wu Zhen.
In our contemporary age, such a longing for simplicity or austerity may be interpreted as a sign of a less sophisticated or uneducated mind. Yet these preconceptions can be misleading. Wu Zhen’s work is a reminder that in accepting such a one-dimensional stereotype, we may overlook the richness and depth of an individual. And we are all the worse for the loss.
How can you transfer the experience of art to the practice of medicine? Consider what happens when you meet a patient or somebody in your everyday life. With the brief time allotted for the encounter, you might only be given the outlines of that person, almost like a quick sketch.
Perhaps if you’re open to a richer way of seeing, you will take a few moments to appreciate those outlines. In doing so you might be able to discern more layers than you first realized, and to notice that more often than not, your patient does not fit into a simple template. Maybe it’s the choice of clothing, the way they carry themselves, the book they hold in their hand. And as a result of this discernment, your questions may become more nuanced and your listening more focused.
Think about this way of relating as creating sort of a bridge between you and the other person. You might be able to find a connection or trace a thread of a clue in the same way as you might experience a work of art.
An earlier version of this article appeared on this website in April 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.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
My Podcast Appearance on Dr. Bill Lombardi’s Journey to Better
It was a thrill to appear on the legendary cardiologist Dr. Bill Lombardi’s podcast The Journey to Better. I was honored to be invited onto the show to discuss mindfulness, goal setting, and combating burnout.
An earlier version of this article appeared on this website in June 2024
It was a thrill to appear on legendary cardiologist Dr. Bill Lombardi’s podcast The Journey to Better in 2024, and a pleasure to revisit our conversation. I was honored to be invited onto the show to discuss mindfulness, goal setting, and combating burnout, and the topics remain as relevant as ever.
Dr. Lombardi is one of the world’s most experienced operators in complex PCI and chronic total occlusion procedures. He has also spoken candidly about his own challenges with well-being in this demanding, high-stakes field. His episodes with a diverse group of cardiologists and other healthcare professionals will resonate with any physician who understands the rewards, pressures, highs, and lows of caring for patients today.
Physician Coaching or Mentoring: What’s the Difference?
As a physician coach, I am often asked to explain the difference between coaching and mentoring.
The main difference is this: A mentor generally acts as an advisor. A coach does not give you the answers, but will collaborate with you to help you find and follow your own path.
An earlier version of this article appeared on this site in May, 2023.
As a physician coach, I am often asked to explain the difference between coaching and mentoring. It’s an important question, especially when you are thinking about investing in a coach. Both coaches and mentors can help you think more intentionally about your professional life and move toward goals that matter to you.
Coaching and mentoring have some important things in common, but they also work in meaningfully different ways.
Simply put, a mentor usually offers advice based on experience. Unlike a mentor, a coach does not need to have specific expertise in your specialty. Instead, in coaching you are considered the expert in your own life. A coach guides you to step back, think more clearly, and decide what is right for you.
Sometimes a combination of both coaching and mentoring can be helpful. In this article, we’ll go over the differences between the two, and how each can help you to achieve your goals and dreams.
Coaching vs Mentoring: The Core Differences
A mentor is usually someone with more experience in an area you want to explore. They may have followed a path similar to the one you are considering, so they can share what worked, what did not, and what they wish they had known. They will often give you specific guidance and direction.
A coach takes a different approach. Rather than telling you what to do, a coach asks questions that help you sort through your own thoughts, priorities, and possibilities. Through this process, you’ll develop your own meaningful goals that support the life that you envision for yourself.
That does not mean a coach simply sits back and listens. A coach may offer observations, help you notice patterns, challenge assumptions, and support you in creating a realistic plan. But the goal is not to steer you toward a particular answer. It is to help you find the answer that fits your life.
What happens in physician coaching?
Coaching often begins with taking a closer look at what matters most to you.
What are your values? What is working well? What feels out of balance? What is the life that you are hoping to build, and what might be getting in the way?
From there, you and your coach can identify meaningful goals and begin turning them into practical next steps. Those goals may change over time as you gain clarity or discover new options.
Physician coaching usually starts with a professional concern, but personal life and well-being often become part of the conversation. That is not surprising. For most physicians, career decisions are closely connected to family, health, identity, finances, and quality of life.
A coach also brings neutrality to the process. A mentor, colleague, or supervisor may have ideas about what you should do next. They may even be invested in the outcome. Coaching offers more freedom to explore a wider range of possibilities.
Why do physicians seek coaching?
A physician may seek coaching for many different reasons. Some examples include:
As you can see, these are often complex topics that do not have straightforward or defined answers. The process and outcome will be different for each person, depending on their own unique desires, circumstances, and stage of life.
