Rethinking Work-Life Integration: When Work Takes Over Your Personal Life

With the rise of EHRs and telemedicine, the term "work-life integration" has rapidly become an administrative buzzword.

Initially proposed as an alternative to the traditional "work-life balance" concept, the term encourages blending your professional responsibilities with your personal life. However, for physicians who are expected to be always on duty, this approach can paradoxically increase stress and decrease balance.

In this article, I’ll explore why work-life integration might not be the promised panacea for getting it all done.

The Myth of Seamless Integration

Despite the corporate happy-speak, work-life integration often translates to being ceaselessly connected.

For physicians, this means being perpetually available for patient queries, administrative tasks, training modules, and continuing education. This expectation of constant and immediate connectivity can lead to burnout and decreased job satisfaction

By definition, personal time is for the parts of your life that cannot be fulfilled at work.

Childcare, working out, maintaining relationships-- the list of things that pull on your personal time is endless. For the most part, these responsibilities and more require your full engagement.

But a focus on work-life integration can create an expectation of multitasking. This hits solidly against the basic tenets of the medical profession, which demands focus and precision.

Multitasking, as we all know by now, is a misnomer. Beyond the mental stress of juggling multiple tasks simultaneously, the unwieldy cognitive load can impair a physician’s ability to provide high-quality care.

The Impact on Personal Life

When work infiltrates all aspects of your life, personal time is often the first casualty. It’s common for physicians to find themselves checking emails during family time or thinking about patient care while trying to unwind.

Ultimately, you’re neither fully there for your patients nor for yourself and your loved ones.

While work-life integration is often hailed for its flexibility, it can lead to longer working hours under the guise of convenience.

Let’s be clear. You’re probably not bringing your toddler or your elderly mother to your office. And you’re not taking a walk with your EHR.

As someone whose parents were both full-time physicians well before the days of the internet, I can tell you from experience that it’s very unlikely that your home life is being integrated into the workday. A few furtive emails and rushed phone calls hardly count as connection.

Professional Implications

The stress and fatigue resulting from a lack of clear boundaries between work and personal life can increase the risk of medical errors. A tired and overworked physician is more prone to making mistakes, which can have serious consequences for both patients and the healthcare system.

But the threat of serious medical errors isn’t the only potential drawback of the constriction of your personal life. The consequences are not usually so blatantly obvious. Although it may be uncomfortable to admit, continuous engagement with work-related activities can lead to emotional exhaustion, reducing your ability to empathize with and care about your patients.

This diminished capacity for empathy and engagement can adversely affect patient satisfaction and trust, as well as outcomes.

The Bottom Line

For those in administration, creating a culture that supports and empowers physicians to do their best work is crucial. It’s time to go beyond talking points and take action. Removing unnecessary and burdensome “click work” is one way to reduce a physician’s load. Allowing support staff to handle simple messages and requests is another.

For physicians, establishing clear boundaries between your personal and professional lives can help to maintain your mental well-being, ensure the delivery of quality care, and support a fulfilling and sustainable personal life.

Despite the popular business-speak narrative around work-life integration, true balance often requires a clear separation of work and personal life, so that both may flourish.

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.

How Do You Know if You’re Burned Out?

Burnout is not going away.

It’s no surprise that nationwide, levels of burnout reached record highs during the pandemic, impacting over 60 percent of physicians. But now that we are back to a semblance of normal, the percentage of physicians experiencing burnout symptoms hovers a little under 50 percent. That’s still far above the “baseline” of 38 percent in 2020.

Topping the list of burnout-inducing specialties are

💉Emergency Medicine,

💉Internal Medicine,

💉OB-GYN

💉Family Medicine

Although burnout has decreased in all of these groups, more than 50 percent of doctors surveyed in these specialties described classic symptoms of burnout.

While any improvement is good news, the fact that nearly one in two physicians across the board are suffering from burnout is nothing to celebrate.

Not only is burnout demoralizing, but it also contributes to job turnover and increased healthcare costs. Not surprisingly, a Mayo Clinic study found that burnout can raise the likelihood of medical errors. And a 2019 study reported a conservative yearly cost to the US healthcare system of $4.6 billion dollars.

