My Podcast Interview with Digital Diagnostic’s John Bertrand

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

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

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

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

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

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

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

Break the Cycle of Repetition

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

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

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

Spring Free of the Inaction Trap

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

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

Unaddressed Issues

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

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

The Burden of Incomplete Tasks

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

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

The Value Dilemma

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

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

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

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

Conforming to Expectations

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

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

Moving Forward

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

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

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

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

My Podcast Interview with AI Pioneer Dennis Cogan of Caresyntax

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

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

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

Why Should Healthcare Systems Invest in Coaching?

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

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

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

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

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

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

How can coaching help?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1. Reflect on Your Values and Goals

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

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

2. Assess Your Skills and Interests

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

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

3. Seek Guidance and Support

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

4. Explore Your Options

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

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

5. Embrace Flexibility and Adaptability

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

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

6. Take Small Steps

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

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

7. Practice Self-Compassion

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

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

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

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

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

Dressing to Inspire Confidence: My Kevin MD Podcast Conversation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Experiencing art mindfully

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

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

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

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

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

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

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

My Podcast Interview with Tax Expert Alexis Gallati, MBA

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

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

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

From Conflict to Collaboration: Overcoming Challenges with Your Staff

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

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

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

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

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

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

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

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

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

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

• Don’t make it personal

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

• Consider involving HR:

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

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

• Document everything

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

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

• Try to understand the root cause of the behavior

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

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

• Be direct and honest. 

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

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

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

• Be prepared to offer a solution

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

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

• Be supportive and encouraging

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

• Be fair and consistent

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

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

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

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

My Podcast Interview with Health Tech Expert Shanil Ebrahim

Shanil Ebrahim is on the cutting edge of healthcare technology, with expertise not only as a scientist but also with meaningful experience in the fields of AI and health equity. His insights are timely and thought provoking.

As a frequent host of the TechLink Health podcast, it's always such a pleasure and a privilege to meet with leading innovators in the health and tech space. The industry is moving at warp speed, and it's great to have a front row seat!

You can listen to the podcast at TechLink Health as well as Spotify and Apple Podcasts.

Managing Uncertainty as a Physician

Uncertainty is a fact of life if you are a physician. Patients don’t always get better, there is not always one best choice or right answer, and sometimes our decisions are affected by factors that are completely out of our control.

Managing uncertainty is a skill set that doesn’t come easy for many of us. Perfectionism is likely a way of life, and to be truthful, that’s not always a bad thing. We want to do the best for our patients, we want excellent outcomes, and we want to be acknowledged for the care we provide. But when we set unrealistic standards, it can actually be a barrier to optimal care and to our own well-being.

A recent study examined the connection between tolerance for uncertainty and burnout in 2000 faculty physicians. Not surprisingly, intolerance for uncertainty was associated with a three-fold increased likelihood of burnout.

As you might expect, those who struggled with uncertainty were much less likely to be satisfied with their career, and tended to be less engaged at work. Factors that correlated with a greater intolerance of uncertainty were

• Female gender

• Primary care

• Earlier stage of practice

• Lack of a trusted advisor.

Although these were important risk factors, many men, specialists, and later stage physicians were also burdened by intolerance of uncertainty.

Burnout and physician unhappiness are crucial pain points in our current healthcare environment. Not surprisingly, stress from uncertainty correlates with depression and low levels of resilience. Intolerance of uncertainty has been linked to poorer outcomes and even to increased healthcare costs. And burned out physicians are more likely to leave the practice of medicine.

Our innate perfectionism combined with the prevailing medical culture of stoicism means that physicians may be reluctant to admit that they are dealing with uncertainty. This makes it all the more important for more senior colleagues and mentors to acknowledge that despite all we know and no matter how hard we try, uncertainty will always be a part of the life of a physician. Simply sharing that insight can make it a little easier to come to terms with the fact that we cannot control everything.

Although becoming comfortable with uncertainty may always be a challenge, managing your response to uncertainty can open up opportunities to react to life’s curve balls in ways that are both positive and beneficial to all involved.

In their thorough analysis of the issue, Samuel Reis-Dennis and colleagues describe “three corrective virtues” that might help physicians navigate the challenges that uncertainty creates. These include:

• Courage: avoiding the tendency to run away from threats by developing strategies to cope with new challenges

• Diligence: seeking guidance from trusted colleagues and staying current on the medical literature

• Curiosity: addressing uncertainty by viewing it as an opportunity to learn and grow

It’s not an easy task to recognize the factors that may be holding you back. And it’s even more difficult to be objective and to find your own way while living the unpredictable and demanding life of a physician. Medical schools are increasingly understanding the importance of teaching these skills, but it’s not always enough once you hit the real world. Working with a coach or trusted advisor may help to get you on track, discovering the solutions and opportunities that best fit your needs.