Two physicians dealing with burnout, for example, may be seeking very different solutions. One may want to change schedules or responsibilities. Another may be considering a new role or leaving clinical practice altogether.
Coaching creates a safe space to explore what is meaningful and possible for you, and to envision a future that aligns with your hopes and dreams.
Mentorship: Guidance from experience
Mentoring is often especially helpful when you have a specific goal and want guidance from someone who has already done something similar.
You might seek a mentor if you want to:
Learn a new procedure
Build a research career
Move into leadership
Navigate promotion
Develop an area of expertise
Start or grow a medical practice
A mentor can explain how things work, introduce you to the right people, and help you avoid common mistakes.
Mentorship can be especially important early in a physician’s career, but it can also be valuable later on. Many physicians seek new mentors when they take on an unfamiliar role or move into a new area of interest. But that can also be a valuable time to engage a coach.
How coaching and mentoring can work together
Coaching and mentoring are different, but you do not have to choose only one.
A physician moving into leadership might work with a mentor who understands the organization and can offer practical advice. At the same time, a coach might help that physician think through communication, boundaries, confidence, and the kind of leader they want to become.
A physician experiencing burnout might talk with a mentor about optimizing a clinic schedule or revising a practice role. A coach could help explore the larger questions underneath the burnout.
Which one do you need?
Mentoring may be the better fit when you are asking:
How is this usually done?
What specific steps should I take?
Are there skills that I need to develop or hone?
Who should I meet with?
What mistakes should I avoid?
What do I need to know about this field or organization?
Coaching may be more helpful when you are asking:
What do I really want?
Why do I feel stuck?
What is getting in the way?
What matters most to me now?
How do I make a decision I can feel good about?
How do I turn my intentions into action?
Empowering physicians: The coaching experience
As a physician, you may find yourself spending so much time responding to other people’s needs and expectations that it can be difficult to step back and think about your own life. Coaching creates that space.
Coaching can help you see a situation more clearly, recognize choices you may not have considered, and move forward with greater confidence.
If you have questions about coaching and how it might work for you, please contact me through the website, or schedule your complimentary 30 minute discovery session.
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.
Three Things Physicians Should Know About Meditation
Meditation is a hot topic with deep roots, but sometimes it feels like it’s being pushed as a modern-day cure-all for what ails the spirit.
The practice is often touted as an antidote to burnout, when in truth most of us know that a meditation app won’t solve the systemic issues that plague healthcare today.
That’s why it’s exciting that academic researchers have been taking this ancient practice seriously. And they are discovering that meditation can often have powerful and measurable benefits for your mental well-being, your memory, and even your physical health.
An earlier version of this article appeared on the KevinMD website in November, 2o23.
Meditation is a hot topic with deep roots, but sometimes it feels like it’s being pushed as a modern-day cure-all for what ails the spirit.
The practice is often touted as an antidote to burnout, when in truth most of us know that a meditation app won’t solve the systemic issues that plague healthcare today. It’s no wonder that some physicians might be skeptical.
That’s why it’s exciting that academic researchers have been taking this ancient practice seriously. And they are discovering that meditation can often have powerful and measurable benefits for your mental well-being, your memory, and even your physical health.
A quick search on PubMed.gov retrieves thousands of reports and peer-reviewed studies on meditation, most of which were published in the past 10 years. Trying to sort through the evidence can quickly become a fascinating, winding rabbit hole worthy of Alice in Wonderland.
To make the evidence easier to navigate, this article will focus on one specific type of meditation: mindfulness meditation. Mindfulness meditation is sometimes associated with Vipassana, or insight meditation, although Vipassana is a more specific practice rooted in the Buddhist tradition.
Mindfulness meditation centers on being present in the current moment. It involves noticing thoughts, emotions, and sensations as they arise, without immediately judging them or getting swept away by them. These qualities can be especially valuable for physicians, whose work requires focused attention, emotional steadiness, and the ability to stay present with patients under stressful conditions.
Here are three things that you should know about mindfulness meditation.
Meditation may enhance your clinical skills
There is a broad range of research looking at the impact of meditation on neuroanatomy and neurophysiology. The practical implications are powerful.
Meditation can help by
Improving the ability of the brain to pay attention to a task
Enhancing body awareness
Helping you to regulate your emotions
Increasing capacity for memory
Boosting your sleep quality
Improving your cardiovascular health
For physicians, this means that regular meditation can support your ability to focus on important details. It can also help you stay present with your patients, even during a busy or emotionally demanding day. Over time, this practice may make it easier to maintain equanimity when stressful situations arise.