So how do you know if you're burned out?

❓ A. Is it just a feeling?
❓ B. Is it something we can measure?

If you answered B, you're right. Burnout isn’t just a trending term. There are standardized tools to measure burnout. The Maslach Burnout Inventory is the granddaddy of burnout tools, and has been in use since 1981.

Burnout affects doctors of all ages and across all spectrums. It is not a personal failing, and it’s not a mental illness.

If you’re experiencing burnout, it’s important to understand that burnout is not your fault, and you’re not alone. Here’s what you need to know:

✴ According to the World Health Organization and the ICD-11, burnout results "from chronic workplace stress that has not been successfully managed."

✴ Symptoms of burnout include:

🚫 feelings of low energy or exhaustion
🚫 negative feelings or cynicism about your job
🚫 loss of motivation and a sense of detachment from work

✴ Burnout is not a mental health condition.

So how do you know if you’re burned out? If you're wondering if you've just hit a rough spot or if you're truly burned out, you could invest in the Maslach Inventory. Or you could save yourself a little time and money and take a simple Two-Minute Burnout Inventory created by Chris Bailey for Harvard Business Review.

If you're a physician living with burnout, you don't need to suffer in silence. There are ways to get through it, but you can't always get there on your own.

Systemic changes to our profession are critical, and there are signs that change is coming. But while we wait for the slow gears of progress, it's important that you take care of yourself now.

Your health, your loved ones, and your patients are counting on you. If you’re feeling burned out, consider coaching, either through your institution, or through a certified Physician Coach. Studies, including a randomized controlled trial published in 2024, have found coaching to be an effective strategy for reducing physician burnout.

There are no easy answers to the complex issues facing healthcare today, but getting clarity on your own needs and values will empower you to chart your own course.

An earlier version of this article was published 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.

The Hidden Downsides of Meditation: A Guide for Physicians

As a physician coach and certified mindfulness meditation teacher, I find meditation to be a powerful and sustaining practice.

Meditation, especially a mindfulness practice, has been shown to improve focus and to mitigate stress and burnout. It can even improve sleep quality.

But while meditation has numerous benefits, 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.

For some people, meditation may have unintended, and unexpected consequences. In some cases, 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 strategies for getting 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. People with diagnosed anxiety often benefit from meditation, but they may be especially vulnerable to this negative effect.

Of course, it’s normal to feel a little anxious when you are not accustomed to sitting quietly. Cultivating stillness can take time. But if the anxiety does not lessen, or if you are not able to let go of uncomfortably intrusive thoughts, then meditation may not be right for you.

And while detachment is often a goal of mindfulness meditation, some people may develop a distressing sense of detachment from reality.

Longer meditation sessions, including meditation 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 a focused meditation at bedtime might actually cause the mind to become more alert, making it harder to fall asleep.

Consider meditating in the morning, mid-day, or before you head home from work. That way you’ll refresh your mind and gently reset your focus for the rest of the day ahead.

Decision Making

For many people, mindfulness meditation can improve decision-making speed and help with goal setting for positive outcomes.

But if you are someone who consistently tries to find the “best” possible choice when making decisions, you may find that mindfulness practices actually make it harder for you to make decisions. Instead of taking action, you might find yourself ruminating on all the possible outcomes.

Physical Discomfort

Sitting for extended periods, especially without proper support or in an uncomfortable posture, can lead to physical discomfort, including back pain, 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 to consider 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.

Conclusion

While meditation can be a powerful tool for improving focus, reducing stress, and enhancing sleep, it’s important to be aware of its potential downsides.

By starting with shorter sessions, being mindful of any arising emotions or negative feelings, and ensuring a comfortable posture, you can minimize risks.

Reach out to your mental health professional if you feel that meditation has aggravated or brought on uncomfortable feelings or persistent symptoms.

For many people, setting the stage for meditation with gentle stretching or yoga may offer a more sustainable and beneficial experience.  

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.

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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.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.

Rethink Your Path: Embracing the Be-Do-Have Paradigm for Physicians

Do you ever find yourself daydreaming, thinking that if you only had (x) then you could do (y), and finally be (z)? Perhaps if you only had more time, more money, a spouse, or something else- then everything would fall in line.