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

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

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

References

Allison, J. J., Kiefe, C. I., Cook, E. F., Gerrity, M. S., Orav, E. J., & Centor, R. (1998). The association of physician attitudes about uncertainty and risk taking with resource use in a Medicare HMO. Medical decision making : an international journal of the Society for Medical Decision Making

Begin, A. S., Hidrue, M., Lehrhoff, S., Del Carmen, M. G., Armstrong, K., & Wasfy, J. H. (2022). Factors associated with physician tolerance of uncertainty: an observational study. Journal of general internal medicine

Berg, S. (2020). Feeling burned out? Try picking up the phone to call your coach. American Medical Association

Cook, J. (2022). Forget resilience, improve your uncertainty tolerance. Forbes

Iannello, P., Mottini, A., Tirelli, S., Riva, S., & Antonietti, A. (2017). Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians. Medical education online

Reis-Dennis, S., Gerrity, M. S., & Geller, G. (2021). Tolerance for uncertainty and professional development: a normative analysis. Journal of general internal medicine

Simpkin, A. L., Khan, A., West, D. C., Garcia, B. M., Sectish, T. C., Spector, N. D., & Landrigan, C. P. (2018). Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study. Academic pediatrics

Sinsky, C. A., Brown, R.L., Stillman, M. J., & Linzer, M. (2021) COVID-related stress and work intentions is a sample of US health care workers. Mayo Clinic proceedings

My Podcast Appearance with Kevin MD on Meditation and Mindfulness

I enjoyed my recent conversation with Kevin Pho, M.D. We discussed how mindfulness can have far-reaching effects not only for yourself, but for those you 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.

Despite often heavy-handed corporate efforts to the contrary, mindfulness is not a bandaid to fix all that is wrong with healthcare. And it’s not a substitute for the meaningful change that is so desperately needed. Instead, it’s a reminder to be present and engage with what is happening right now, without judgement or reactivity.

Through mindfulness, you are can find a way to take a moment in the middle of the daily storm to re-center and reset. And for physicians, that can go a long way towards building stronger relationships with patients and staff based on trust and respect.

HALT: A Self-Coaching Stress Management Tool for Physicians

As a physician coach specializing in burnout and professional transitions, I've seen firsthand how the current state of healthcare can push even the most resilient doctors to their limits. Unchecked anger, frustration, and passive aggressive behavior can often be symptoms of the times.

By now you probably know that burnout is not your fault. Nor is it a mental health issue. Instead, it’s the consequence of a broken system.

At the moment, this is the system we are living in. While some headway is being made, the forces that are driving the burnout epidemic are not likely to improve overnight. And while it can be tempting to lash out when you’re stressed, it’s likely to make the situation worse, straining your relationships with colleagues, staff, and patients.

Beyond burning your bridges, the effect that an emotional outburst can have on your own well-being is profound. What’s more, healthcare systems are cracking down on behavior that’s deemed inappropriate or unprofessional.  

Although you didn’t cause the problem, it’s important that you remain mindful of the far-reaching implications of your communications and actions, regardless of the high quality of care that you provide.

To get you back on track, the simple acronym "HALT" – Hungry, Angry, Lonely, Tired – can be an important tool for self-awareness and self-care.

HALT was originally developed by David Streem, MD, a psychiatrist and addiction specialist, as a reminder to stop and identify the triggers that might lead to a relapse.  But for physicians, the acronym is also an intuitive tool that can remind you to mindfully take a pause and check in with how you’re feeling, and why, when something or someone triggers a reaction.

By using HALT, you can slow your roll before impulsively acting in ways that might harm your personal and professional relationships.

Here's how HALT works:

Hungry

When you're hungry, or “hangry”, even small problems can feel overwhelming. Hunger can make your patience wear thin and your trash your tolerance for stress and difficult interactions.

If you’re like many physicians, being hungry may be your default mode. Although it shouldn’t be the norm, it’s painfully common for physicians to skip meals or eat irregularly due to hectic and overbooked schedules.

Junk food from the snack machine or physician’s lounge might fill you up, but it can make you feel even worse. One straightforward strategy that can help is to pack simple but healthy food for the next day each evening.

But hunger isn't just about food. It's often about other unmet needs, whether emotional, physical, or intellectual.

Take action on hunger by getting in a 10–15-minute break to reset your mind and body once or twice daily whenever possible.  You’ll probably find that when you fill up the tank, even out your blood sugar and slow down your sympathetic nervous system, you’re able to maintain a more balanced mood and energy level.

In the long run, the few minutes you set aside to care for yourself will pay off in more respectful relationships, improved productivity, and better health.

Angry

Anger is a natural emotion, but how you handle it in the workplace is crucial. Unchecked anger can lead to conflicts with colleagues and unpleasant meetings with administrators. When it carries over to the bedside or operating room, it may impact the doctor-patient relationship, undermine teamwork, and even affect patient care.

Become aware of this emotion, and how it feels in your body. When you find yourself getting angry, take a moment to pause and step back. Give yourself time to process, reflect, and move on.

Deep breathing, a short walk, or even bluntly but respectfully discussing your feelings with a trusted colleague can open up a fresh perspective and prevent words and actions that you’ll regret later.

Lonely

If you’re feeling lonely, you may react harshly to stress out of a sense of isolation. Although you’re likely surrounded by people all day, medicine, our profession, ironically, can be a lonely one.

The burdens of responsibility, the fear of making mistakes, the ever-present perception of competition, and the need for confidentiality can all leave physicians feeling isolated.