It may be best to meditate in the morning.
Although meditation may improve your sleep quality, there is good evidence that in the short term, mindfulness meditation can actually increase brain arousal. Why does this happen? The theory is that since meditation may help to focus the mind, it may lead to heightened awareness and attention. That’s why some people may find that meditating at the beginning of the day is most beneficial.
A daily five-minute meditation can have lasting benefits
Morning might be the best time to meditate, but few of us are willing to wake up 30 minutes early just to sit quietly in a comfortable position. The good news is that a study of stressed-out mental health professionals found that a mere 5 minutes of mindfulness meditation can have important benefits.
How to get started with meditation
Getting started with meditation is easy. You don’t have to escape to an ashram or travel to a tropical island to learn how to do it. I’ve written a quick-start guide to meditation for physicians that you can access here.
As with many practices, meditation isn’t for everyone. For some, it can even create mental distress. If you find that meditation provokes anxiety or agitation, it may be best to avoid it. And if you’re under the care of a mental health professional, check in with them first before beginning a meditation practice.
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.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
References:
Britton WB et al. Awakening is not a metaphor: the effects of Buddhist meditation practices on basic wakefulness. Ann N Y Acad Sci. 2014 Jan;1307:64-81.
Fox KC et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev. 2014 Jun;43:48-73.
Hölzel BK et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011 Jan 30;191(1):36-43.
Kozasa, EH et al. Meditation training increases brain efficiency in an attention task. NeuroImage, 2012 Jan; 59: 745-749,
Krittanawong C et al. Meditation and Cardiovascular Health in the US. Am J Cardiol. 2020 Sep 15;131:23-26.
Lam AG et al. Effects of Five-Minute Mindfulness Meditation on Mental Health Care Professionals. J Psychol Clin Psychiatry 2015 March; 2(3): 00076.
Levine, G. N., Lange, R. A., Bairey‐Merz, C. N., Davidson, R. J., Jamerson, K., Mehta, P. K., Michos, E. D., Norris, K., Ray, I. B., Saban, K. L., Shah, T., Stein, R., & Smith, S. C. (2017). Meditation and cardiovascular risk reduction. Journal of the American Heart Association, 6(10). https://doi.org/10.1161/jaha.117.002218
Pérez-Peña M et al. Mindfulness-Based Interventions and Body Awareness. Brain Sci. 2022 Feb 18;12(2):285.
Rusch HL et al. The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Ann N Y Acad Sci. 2019 Jun;1445(1):5-16.
Taylor, G. B., Vasquez, T. S., Kastrinos, A., Fisher, C. L., Puig, A., & Bylund, C. L. (2022). The Adverse Effects of Meditation-Interventions and Mind–Body Practices: a Systematic Review. Mindfulness, 13(8), 1839–1856. https://doi.org/10.1007/s12671-022-01915-6
Youngs MA, Lee SE, Mireku MO, Sharma D, Kramer RSS. Mindfulness Meditation Improves Visual Short-Term Memory. Psychol Rep. 2021 Aug;124(4):1673-1686. doi: 10.1177/0033294120926670. Epub 2020 May 25. PMID: 32448056; PMCID: PMC8242403.
Wu R et al. Brief Mindfulness Meditation Improves Emotion Processing. Front Neurosci. 2019 Oct 10;13:1074.
The Hidden “Deep Work” of Medicine: Why Your Inbox Is More Demanding Than It Looks
For many physicians, the electronic health record (EHR) inbox is treated as “light work.”
A message from a worried patient. A lab result. A radiology report to review. Something you’re expected to squeeze in between patients, or finish at the end of the day.
But if you’ve ever sat down to thoughtfully review a complex lab trend, interpret an imaging report in context, or respond to a nuanced patient message, you know this is not light work.
In many cases, it’s exactly what productivity expert Cal Newport would call deep work.
For many physicians, the electronic health record (EHR) inbox is considered “light work.” It’s necessary but unrewarded. The only metric that matters is whether it gets done within a prescribed time frame.
A closer look reveals more depth: A message from a worried patient. A lab result that’s a little bit off. A radiology report that raises more questions. A preauthorization for a needed test. They’re important and necessary, but something you’re expected to squeeze in between patients, or finish at the end of the day.
Let’s be clear: It’s not light work when you
⚕️take the time and mental energy to thoughtfully review a complex lab trend
⚕️interpret an imaging report in context of the past medical history and recent symptoms
⚕️advocate for your patient with a persuasive argument to a nameless utilization review auditor
⚕️respond to a nuanced message
In many cases, it’s exactly what productivity expert Cal Newport would call deep work.