This is what is known as the Have-Do-Be mindset. It was first described by the late psychologist and spiritual teacher Ram Dass in the 1970s, but it remains remarkably contemporary.

Put another way, the "have, do, be" concept is a way of thinking about how we relate to the world around us. According to this framework, it’s easy to build our lives around the belief that our possessions, actions, or achievements will make us happy or fulfilled.

But in truth this way of thinking can actually hold you back from achieving your dreams. It can make you a passive observer, giving up your power and your agency in service to an imagined future over which you may have little control.

Instead of focusing on what you wish you could have, and what you are unable to do, you can flip the script by reflecting on who you want to be right now.

By making this choice, the path forward, the doing, becomes so much more clear. While the “having”, or what you might define as success, may not always be directly in reach, each step will move you closer to the life you want to live. And what may at first have seemed to be the goal might ultimately shift into something a little different, but even more fulfilling.

Be

Reversing the script can feel uncomfortable because it forces you to become accountable to yourself.

Getting started right now, rather than waiting for some unmapped date in the future, can be unsettling. And searching for firm footing to define exactly who you want to be can feel a little awkward.

But there are a few simple steps that can help you to get there with more clarity and certainty. And once you do so, you will begin to discover a sense of calm and purpose that may have eluded you before.

The key to getting started is to identify your own personal guiding principles.

What kind of person do you want to be, both personally and professionally? In other words, what are your core values? How can you live them out in your work as a physician and in your broader life as a friend, partner, parent, citizen, community member, or individual?

This exercise can be enlightening and sustaining. If you’re looking for a way to define your own personal values, my Core Values Worksheet can help.

Do

By naming your core values and aspirations, you can make intentional choices rather than simply reacting to external pressures or expectations.

Your priorities and goals will become clearer and more personal. And from there, you’ll be able to define the steps you need to take to keep yourself on track.

This could be as simple as setting aside a little protected time each day to work on your goals, or it may mean making a major life change. You may surprise yourself by what you discover as you work through this process.

Have

In defining your values and taking action, you will begin to find yourself living a life that aligns with who you are now and who you hope to become.

The “have” part of this equation will become more real and more attainable, rather than simply a dream.

As you grow towards your own North Star, your goals may shift a little, or maybe even a lot. And that will be how you know that you are on your own path.

Most importantly, if you’re feeling stuck, take action and don’t give up. You’ve done this before. If you got through medical school, you know that you are capable, resourceful, and smart. Your time may be more constrained now, but taking even a 15-minute block each evening to plan for the day ahead is a good place to start.

Know that through action you will find clarity.

An earlier version of this article appeared on this site in May, 2023

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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.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.

How to Begin a Meditation Practice: A Guide for Physicians

As a cardiologist, a certified mindfulness meditation teacher, and a yoga teacher, I’ve been fortunate to learn from a diverse group of mentors, ranging from world leaders in cardiology to a former Buddhist monk.

I learned about the power of meditation early on in my professional life and found that the presence and equanimity it cultivated inspired both my medical practice and my life outside of medicine.

If meditation sounds a little too nebulous, out-there, or maybe even intimidating, take heart from knowing that meditation is something that many of our key thought leaders practice on a daily basis. It’s not a new trend or a fad. In fact, mindfulness meditation has been incorporated into healthcare since the 1970s, when molecular biologist Jon Kabat-Zinn, Ph.D.  founded the Mindfulness-Based Stress Reduction Clinic at the University of Massachusetts Medical School.

Meditation can enhance your skills as a physician, improving your ability to focus on details and remain calm under stress. It may improve your sleep quality and even enhance your cardiovascular health.

You don’t need a guru or even a class to learn how to meditate. In this article, I’m sharing some simple ways that you can get started with meditation.

Start Small

Begin with just 3-5 minutes of meditation each day. Even this short duration can offer significant benefits. From there you might try a 10-minute practice.

Some people prefer longer meditations, but it’s good to know that when scientists compared 10-minute to 20-minute sessions, there was very little difference in overall mindfulness measures.

Use Guided Meditations

If you're new to meditation, guided meditations can be very helpful. There are many apps and online resources that offer free guided sessions tailored to different needs and preferences. Some good options are Head Space, Waking Up, Insight Timer, and Calm. Most have free or introductory options.