Acknowledging loneliness is the first step towards seeking connection.  Regular interaction with friends, family, and community, even if brief, can hold back isolation and create a sense of belonging. Finding a hobby that gets you out of the doctor mindset or working out with a group of like-minded people can help as well.

Tired

When you’re tired, everything just feels harder. It’s no surprise that fatigue is a common issue among physicians. Long hours, high stress, and fractured sleep while on call mean that more than 40 percent of doctors surveyed report that their work schedule simply doesn’t allow for adequate sleep.

Chronic tiredness can impair your judgment and your empathy. Although it can be hard to feel compassion for your staff and others though the fog of fatigue, noticing what’s driving your irritation can soften your reaction to stress.

How to Use HALT in Your Daily Practice

• Check In: Before reacting, run through your HALT checklist. This simple pause can reset your frame of reference.

• Be Proactive: Make time for healthy meals, use brief but meaningful stress-relief techniques like mindfulness, get regular exercise, cultivate a life outside of work, and do your best to get restful sleep.

• Seek Support: Don't hesitate to seek professional help if you're struggling with anger, loneliness, or fatigue. Therapy, coaching, and peer support groups can all be helpful, depending on your circumstances.

• Communicate with Colleagues: Foster an environment where it's safe to respectfully express what you’re feeling. This openness can build stronger, more supportive team dynamics.

When you’re feeling reactive, upset, or tempted to lash out, use HALT to take a pause. Are you Hungry, Angry, Lonely, or Tired?

Simply becoming aware of your inner state can help you to defuse a situation and craft a different response. It’s also a great reminder that caring for yourself is neither selfish nor optional if you want to work at your optimum.  

When you take care of your own needs, you’ll find that you will be better equipped to care for those whose lives and well-being depend on you.

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.

Coaching for Physicians: A Guided Journey to Goal Setting, Overcoming Obstacles, and Finding Fulfillment

If you’re curious about physician coaching, and want to know more, this article is for you. As someone who loves getting outdoors, I like to use the metaphor of a hike or journey when describing my coaching process. In this coaching journey, I serve as your experienced companion, providing support, insight, and encouragement, helping you navigate both familiar and new terrain, and celebrating with you as you discover your destination.

1. The Trailhead: Preparation and Goal Setting

 Just like preparing for a hike, the first step in coaching is to understand where you are right now and where you want to go. This involves an in-depth assessment of your current professional and personal landscape, identifying both the peaks (successes) and valleys (challenges) you face. Whether you’re dealing with burnout, challenges with time, professional transitions, or finding the right work-life balance, together we’ll set specific and achievable goals. You can think of this as choosing the right trail that aligns with your current fitness level and hiking experience. Don’t worry if this is all new to you. You may be surprised at the ways your strength and endurance will naturally grow along the way.

 2. Gathering Gear: Equipping for the Journey

After setting the goals, the next step is to equip you with the necessary tools and skills. This includes exploring techniques for time management, stress reduction, and effective communication. Similar to choosing the right gear for a hike, these tools are personalized to fit your unique needs and circumstances, ensuring you are well-prepared for the journey ahead.

3. The Hike Begins: Embarking on the Journey

With goals set and tools in hand, we begin the coaching journey. This phase is about action and moving forward. Regular coaching sessions serve as checkpoints, where we assess progress, celebrate achievements, and address any new challenges. The journey may involve steep climbs and unexpected obstacles, but with guidance and support, you keep moving towards your goals. 

4. Difficult Terrain: Navigating Challenges:

Just as a hiker encounters rough patches along the trail, you may face challenges in your professional journey. Burnout, difficult workplace dynamics, and balancing personal life are common terrains we navigate. Together, we develop strategies to overcome or get around these obstacles, building strength, creativity, and adaptability, much like a seasoned hiker learns to navigate through challenging paths.

 5. Scenic Views and Rest Stops: Reaching Milestones

Along the way, it’s important to recognize and celebrate milestones. These are like the scenic views or rest stops on a hike, offering a pause to appreciate how far you’ve come, recharge, and reflect on the journey. Although it’s tempting to keep pushing forward, these waypoints are crucial for maintaining motivation and perspective.

 6. The Evolving Trail: Continued Growth and Adaptation

The journey doesn’t end at the first summit. Like a trail that changes with the seasons, your professional life will continue to evolve. Ongoing coaching can help you adapt to these changes, develop new goals, and continue growing. The journey is continuous, and as your coach, I am there to guide, support, and celebrate with you every step of the way.

 7. The Lookout Point: Reflection and Forward-Thinking  

As you reach significant milestones, we’ll take time to reflect on the journey. From this vantage point, much like a lookout on a hike, we’ll assess the path taken, lessons learned, and obstacles overcome. From there, we’ll plan for the next phase of your journey. Together we’ll chart out the travels ahead, including strategies for keeping burnout and inertia at bay. As you move into the future, you’ll be empowered and well equipped to stay engaged, inspired, and energized.