What Is “Deep Work”—and Why Does It Matter in Healthcare
Cal Newport describes deep work as cognitively demanding high-value work that requires sustained focus, careful thinking, and meaningful decision-making.
Many inbox tasks fit the definition of deep work. They may be considered task completion, but in reality it’s clinical decision-making. And this work often requires the same level of focus as seeing a patient face-to-face.
The Hidden Cost: Attention, Energy, and Time
One of my recent coaching clients—a highly skilled subspecialist—put it perfectly: “It’s not only the volume, which is a lot. It’s the work of thinking.”
Patients are complicated human beings. Decisions about their care are rarely binary, and small, easily overlooked details can change management. Reviewing the chart, searching out records from the hospital or outside sources, and responding to a patient’s concerns takes time and mental energy.
Because inbox work is not formally structured into the clinical day, it often gets pushed to the margins. That usually means between visits, during lunch, at the end of the day, or at home, late at night.
One physician I know gets up in the middle of the night to work on his charts, because it’s the only time he can work without interruptions.
It’s easy to see how these strategies can lead to cognitive fatigue and even burnout. Increased risk of errors, an anxiety-producing sense of always falling behind, and difficulty feeling finished at the end of the day are natural consequences of a perpetually replenishing inbox.
This physician-level work largely goes uncompensated. But because it happens in small, fragmented pieces, it’s easy for both institutions, and physicians themselves, to underestimate its true impact.
The Mismatch: Deep Work in a Fragmented Environment
According to Cal Newport, deep work requires:
🔺Focus
🔺Time
🔺Continuity
But the typical clinical environment offers:
🔻Interruptions
🔻Time pressure
🔻Constant task switching
This mismatch is at the heart of why inbox work feels so draining, and why it can be a driver of moral distress. You’re being asked to do cognitively demanding work in conditions that actively undermine your ability to do it well.
A Call to Healthcare Leaders
If we continue to treat inbox work as administrative overflow, we will continue to underestimate its impact on physician capacity, decision-making, and patient care.
It’s time to take a closer look:
⭕ How much cognitively complex work is being done outside of scheduled hours?
⭕ How often are physicians expected to perform deep clinical thinking in fragmented time?
⭕ How can this work be fairly compensated?
⭕ How can tasks be pre-screened and delegated to other qualified staff members when appropriate?
Instead of relying on physicians to absorb this work at any cost, how can systems better support them in doing it well?
Providing the time and space for deep work in all its forms is essential for both physician sustainability and high-quality patient care.
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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.
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Strategies for Success for New Physicians in Outpatient Care
If you’re just getting started in practice, or beginning a new role, it’s important to set yourself up for success from the very beginning. Whether your career path is in academic medicine, a large healthcare system, or a private practice, the habits and systems you develop early on can shape both your professional trajectory and your personal well-being for years to come
In this article, we’ll focus on five key areas that will help you provide the best care while managing the demands of a busy practice. Developing these strategies early on can improve both patient outcomes and your own well-being.
An earlier version of this article appeared on this website in September 2024
If you’re just getting started in practice or beginning a new role, it’s important to set yourself up for success from the very beginning. Whether your career path is in academic medicine, a large healthcare system, or a private practice, the habits and systems you develop early on can shape both your professional trajectory and your personal well-being for years to come.
The good news? Although delivering excellent care is a given, success in outpatient medicine is not simply about working harder. It’s also about building sustainable systems and developing strong communication skills, while at the same time protecting your own well-being.
In this article, we’ll focus on five key areas that can help you thrive in outpatient practice while managing the demands of a growing clinical workload.
Master Time Management and Efficiency
Let’s be honest: managing a busy outpatient schedule without sacrificing the quality of care can feel overwhelming. Physicians often find themselves juggling patient visits, charting, inbox messages, and administrative tasks without a clear strategy. The result? Late nights spent finishing notes, mounting frustration, and an overextended staff.
If your role also includes hospital responsibilities, teaching, supervision, or research, the complexity grows quickly. And while it can be tempting to cut corners just to survive the day, shortcuts often create even more stress and inefficiency down the road.
Your strategy for success:
Developing strong time management skills early on is crucial. Prioritize workflows that reduce unnecessary friction and preserve your attention for the work that matters most.
Consider:
⭐Using EHR templates and smart phrases thoughtfully
⭐Building efficient charting workflows
⭐Creating systems for task delegation when appropriate
It’s also worth investing a few hours up front to customize your EHR tools and workflows, including appropriate AI-assisted documentation if available within your system.