Find a Quiet Space

It’s hard to meditate when there are too many external stimuli. Although you can learn to meditate anywhere, start by choosing a quiet, comfortable place where you won't be disturbed. If you can close a door and put your phone in do-not-disturb mode, so much the better. This will help to create a calmer environment for relaxation and focus.

Eventually you’ll be able to incorporate this sense of focus and ease into your daily life wherever you happen to find yourself.

Focus on Your Breath

A simple way to begin to meditate is to focus on your breath. Close your eyes and take slow, deep breaths in through the nose and out through the mouth. There are a number of different ways that the breath can be used in meditation, but there’s no need to overthink it. Just settle into a rhythm that feels comfortable. By bringing your attention to the sensation of the breath, you’ll use it to anchor your meditation.

Go for a Walk

Walking meditation is a legitimate and ancient form of mindfulness practice.  Instead of using the breath as an anchor, walking meditation brings purposeful attention to the movement of your feet as they contact the ground.

Walking meditation is generally slow and contemplative, and often involves walking back and forth on a path. It’s not about getting from one place to the next. It can be done in the space of your living room, but there’s no reason you couldn’t use your walk from the parking lot to the hospital or office as a walking meditation. Most of the apps I’ve referenced above offer options for walking meditation.

Although traditional walking meditation is not fast, some runners find rhythmic running meditative when they mindfully attend to each stride.

Be Consistent

Like anything else, getting started with meditation is a habit to be cultivated. Since briefer meditations of 5-10 minutes can be highly effective, let go of any tendency to think that longer is better.  Consider setting a goal of 3-4 five-minute sessions per week and see how that feels for you.

Don’t give up if you’re not noticing any difference right away. One study found that 8 weeks, but not 4 weeks, of daily meditation improved mood, attention, and fatigue.

Listen to Your Inner Wisdom

Keep in mind that meditation isn’t right for everyone. For instance, although many people with anxiety find meditation helpful, some people will experience worsening anxiety or an uncomfortable feeling of disconnection while meditating. Longer meditations (over 30 minutes) are often more problematic, and retreats can be especially triggering.

If meditation is not right for you right now, remember that simply taking a mindful pause can make all the difference in a hectic day.

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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.

How to Manage Interruptions and Limit Attention Residue: A Guide for Physicians

It’s not just your imagination. It’s more challenging than ever to maintain your mental focus at work.

💉 EHR alerts

💉 Phone notifications

💉 Interruptions from staff

💉 Attention sapping apps

💉 Email

All of these and more conspire to make focus more difficult than ever before.

These constant interruptions and the lingering effects of shifting attention, known as attention residue, can severely hamper not only your effectiveness and productivity, but also your own well-being.

Resolving the current state of disorder in healthcare will require systemic change, including a fundamental shift in the functionality of many EHRs.

But protecting your headspace is a critical skill that can help you stay above the fray.

In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily life and practice.

Understanding Attention Residue

Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task.

The little breadcrumbs that remain can jumble up your thoughts and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to switch over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.

Realistically, interruptions are a part of life in most medical settings. Apart from a few innovative healthcare systems, the current state of affairs creates the perfect setup for attention residue.

Each interruption requires a mental reset, which can take a considerable amount of time and effort. Ultimately this leads not only to decreased productivity and lost focus, but also to increased stress.

This isn’t just theoretical. Research looking at Emergency Department physicians and nurses has found that interruptions from a broad range of sources can seriously degrade the ability to remain focused and aware. What’s more, the disruptions in this study occurred on average about 11 times every hour.

Strategies to Regain Mental Focus

Ideally, our healthcare system leaders will realize the importance of creating pathways that will minimize interruptions. This process is underway in a number of medical systems. But even under the best of circumstances, interruptions are going to happen. Here are a few ways that you can limit the mental drain.

Prioritize and Plan

This can be a difficult step for physicians, since we don’t always have control over the way the day might go. But simply outlining your top priorities can help by giving you a focus and a “north star” for the day,

Start your day by outlining your top priorities. Whenever possible, highlight high-impact tasks when your mental energy is at its peak. For many people, that is the first thing in the morning.