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

How to Find Your Creative Spark: A Guide for Physicians

As physicians, we learn to practice from an evidence-based standpoint, checking the data, keeping up with the literature, and following carefully researched guidelines. But as crucial to good patient care as this is, providing the best care requires the ability to go deeper, connecting a series of disparate dots, asking probing questions, and creating trust.

Having your own creative practice can stimulate this stronger connection by giving you tools and insights that come from a less rigid view of the world. It’s not suprising that a British study found that people who engaged in creative activities at home were more likely to discover creative solutions to problems at work.

And at the same time, creativity can be a refuge, offering an escape and a form of mindfulness that is often difficult to access in our precision-driven world.  

You don’t have to have talent or special skills to begin a creative practice. It can be something that you do for yourself alone. But once you get started, you may find that your imagination awakens, opening your mind to new techniques and ideas that might never have occurred to you if not for this artistic exploration.

In this article, I’ll discuss how you can awaken and nurture your inner artist.

1. Just Get Started

Do the work. It sounds simple, but overcoming inertia can be the hardest part. You don’t need a grand plan, a fancy camera, or a fully equipped studio. Just begin and set the wheels in motion. Your first step doesn’t have to be perfect; it just has to be taken.

2. Embrace Imperfection

Check your perfectionism at the door. For people immersed in the creative arts, imperfection is not just accepted; it’s often celebrated. Express, explore, and learn. Give yourself the freedom to make mistakes and be messy. This is a crucial part of the creative journey, and it’s how new ideas are generated.

 3. Inspiration Appears While You’re Working

Waiting for inspiration is like waiting for the perfect moment – it rarely comes when you're idle. To borrow a phrase from mindfulness meditation, creativity is about being in the now. As Picasso is famously quoted, “Inspiration exists, but it has to find you working.” The muse, that elusive spark of creativity, is not impressed by your aspirations. She finds you when you’re in the messy midst of creation. 

4. Set Aside Time for Creativity

Schedule your creative time just like you would for any appointment. Whether it’s 30 minutes a day or a few hours once a week, having a dedicated slot for creativity can open windows in your mind and give you room to explore. If it feels overwhelming, commit to simply 10 minutes each week, and see where that takes you.

5. Explore Different Creative Avenues

Creativity means different things to different people. You might enjoy writing, while someone else might find solace in painting, dancing, or playing an instrument. Simply wandering around intentionally with your phone’s camera can be a form of creative play. If you have time, taking a weekend class in pottery or some other art form could be a fun place to start. If you’re not sure how to start, experiment with different forms of creative expression to find what resonates with you.

6. Join a Creative Community

There's something magical about being part of a community that shares your passion. Look for local art classes, writing groups, photography clubs, or online forums. Share your work, get feedback, and enjoy the collective creative energy. These communities can offer support, inspiration, and a sense of belonging. And unlike your practice as a physician, no one will expect you to be perfect or have all the answers.

7. Pause, Reflect and Adjust

Every now and then, take a step back and reflect on your creative journey. Stay curious. What have you learned? What do you enjoy the most? Where has your creativity taken you? You might choose to keep a creative journal to celebrate your milestones, explore the unexpected detours, and maybe even recalibrate your goals.

Integrating creativity into your life isn’t just about producing something; it’s about the process, the joy, and the journey of self-discovery it brings. It can be a form of meditative practice, and an escape hatch from the rigidity of a schedule and a task list.

As a physician, you have a unique perspective of the world, shaped by your experiences and the people whose lives you’ve touched. Infusing this perspective into your creative endeavors can lead to something unexpected, tangible, and uniquely yours. By exploring your creativity without self-judgment, you may find that the insights you discover enrich and deepen your relationships with others, including your loved ones, patients, and colleagues.

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

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

Physician Stress and Burnout: How Mindful Coaching Can Help

Physician burnout is not a new phenomenon, but over the past several years, it has become a true epidemic. In 2021, 930 academic papers were published on the topic, compared to 129 in 2011. In 1984, the year I started medical school, a total of 4 articles can be found in the PubMed archives.

Today burnout is out in the open. But the tools to manage and prevent burnout remain elusive.

The term “burnout” itself may sound a little nebulous, but there are methods to measure and define it. The Maslach Burnout Inventory defines burnout as “a psychological syndrome” that “occurs among individuals who work with other people”, with symptoms including:

• Emotional exhaustion, feeling unable to give more of yourself

• Depersonalization, resulting in negative or cynical attitudes towards patients

• Reduced sense of personal accomplishment, meaning a tendency towards negativity towards your own accomplishment.

It’s important to understand that burnout is not a psychiatric disorder, but rather it is “ a normal response to a chaotic and stressful environment”.

Many of us have experienced these feelings from time to time, and that’s completely normal. But when these feelings are persistent and overwhelming, then it’s likely that you’re dealing with burnout.

In a 2022 survey, Medscape found that 47% of physicians reported burnout, up from 42% in 2021. Not surprisingly, Emergency Medicine and Critical Care reported the greatest burnout (60% and 56% respectively), but Ob-Gyn (53%), Infectious Disease (51%) and Family Medicine (51%) were close behind.

Women reported more burnout (51%), perhaps due to competing responsibilities at home which were aggravated by the pandemic. But more than a third of men were also affected.