When your day is structured intentionally, you’ll not only reduce after-hours charting, but you’ll also improve patient care, communication, and overall satisfaction.
Cultivate Work-Life Balance
In medicine, it’s become increasingly common for work to spill into personal time. What starts as “just finishing a few charts” can gradually become evenings, weekends, and vacations consumed by unfinished work.
Over time, that lack of control affects not only you and your family, but also the quality of care you provide. Chronic exhaustion and burnout can impair focus, increase the risk of mistakes, and diminish your sense of fulfillment in medicine.
Your strategy for success:
Create clear boundaries intentionally rather than waiting for them to appear naturally. One of the most important skills you can develop early in your career is learning when to say “no,” and when to say “later.”
As a new physician, opportunities may come quickly — committee invitations, leadership projects, research collaborations, teaching requests, and extra clinical responsibilities. While some of these opportunities can be valuable, saying yes to everything often leads to overload and resentment.
Before taking on additional responsibilities, pause and ask yourself:
❓Does this align with my long-term goals?
❓Do I realistically have the time and energy for this right now?
❓What will I need to give up in order to say yes?
Sometimes the answer truly is “no.” Other times, “not right now” is the wiser and more sustainable choice.
Protecting time for rest, relationships, exercise, and activities outside of medicine is not selfish. It helps preserve the energy, focus, and emotional presence needed to care well for your patients over the long term.
If there’s a hobby or interest you’ve been wanting to explore, give yourself permission to begin, without expecting perfection. Reconnecting with curiosity and enjoyment outside of work can be deeply restorative.
Focus on Connection and Communication
Strong patient relationships are at the heart of excellent outpatient care. When patients trust you, communication becomes more effective, visits become more efficient, and misunderstandings are less likely to spiral into repeated calls or after-hours messages.
Patients want to feel heard, respected, and cared for. But building rapport can feel difficult when schedules are tight and complex conversations are emotionally demanding.
Your strategy for success:
Start with preparation. Keeping charts current and reviewing key information before the visit helps patients feel confident that they are in capable hands.
But communication is about more than preparation alone. Your ability to listen actively, communicate clearly, and respond with empathy has a major impact on both patient outcomes and patient experience.
Especially when discussing complex diagnoses or treatment plans, setting expectations early and explaining decisions clearly can reduce confusion, improve adherence, and strengthen trust. Over time, strong communication skills can also make your workday easier and more rewarding.
Sharpen Your Decision-Making Skills
As a physician, you are constantly asked to make important decisions, often quickly, and sometimes with incomplete information. Early in practice, managing uncertainty can feel especially challenging.
But one of the most important things to remember is this: becoming an attending does not mean your skillset is complete. Medicine is continually changing. Lifelong learning and continual refinement of clinical judgment is part of the job, and something that makes this work both challenging and fulfilling.
Your strategy for success:
Stay engaged and intellectually curious.
In addition to maintaining CME requirements:
✅Stay current with evidence-based guidelines
✅Use clinical decision support tools when appropriate
✅Build strong referral and consultation networks by meeting and collaborating with your new colleagues
✅Get to know your more experienced colleagues, and respectfully reach out to them when you need their input
Resources such as journal summaries, evidence-based newsletters (like NEJMClinician), and curated educational platforms can help you stay informed without becoming overwhelmed by information overload.
Most importantly, recognize that confidence grows through repetition, reflection, and experience. You’re not expected to know everything on day one.
Cultivate Emotional Resilience and Stress Management
Outpatient medicine can be emotionally demanding. Physicians routinely navigate uncertainty, grief, high expectations, administrative burden, and emotionally charged interactions.
And while personal resilience matters, it’s important to acknowledge that physician burnout is not an individual failure. Healthcare systems play a major role, and the cost of burnout affects everyone, including patients.
If your work environment feels consistently toxic or unsustainable, it may be time to explore other opportunities that better align with your values and well-being. Still, there are often constructive ways to improve your day-to-day experience and protect your emotional health without exiting your practice or career path.
Your Strategy for Success:
Incorporate stress-reducing practices into your routine before you reach a crisis point.
This might include:
⭕Regular physical activity
⭕Mindfulness and/or meditation practices
⭕Adequate sleep
⭕Nutritious meals
⭕Time outdoors
⭕Meaningful social connection
Building a strong support system matters too. Trusted colleagues, friends, family members, mentors, therapists, or coaches can all provide perspective and emotional support during difficult periods.