Use tools like the Eisenhower Matrix (also known as the Time-Priority Matrix) to distinguish between urgent and important tasks, and mitigate those less important time-wasters.

Time Blocking

Whenever possible, consider setting aside specific time blocks for different types of tasks. For example, set aside uninterrupted time to study for your boards, or for administrative work. If you have some control over your schedule at work, scheduling similar patient visits may be helpful, so that your mental flow is less likely to be interrupted.

Communicate your schedule and your plan to create these focused blocks of time to your team (or your family) to minimize unnecessary interruptions. Getting buy-in from your schedulers and administrative staff can help to make time blocking work for you.

Mindfulness and Meditation

Consider incorporating mindfulness practices into your daily routine. Techniques such as deep breathing, meditation, or yoga can help improve focus and reduce stress.

Meditation in particular has been found to be helpful in improving attention, focus, and memory and reducing stress. Just like medication or physical therapy, it’s important to be consistent. In one study, it took 8 weeks of regular practice before the impact of meditation was clear.

Taking a mindful pause before and after each patient, study, or procedure is a great way to mentally reset. In many cases, even this very  brief break can improve your efficiency.

Meditation might sound intimidating, but it’s really quite simple. This article shows you how you can easily get started. Don’t just think of meditation as something that you can investigate when you have the time. There is good evidence that engaging in a regular meditation practice can enhance your attention and mental efficiency.

Limit Multitasking

Multitasking used to be considered a superpower. But now we know that when people multitask, they often make more mistakes. And because of inefficiency, it may actually take longer to get tasks done than if each one was done separately. That’s especially likely if both tasks require mental energy, rather than rote memory.  

By focusing on one task at a time, you may improve the quality of your work, reduce the cognitive load, and actually save time.

If you have tasks that are time-consuming and not realistically amenable to completion in one sitting, break them down into smaller, more manageable steps. That way you can think of each step as a separate and achievable task. It can be helpful to write each of these sub-tasks out and check it off the list when it’s completed.

As you knock out these smaller to-dos, you’ll feel a sense of accomplishment. That can reduce the attention residue that builds up when you stress about unfinished work.

Set Boundaries

It’s not surprising that research has found that interruptions increase the likelihood of errors, which may put your patients at risk.

What’s more, these unwanted intrusions also impact your own mental well-being, provoking measurably high levels of anxiety and annoyance.

Ideally, set clear boundaries with colleagues, staff, and patients regarding when you are available for interruptions.

When practical, limit social and nonessential chatter when you’re focused on something that requires deep thought or careful consideration. Reading studies, creating notes, reviewing charts, and developing treatment plans all fall into this category.

Use simple visual cues, like a closed door or a "Do Not Disturb Unless Urgent" sign. Distractions can’t all be eliminated, but taking these and other attention-preserving actions will likely build awareness and respect for your focused time.

It can also be helpful to set expectations with patients and staff that non-urgent in-box messages will only be addressed during or after certain hours of the day.

Conclusion

Maintaining mental focus requires practical, intentional strategies and consistent effort. By experimenting with some or all of the steps I’ve listed above, you will enhance your ability to concentrate, manage interruptions, and reduce attention residue.

Developing these practices will not only improve your productivity but also contribute to better patient care and support your own vital well-being.

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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.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.

How to Get Started as a Medical Writer

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

Side gigs are a hot topic for physicians. Some people do it for the extra cash, others want to stretch and learn something new. Some doctors are looking to pivot from clinical medicine entirely and may use a side gig like writing to test the waters.

As a medical writer since 2009 and an author of four books aimed at a lay audience, I have learned a lot about the process, including how to make connections and what it takes to get published in the popular press. But before going any further, let me be clear: Unless you are a celebrity with a powerful platform, you probably aren’t going to get rich off of medical writing. Not even a little.

That’s not meant to discourage you. Writing is a fantastic way to clarify your position, share information, and get in front of a larger audience than you might otherwise find. It’s also a terrific way to deepen your own knowledge base.

Writing can open doors to other opportunities that you may never have considered. And it will introduce you to a world of people, including publishers and other writers, that can expand and challenge your point of view.