The contributors to burnout reported in the survey are not surprising to anyone in healthcare. Topping the list:

• Bureaucratic tasks

• Lack of respect

• Long hours

• Lack of autonomy

These features are nearly identical to the six factors associated with workplace stress that were identified by the British workplace health and safety regulatory agency:

• High work demands

• Low control over workload and process

• Inadequate support from management and colleagues

• Poor workplace relationships

• Lack of clarity regarding professional role and responsibilities

• Poor management of change within the organization

Beyond making you miserable, stress and burnout affect your quality of life, your self-confidence, your relationships at work and at home, and perhaps even your patient care.

Sometimes it feels as if everyone is talking about stress and burnout, but nothing is being done about it.

Although mindfulness has been shown to be effective in mitigating the symptoms of stress and burnout, it feels disingenuous to tell physicians to get a grip by practicing yoga and meditating.

Clearly, we are not going to yoga our way out of this mess. And hospitals and healthcare systems need to do more than offer lip service. But in the meantime, a little mindfulness may help. Here’s how:

First let’s start with a simple definition of mindfulness. As a certified Mindfulness Meditation Teacher, I’ve been fortunate to learn from Sean Fargo, a former Buddhist monk and gifted teacher. Sean defines mindfulness as “paying attention to the present moment with curiosity and non-judgment”. In other words, simply being present.

This sounds nice, but how can it possibly help you overcome the powerful forces that lead to stress and burnout?

As it turns out, there have been a number of studies in recent years that were designed to answer just this question. A meta-analysis of six high quality randomized controlled studies of mindfulness interventions for medical students, published in 2020, reported substantially lower stress indices in students who participated in the programs.

These programs incorporated interventions that included

• Body scanning

• Awareness of thoughts and emotions

• Breathing exercise

• Walking meditation

• Sitting meditation

• Coping with stress

Most programs were once weekly group sessions, while one used a mobile app.

Not only did stress scores improve in the short term, compared to controls, but studies that reported six-month follow-ups found that the benefits of mindfulness teaching persisted.

Coaching is another effective strategy for physicians at all stages of professional life. Although it is no substitute for system-wide change and mitigation of the issues that lead to burnout in the first place, coaching can help physicians gain traction and make decisions that help them to reclaim their connection to the profession.

That can range from important changes that create a better work-life balance in the current setting to a move to a new position or workplace. In some cases, a coach may work with a physician who decides to leave the profession altogether.

Research supports the role of coaching as a powerful tool for physicians at all stages. A small study from Duke University included primary and specialty care physicians ranging from first year residents to more senior physicians with leadership roles. The program focused on coaching for physician well-being, and reported improvements in coping strategies, resilience and stress.

Regardless of the specific modality or focus, physician coaching as an intervention has clearly been linked to improvement in well-being and resilience. A 2019 randomized controlled trial of primary care physicians in the Mayo Clinic system looked at the effects of 6 telephone coaching sessions on

• Burnout

• Quality of life

• Resilience

• Job satisfaction

• Engagement

• Meaning at work  

After 6 professional coaching sessions by credentialed coaches, the rate of burnout decreased by over 17% in the coached group but increased by nearly 5% in the control group. And absolute rates of emotional exhaustion dropped by nearly 20% in the coached physicians but increased about 10% in controls.

Coaching is a powerful tool. Mindful coaching may help physicians manage and overcome the effects of the sometimes-overwhelming forces that impact them and, indirectly, their patients on a daily basis.

But most importantly, addressing and repairing the underlying sources of burnout and stress is paramount. This is a commitment that needs to come from the highest levels of our healthcare systems.

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

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

References

Berg, S. (2021). Q&A: Clearing up confusion on physician burnout and depression. American Medical Association

Christensen, A. J. et al. (2023). Addressing Burnout in the Primary Care Setting: The Impact of an Evidence-Based Mindfulness Toolkit. Military medicine, 189(Suppl 1), 64–70. https://doi.org/10.1093/milmed/usad277

Drybye, L.N. et al. (2019). Effect of a professional coaching intervention on the well-being and distress of physicians: a pilot randomized clinical trial. Journal of the American Medical Association Internal Medicine

Garcia, C. L. et al. (2019). Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina

Hathaisaard, C. et al. (2022). Mindfulness-based interventions reducing and preventing stress and burnout in medical students: a systematic review and meta-analysis. Asian Journal of Psychiatry

Health and Safety Executive. (2019). Tackling work-related stress using the management standards approach

Kane, L. (2022). Physician burnout and depression report 2022: stress, anxiety, and anger. Medscape

Maslach, C. et al. (1997). The Maslach Burnout Inventory Manual

Schneider, S. et al. (2014). Physician coaching to enhance well-being: a qualitative analysis of a pilot intervention. Explore

Maximize Your Time: Essential Toolkit for Physician Time Management

Being a physician often means that you are expected to be a wizard with time, creating minutes and hours out of thin air. It’s not your imagination. A recent study found that in order for a primary care physician to provide guideline-recommended care and communication, they would have to work nearly 27 hours every single day.