Many healthcare organizations now offer physician coaching and wellness resources. Take advantage of those opportunities when they’re available. And if you are struggling with depression, anxiety, or other mental health concerns, seeking professional support from a therapist is a sign of wisdom, not weakness.
You’ve worked hard to get here. You deserve to feel healthy, engaged, and fulfilled in your career.
Building a Sustainable Career in Medicine
Starting your career in outpatient medicine comes with real challenges, but it also offers tremendous opportunities for growth, connection, and meaningful impact.
By developing strong systems for time management, communication, decision-making, and well-being, while also building strong professional relationships, you can build a more sustainable and rewarding career.
Success is not simply about endurance. It’s about creating a way of practicing that allows you to continue showing up with skill, presence, and humanity over the long term.
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.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
In the Media: Medscape on Physician Focus and Attention
I was honored to be featured recently in a Medscape article discussing one of the greatest challenges facing physicians today: constant interruption and fragmented attention.
Physicians are expected to manage complex cognitive work while navigating inboxes, notifications, documentation demands, and frequent disruptions. But fragmented attention can have serious consequences, not only for physician well-being, but also for patient care.
I was honored to be featured recently in a Medscape article discussing one of the greatest challenges facing physicians today: constant interruption and fragmented attention.
Physicians are expected to manage complex cognitive work while navigating inboxes, notifications, documentation demands, and frequent disruptions. But fragmented attention can have serious consequences, not only for physician well-being, but also for patient care.
One of the ideas I shared in the article is that attention is a finite resource. When physicians are repeatedly interrupted, it becomes harder to engage in the kind of deep thinking that complex patient care often requires.
There’s no question that healthcare infrastructure needs to change in order to support physicians to do their best work. Meanwhile, if you’re a physician struggling with overwhelm, fragmented attention, or difficulty finding time for meaningful work, physician coaching can help you create more sustainable systems and protect your focus.
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.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
My Podcast Appearance with Kevin MD on Meditation and Mindfulness for Physicians
In my recent conversation with Kevin Pho, M.D we discussed how mindfulness can have far-reaching effects not only for physicians, but for those you we care for. We also discussed the best times for meditation, when you might want to avoid it, and how a brief meditation can impact your sense of well-being.
As a physician coach, I love sharing this story, because it encapsulates how such a simple and brief practice can have a meaningful impact.
An earlier version of this article appeared on this website in January, 2024
I enjoyed my conversation with Kevin Pho, M.D, where we explored how mindfulness can have far-reaching effects not only for yourself, but for the people you care for. We talked about the best times to meditate, when it may not be helpful, and how even a brief pause can shift your sense of well-being.
As a physician coach, I often return to this idea because it captures something important: a simple, brief practice can create a meaningful impact.
At the same time, it’s important to be clear about what mindfulness is, and what it isn’t. Despite some well-intentioned but overly simplified messaging, mindfulness is not a band-aid for the deeper challenges within healthcare. It cannot replace the structural changes that are so clearly needed.
Instead, mindfulness is powerful support for your ability to stay present and engaged in a complex and unpredictable environment.
Mindfulness offers a way to pause in the middle of a busy day and reconnect with the present moment, without judgment or reflexive reaction. It creates space. And in that space, you can re-center and reset.
For physicians, even a brief moment of presence can shape how you show up with your patients, your colleagues, and yourself. Over time, this can support stronger relationships built on trust, respect, and genuine attention.
I hope you enjoy the podcast.
The Sunk Cost Fallacy: When Physicians Struggle with Change
When I learned about the concept of “sunk cost”, I felt as if a giant lightbulb had clicked on in my head. The term, borrowed from economics, refers to our tendency to keep doing something that is not in our best interest due to expenses that have already been paid and are not recoverable. These compounded investments of time, energy, and capital can influence your decision making for years to come, leading to choices, both professional and personal, that are increasingly disconnected from your goals and values.
An earlier version of this article appeared on this website in September, 2024
When I first learned about the concept of the “sunk cost fallacy”, it felt as if a giant lightbulb had clicked on in my head. Suddenly, so many old misaligned decisions began to make sense.
The term, borrowed from economics, describes our tendency to keep investing in something that is no longer aligned with our goals or values, simply because we’ve already put so much into it.
Sunk costs include all the time, energy, and resources you’ve already put into your current situation, whether that’s a job, a relationship, or even a major purchase. These accumulated investments can shape our decisions for years, often pulling us further away from what truly matters to us.
For physicians, the concept can be especially trying. You may have poured years of training, effort, and identity into building a practice or reputation, even when it no longer feels like the right fit.