With burnout impacting more than half of US physicians, some healthcare systems and many medical associations are beginning to take note. The problem is multifactorial, but administrative burdens are an important issue for many physicians. System-wide commitments to streamline tasks and automate simple processes are beginning to take hold. But true reform is likely to be several years away.

Meanwhile, when every second of your day seems to belong to someone else, managing your personal time isn’t just an option, it’s a necessity. But despite the ever-growing demands of the profession, the skills of time management are rarely taught in our training years.

As a cardiologist in a busy practice for many years, I developed a keen interest in productivity, educating myself by studying some of the masters in the field. The skills I learned allowed me to practice more efficiently. And equally important, I found meaningful ways to nurture my interests outside of medicine, and to create more time and energy for my friends and family.

As a physician coach, I enjoy sharing these simple techniques and insights with my clients. For some, they can be transformative. By optimizing your personal time, you may find that the more rigid pressures of work feel like less of a burden.

You can pick and choose what works best for you, but the important thing is to commit to making at least one change. When you invest a little time and energy to get started, you may be surprised by how much you get back.

Bullet Journal

A bullet journal is more than just an old-school planner. It's a customizable, hand-written system that combines planning, organizing, goal setting, and reflection.  Here’s why it’s beneficial:

• Customizable Layout: Tailor it to your specific needs, whether it’s daily to-dos, long-term goals, or reflective journaling. Don’t worry about making it look pretty. I use a very simple to-do checklist, and scribble notes as they pop into my head during the day.

• Mindfulness Practice: The act of writing by hand encourages memory retention and mindfulness and will help you to prioritize tasks. I like to take 10 minutes every evening to set up my plans for the next day. Even if I don’t meet all of my goals for the day, simply writing them down creates an intention and makes it more likely that they will be completed in the future.

If you want a deeper dive into bullet journaling, check out The Bullet Journal Method, written by Ryder Carroll. There’s no rush to get through it. Commit to reading just 10 minutes each evening (or morning), and over time you’re likely to create serious momentum.

Colored Pens

Never underestimate the power of colors for organization. When you use your colored pens for your Bullet Journal or to take notes while studying for boards, talks, or other commitments, you will:

• Enhance Organization: Assigning different colors to various tasks or appointments helps create quick visual categorization.

• Boost Memory Retention: Color coding  will help you to remember important ideas, tasks and deadlines.

Audiobooks

In general, multitasking is overrated. That’s because most people tend to do both things halfway. And multitasking can make you more vulnerable to distractions. But listening to a good podcast or audiobook on your commute or while exercising can be a great way to safely and efficiently feed two birds at the same time. That could be CME, a good story, or personal development.

Here’s a brief list of some of my favorite productivity audiobooks:

• Atomic Habits by James Clear focuses on the development of small, incremental habits to achieve significant life changes. The book emphasizes the compound effects of your small daily decisions and the importance of establishing systems rather than focusing solely on goals.

• Stolen Focus by Johann Hari delves into the modern crisis of attention, exploring how various factors in our environment and daily lives erode our ability to concentrate. Hari argues that the decrease in attention spans is not an individual failing, but rather a systemic issue influenced by technology, diet, sleep patterns, and societal structures. Although Hari advises systemic change, simply being aware of these forces can help you to push back.              

• Deep Work: Rules for Focused Success in a Distracted World by Cal Newport advocates for a practice of deep, focused work as opposed to the more common shallow, multitasking approach. The book offers practical advice on how to cultivate a deep work habit, minimize distractions, and maximize your cognitive capabilities. Although the ideas in the book are not always applicable to the reality of a physician’s practice, you will come away with a greater understanding of the importance of focus and the negative impact of constant distractions.

Online Yoga (or other activities)

Physical and mental well-being is integral to managing time effectively. As a registered yoga teacher, I love the option of online yoga classes. That’s because they offer:

• Flexibility: Yoga apps allow you to practice at your convenience, fitting sessions into a busy schedule. Most yoga apps give you a range of types, levels, and duration. I like DownDog, AloMoves, and YogaWorks. All three also offer options besides yoga, including strength training and meditation. And some offer live options as well.

• Stress Relief: Yoga is a great way to unwind and maintain physical and mental health. So are many other forms of physical activity. If you want to start, but exercise isn’t part of your routine, simply commit to 10 minutes twice weekly, and see where that takes you.

One caveat: if you’re new to yoga, Pilates, weight training, or any other chosen activity, consider taking a few classes or working with a private teacher first. That way you’ll have the basics, get your questions answered, and develop a practice that is safer, more effective, and more enjoyable.

 Time Tracking App 

Understanding where your time goes is the first step to better time management. My favorite easy-to-use option is Toggl. Time tracking apps can help you to:

• Identify Time Drains: When you track your time online, you may pinpoint activities that take up unnecessary time. That doesn’t mean you shouldn’t stay up to date on email or social media, but when you know where your time is going, you may find that you naturally begin to make choices that are more aligned with your priorities and values.

• Create Structured Work Intervals: I especially like the Pomodoro Technique. It goes like this: Work for 25 minutes, then take a 5-minute break. This structured and repeatable process can enhance focus and prevent burnout. You can also use time tracking to break larger projects (as well as tasks like charting) into smaller intervals. That way you’ll maintain your focus and create a more manageable and efficient process.

What time management tricks and tools have you found that keep you organized and on task? Drop me a line. I’d love to hear from you!

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

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

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

My Podcast Interview with Grenville Thynne of Neuroflex

I recently had a fascinating conversation with Grenville Thynne for the Techlink Health Podcast. We discussed his work with the trailblazing Neuroflex company. Neuroflex’s portable technology can quickly detect evidence of concussion on site, which makes it especially valuable to athletes of all types.

The technology is also being studied in aging and neurodevelopmental disorders, and has the ability to provide objective measurements of brain function that can be tracked over time.

This was one of my favorite podcasts of the year. I hope you enjoy it.

Overcoming Your Roadblocks: A Physician's Guide to Navigating Change

Not too many years ago, most physicians in the private sector expected to settle into a medical practice straight out of training and to stay put until retirement decades into the future. The idea of moving, changing practices in the same town, or leaving before a ripe old age was almost unheard of. While change has often been part of the career path of academicians, physicians in all sectors are increasingly finding themselves dissatisfied, frustrated, or simply seeking something new.

In fact, a recent Mayo clinic survey reported that one in five physicians plan to leave their practices within the next two years, and one in three expect to reduce work hours. Burnout and perceived lack of appreciation by their organizations were the two primary issues cited in the study.

If you’re considering a move, this change can feel daunting. Physicians are often motivated by loyalty and compassion. But we are also creatures of habit.

For many of us, the roadmap was clearly defined: college, medical school, residency, maybe fellowship. As long as you followed this straight and narrow path, and nothing unexpected knocked you off course, you would make it down the road.

The promise at the end of the trail was a satisfying and gratifying professional life, with a high probability of a happy and fulfilling home life as well.   

Over the past decade, that promise has frayed. Burnout due to lack of autonomy, higher patient demands, a sicker and older population, falling reimbursements, the endless clicks and messages on the EHR: all have contributed. This new perspective means that physicians are more likely to seek change, or at least to consider it.

But the decision to embark on a new professional journey can often feel like traversing uncharted territory.

And the process of choosing a new path can be riddled with mental roadblocks. As a physician coach, I have found that guiding individuals through these challenges can be transformative, bringing new and unexpected possibilities to light.

Getting started can be the hardest part of the process, but once you begin, you’ll notice that the momentum will slowly build. In this article, we will explore actionable steps that can help you to overcome some of the mental barriers that may stand in your way.

1. Self-Reflection

Before embarking on a new professional path, it's essential to engage in deep self-reflection. Journaling for a few minutes every day can really help.

You don’t have to have a clear endpoint in mind to get started, but you do need to know what matters to you, and why. Consider the specific skills, interests, and passions you want to prioritize, and how you want your personal life to look. Take time to identify your values, strengths, passions, and personal goals.

Ask yourself:

• What are my core values and priorities in life?

• What aspects of my current role do I find most fulfilling and unfulfilling?

• What are my unique skills and talents?

• What are my long-term career and life aspirations?

By understanding yourself on this deeper level, you can better align your career choices with your values and objectives. For more prompts and tips to help you with this process, see my recent article about finding your “why”.

  2. Recognize Your Triggers and Limiting Beliefs:

As you work through self-reflection, you might encounter triggers and limiting beliefs that hold you back. If so, don’t be afraid to ask yourself probing questions such as:

• What specific thoughts or patterns arise when considering a new direction?

• Have you or someone else created any self-defeating narratives about your capabilities or limitations that might be influencing your mindset?

• What might these limiting beliefs be trying to protect you from?

• And how might they be proven wrong?

• If there are meaningful limitations that are keeping you from moving forward, how might you close gaps in your knowledge or skills?

When you pinpoint these mental roadblocks, you’ll take the first step towards disarming their power. Often a coach can be helpful when working through this process.

 3. Seek Guidance

Don't hesitate to seek guidance from mentors, career counselors, and trusted colleagues who have gone through similar transitions.

There can be great value in networking and connecting with others who have found fulfillment in their medical practice or who have ventured into alternative career paths. Their insights and experiences can provide valuable perspectives and inspire you to take bold steps in your own professional journey. Of course, you will want to be discerning about who you confide in, especially if you are leaving your current practice.

 4. Set Achievable Goals

Break your career change into smaller, manageable goals. This not only makes the process less intimidating but also allows you to track your progress. Create a timeline with milestones. These might include

• Gaining specific qualifications or licensure

• Attending relevant conferences,

• Researching places you might want to live

• Reaching out to potential employers or colleagues in your desired field.

Setting specific, measurable, attainable, relevant, and time-bound (SMART) goals can provide you with a clear roadmap and motivate you to move forward despite any mental hurdles.

 5. Embrace Setbacks as a Learning Opportunity

Rejection can sting. It's important to acknowledge that setbacks are part of any professional journey. Instead of seeing them as failures, view them as valuable learning experiences.

Approach unexpected challenges as opportunities for personal and professional growth. Be flexible and willing to pivot, if necessary, but don’t lose sight of your values and your “why”. The key is to use these uncomfortable experiences as opportunities to learn, adapt, and refine your approach.