Understanding the Sunk Cost Fallacy
The sunk cost fallacy helps explain why change can feel so difficult. Even when you recognize that your current path is no longer sustainable, or no longer sustaining, you may still feel compelled to stay.
However, this is precisely where the fallacy lies. The time and energy you've already spent are, by definition, "sunk"—they cannot be recovered, no matter what you decide to do next.
So the most important question is not about the past. It’s about the future: Is staying where you are, be that literally or figuratively, the best decision for your long-term goals, well-being or fulfillment? Or is it time to cut your losses and move on?
Moving Beyond the Sunk Cost Fallacy
If you’re feeling unfulfilled, overworked, or simply stuck in a role that doesn’t align with your goals or values, it may be time to consider a change. But how do you overcome the weight of sunk costs? Here are a few ideas to help you move forward:
Acknowledge the Fallacy
Recognize that your past effort is not wasted if you choose a new path.
Everything you’ve done has shaped you and prepared you. That includes your clinical judgment, your perspective, your resilience. Those are not losses. They are assets you carry forward.
Focus on the Present and Future
Instead of looking backward, ask:
Is my current role or situation sustaining me and helping me to grow, or is it holding me back?
Is it supporting my well-being, or draining it?
Am I contributing in a way that feels aligned with who I am now?
Then look ahead:
Where do I want to be in five or ten years?
Does staying where I am move me closer to that vision?
Reframe the Leap
A new role may feel like starting over—but it isn’t.
Physicians often underestimate the value of their experience. Even though change can feel unsettling, you are not starting from scratch. Instead, you are bringing your depth, skill, and insight forward.
Seek Support
If you’re wrestling with this decision, you don’t have to do it alone.
Talking with trusted colleagues, mentors, or a physician coach can help you see more clearly and move forward with confidence. A coach, in particular, is not invested in the outcome of your decision. That neutral aspect of coaching can help you gain clarity in a way that a colleague might not be able to do.
Stop Letting the Past Decide Your Future
Don’t let past investments of energy and time keep you anchored in a place that no longer fits.
Change can feel uncertain, but your experience is not lost. It has prepared you for what comes next. You may be surprised by the value it holds.
Whether you’re seeking a new role, a leadership path, or a more creative phase of your life, understanding your strengths, and investing in your growth, will help you move forward.
By letting go of what no longer serves or supports you and following your internal compass, you give yourself permission to build a career, and a life, that honors your past while moving you into your future.
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.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
The Unexpected Downsides of Meditation: A Guide for Physicians
Meditation has numerous benefits for physicians, but there are also a few drawbacks that are not often discussed. With widespread recommendations for meditation and meditation apps, it’s important to keep in mind that meditation is not for everyone. Potential downsides include worsening of anxiety, insomnia, rumination, and physical discomfort. . By starting with shorter sessions, being mindful of any arising emotions or negative feelings, and ensuring a comfortable posture, you can minimize risks.
An earlier version of this article appeared on this website in August, 2024
As a physician coach and certified mindfulness meditation teacher, meditation has been a powerful and sustaining practice for me for many years.
Mindfulness meditation has been shown to improve focus and to reduce stress and burnout. It can even improve sleep quality.
But while meditation offers many benefits, there are also a few drawbacks that are less often discussed. That’s what I’ll cover in this article. With the growing popularity of meditation and meditation apps, it’s important to remember that meditation is not for everyone.
What Is Mindfulness?
Mindfulness is the practice of paying attention to the present moment, on purpose and without judgment. It means noticing what’s happening—your thoughts, emotions, body sensations, or surroundings—without immediately reacting or trying to change them.
You don’t have to be sitting still or even meditating to be mindful. You can practice mindfulness while walking, eating, listening to a patient, or even washing your hands between visits. It’s more about how you are paying attention than what you are doing.
Mindfulness vs. Mindfulness Meditation
Mindfulness and mindfulness meditation are closely related, but they are not exactly the same.
Mindfulness is a way of being. It’s an ongoing quality of awareness that you can bring into everyday life.
Mindfulness meditation is a more formal practice. It usually involves setting aside time to sit quietly and focus your attention, often on the breath, while noticing when your mind wanders and gently bringing it back.
In other words, meditation is one way to practice mindfulness, but it’s not the only way. And some forms of meditation (like mantras and visualizations) aren’t mindfulness practices.