 6. Get Comfortable with the Unknown

Fear of the unknown is a common mental roadblock for anyone making a career change. This may be especially true for physicians, since so much of our life has been neatly defined for us. Counteract this fear by engaging in thorough research into your desired path.

If you’re looking into a nonclinical job, understand the industry, its trends, and the challenges you might face.

And if you’re changing focus or practice, get to know more about the system, individuals, and culture you may be working with. Will you need new skills or certifications? If so, how and when can you achieve them? This knowledge will help you feel more prepared and confident as you take the leap.

 7. Keep an Open Mind

Maintaining an open mind is crucial during a career transition. Your initial path may evolve as you gain more insights and experiences. Embracing change and adaptation opens the door to broader opportunities. There may be something you may not have considered, but which may turn out to be a perfect fit.

Conclusion

Choosing a new professional path as a physician takes courage, contemplation, and perseverance. Know that you almost surely will need to step outside of your comfort zone to get somewhere new and more fulfilling.

By facing your roadblocks head on, you will build the skills and resilience you need to embark on this new journey. Remember that your background as a physician has equipped you with valuable skills, fortitude, and experience that are needed both in clinical medicine and in a wide range of connected fields.

Embrace the opportunities that arise, trust in yourself, and move forward towards a more fulfilling professional future that aligns with your values and your strengths.

Rediscovering Your Why: A Road Map for Physicians

If you’re questioning whether you’ve chosen the right job, the right specialty, or even the right profession, you’re not alone.

Most physicians go through cycles of doubt, revisiting old decisions when things aren’t going well. That can be very normal, and over time the chances are good that these periods will become less frequent.

Dissatisfaction today doesn’t always mean that you need to make a drastic change tomorrow. Sometimes short-term pain and sacrifices are necessary to get you where you want to go.

But if this seems like a theme song that just won’t stop playing, then it might be time to rediscover your why.

Often when you feel unfulfilled or frustrated at work or in your personal life, it’s because you are not living a life that feels authentic to you.

• Perhaps you are trying to live up to someone else’s ideal

• Maybe your life has moved in a different direction since you first chose your current path

• It could be the job itself that has changed or not lived up to your expectations

• Perhaps you simply need to rediscover the reason that you chose to become a physician so many years ago

"Finding your why" is the process of discovering and understanding the deeper purpose or meaning behind your actions, goals, and choices. It's about identifying the core values and beliefs that drive you and give your life a sense of meaning and fulfillment.

This concept is often associated with personal development and leadership, and it's a key element in the philosophy of Simon Sinek, an author who has been hugely influential in the business world. Sinek argues that successful individuals and organizations are those who are able to articulate and align their actions with a clear sense of purpose or "why." In fact, one of Sinek’s most popular books is called Find Your Why.

The idea is that when you have a clear understanding of why you do what you do, it can serve as a powerful motivator and guide for decision-making. It can help you stay focused, overcome challenges, and find a greater sense of satisfaction at work and in your personal life as well.

As Sinek puts it

• Your why is your driving force

• Your how is the actions that you take to bring your why to life

• Your what is the manifestation of your why—the actual work that you do

Once you understand your why, everything else starts to make sense. Your decisions will become clearer and your actions more purposeful and meaningful.

Knowing your why is so integral to being a physician that it’s surprising this concept is not routinely taught in medical schools. Discovering your why is not a “one and done”, check-it-off-the-list sort of thing, but it’s logical and easy to understand.

The process involves introspection and reflection on your values, passions, and the impact you want to make on the world. It means going beyond your surface-level goals and digging deeper into the fundamental reasons that drive your choices and actions.

To help you find your why, get a piece of paper or a journal and start writing. You could do this on your computer or your tablet, but writing by hand tends to engage the brain more fully than typing on a keyboard, encouraging a deeper connection with the words and ideas and improving later recall. Most importantly, choose a method and a time that works for you.

Consider taking a few minutes every morning or evening to discover the patterns and thoughts that arise. Here are some questions to get you started:

• What do I find fulfilling about my current job?

• What do I not like about my current job?

• What values do I seek to honor in my work and in my life?

• What other goals and aspirations, professional and personal, do I have?

• What are my strengths, my natural talents, my soft skills?

• What strengths and talents would I like to develop further?

• What are the common ideas and threads that run through my life over the years?

• What makes me happy at work, at home, and in my private life?

• What do people thank me for?

• What do I enjoy teaching?

• What do I enjoy learning?

• What keeps me up at night?

• What moves me to take action?

• What is my ideal day?

After spending a few weeks letting these ideas gain traction, create a mission statement that will encapsulate your why in a single sentence. To get started, ask yourself what contribution you wish to make, and what impact you hope to have. It doesn’t have to be perfect, and it doesn’t have to answer to anyone else’s expectations. Your statement can be a work in progress, but it’s a great way to begin to align your goals with a purpose that is genuine and fulfilling. Over time, knowing your why can become a transformative force.  

 P.S. If you want to learn more about defining your values, click here to sign up for my free Values Workbook.

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