If meditation doesn’t feel right for you, informal mindfulness practices may feel more accessible and sustainable. These might include:
🪷 Making time for a brief pause between patients
🪷 Taking a few slow, deep breaths while scrubbing for a case
🪷 Noticing the feel of your feet on the ground while making rounds in the hospital or walking in from the parking lot
Potential Downsides of Meditation for Physicians
For some people, meditation may have unintended, and unexpected consequences. Sometimes, simply changing the time of day or duration of practice can make all the difference. In this article, we’ll explore the potential downsides, along with strategies to help you get the most benefit from meditation and mindfulness practices.
Mental Health Impact
Because of its inward focus, meditation can sometimes bring up uncomfortable emotions or past traumas. While many people with anxiety benefit from meditation, some may find that it initially intensifies their symptoms.
Of course, it’s normal to feel a little restless or uneasy when you are not used to sitting quietly. Cultivating stillness can take time. But if anxiety persists, or if intrusive thoughts feel overwhelming and difficult to release, meditation may not be the right fit for you.
And while detachment is often a goal of mindfulness meditation, some people may develop a distressing sense of disconnection from reality.
Longer meditation sessions, including retreats, are more likely to cause this type of trouble. If you are prone to anxiety or depression, it makes sense to keep your sessions to 20 minutes or less and to approach meditation gently.
Seek professional guidance if intense emotions or memories arise that are difficult to manage on your own.
Insomnia
Mindfulness meditation can improve your sleep quality. But practicing focused meditation at bedtime might actually make your mind more alert, making it harder to fall asleep.
You may find it more helpful to meditate earlier in the day, such as in the morning, midday, or before leaving work, so you can reset your focus without interfering with sleep. Or seek out sleep meditations that are designed to help your mind rest.
Decision Making
For many people, mindfulness meditation can improve decision-making speed and help with goal setting for positive outcomes.
But if you tend to overanalyze or strive for the “best” possible choice, you may find that mindfulness practices may sometimes amplify this tendency. Instead of moving forward, you may find yourself stuck in rumination, lingering over the possibilities.
If this happens, it can help to pair mindfulness with action. Fore example, setting limits on decision time or committing to small next steps.
Physical Discomfort
Sitting for extended periods, especially without proper support or in an uncomfortable posture, can lead to back pain, muscle stiffness, or joint pain.
When meditating, ensure you are sitting in a comfortable position, perhaps using cushions or a chair for support. You might even find it more comfortable to meditate lying down.
Another option is walking meditation. You can find these types of meditations on most meditation apps.
Many people are not aware that the physical practice of yoga developed as a way to prepare the mind and body for meditation. Yoga works by releasing stress and strain in the muscles and guiding you to consciously slow down your breathing pattern. When time permits, consider incorporating gentle stretching or yoga before meditation.
Using Meditation Thoughtfully
Meditation can be a powerful tool for improving focus, reducing stress, and supporting overall well-being. At the same time, it’s important to recognize that it doesn’t work the same way for everyone.
Starting with shorter sessions, paying attention to how you feel, and ensuring physical comfort can help minimize potential downsides.
If meditation brings up persistent emotional discomfort or distress, it’s important to seek guidance from a qualified professional.
For many people, setting the stage for meditation with gentle stretching or yoga can make the practice more accessible and sustainable.
If meditation isn’t for you, don’t force it. Instead, you can find a similar mental reset by simply taking a brief walk or finding a minute between patients to take a few slow, deep, purposeful breaths. Like any meaningful practice, mindfulness works best when it’s approached with curiosity, flexibility, and respect for your own experience.
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My Interview on the Enlightened Anatomy Podcast
What a pleasure it was to meet with Matt Huey of the Enlightened Anatomy Podcast! Matt and his partner, Andrew McGonigle, have created a community that is focused on evidence-based yoga teaching. As a yoga teacher myself, and a yoga practitioner for nearly 30 years, this is a topic that is near and dear to my heart.
We talked about the ways that yoga, mindfulness, and heart health connect, and how you can put this into practice.
We also touched on the importance of knowing where health information comes from, and how misinformation, often from social media, can lead to mistrust of physicians and fuel physician burnout.
What a pleasure it was to meet with Matthey Huey of the Enlightened Anatomy Podcast! Matt and his partner, Andrew McGonigle, have created a community, The Enlightened Yoga Collective, that is focused on evidence-based yoga teaching. As a yoga teacher myself, and a yoga practitioner for nearly 30 years, this is a topic that is near and dear to my heart.
We talked about the ways that yoga, mindfulness, and heart health connect, and how you can put this into practice. We also touched on the importance of knowing where health information comes from, and how misinformation, often from social media, can lead to mistrust of physicians and fuel physician burnout.
You can find our conversation anywhere you listen to podcasts, or through the Spotify link below. I hope you enjoy it!