In this article, I’ll share my own journey as a medical writer, including my pitfalls and successes. I also offer suggestions that may make your own process easier and more rewarding.

One caveat: When I talk about medical writing here, I am referring to my experience of writing health-focused books and articles for the general public. There are other forms of medical writing, including working within the pharmaceutical industry, working on continuing education, and creating regulatory documents for governmental organizations, that follow a very different set of rules and standards. In some cases, these companies may offer full-time employment.

Like many physicians, I have written for medical journals and presented at innumerable conferences and grand rounds. As a woman in cardiology since the early 1990s, I was enough of an oddity that I was often tapped to give talks and presentations to both professional and lay groups on women and heart disease.

Being comfortable with putting words on paper, and learning to present information in a cohesive, conversational way was an important foundation for my first book, The Smart Woman’s Guide to Heart Health, published in 2009. I’ll be honest. This was not a quick or easy process. It took me several years, carving out 30 minutes here and there to work on my project, but the knowledge I accumulated made me a better physician and communicator.

My book began as a way to address my patients’ questions about diet, supplements, exercise, stress, and other issues that impact cardiovascular health. I realized that fellowship prepared me very well to take care of critically ill patients, and to competently manage preventive care, but I had a very shallow understanding of the impact of diet and lifestyle, and I knew virtually nothing about supplements. These were the questions that my patients kept bringing to me, and I wasn’t comfortable simply addressing their concerns superficially. At the time, the Adkins diet (a precursor to the Paleo and Keto diets) was resurging, so writing critically was a great way to delve into the medical research.

Like most physicians, I depend strongly on evidence-based care. Writing the book was a fantastic way to educate myself, and to become an expert in an area that was crucial not only to cardiovascular health, but to health and well-being in general.

However, it was not a money-making enterprise. The book was published by an independent publisher that required that I pay up front for the services, which included an editor. The publisher also offered marketing services, which I naively bought into. Though I was happy with the book and reviews, and my patients and practice loved it, I never made back the money that I put into it.

Two years later, I decided to take a shot at getting a contract with a traditional publishing house. This time, I received an advance, and the book, Best Practices for a Healthy Heart: How to Stop Heart Disease Before or After it Starts, was published in 2011. That was also the time that my practice was acquired by a large healthcare organization.

I learned belatedly that due to the strict bylaws of the organization, I could not effectively publicize or promote my work. That was important because most publishers rely on (and may even contractually require) their authors to market their books through multiple platforms.

Nevertheless, having now created a body of work as a medical writer, in 2014 I was asked to co-author The DASH Diet for Dummies with two well-known dietitians who were happy to do promotional work. That book is now in its second edition and sells dozens of copies per week.

Had I never sat down and started writing, my financial bottom line would probably not be much different, but writing has given me so many other interesting opportunities.

Writing made me a better educator for patients and trainees, teaching me to communicate more concisely and clearly. It brought many people into my practice, which benefited me, my partners, and my organization.

I’ve written and presented for a number of organizations and websites, receiving modest but still meaningful compensation for my work. I am recognized as an expert in my field. And writing has given me a platform and a way to connect with people from all over the world.

So, how can you get started as a medical writer?

I recommend starting small, testing the waters, to discover if writing is something that feels right to you. From there, you can always move up. Here are some practical ideas to spark your imagination:

Create a brief series of handouts for your patients.

For example, perhaps you’re frustrated with the lack of educational resources that you can offer your patients. You have an idea of creating a handout, but you don’t know where to start or how to get it done. Maybe you think someone else would do a better job, and you don’t want to look amateurish, so you just let it slide. Meanwhile, you’re spending extra time trying to get your ideas across to patients in the limited minutes you have in the office schedule.

It’s easy to feel a bit overwhelmed when tackling a writing project for the first time. Keep in mind that it doesn’t have to be complicated or detailed. A few salient bullet points may be all you need. Start by setting aside a little time to make a simple outline and work from there. You’ll provide something of real value to your patients, and you’ll ultimately create more time to focus on patient care.

Start a blog.

You don’t have to write a book to get your ideas out there. Simply choose a topic you’re interested in, tell a brief story around it, and provide information that you know your patients, family, or friends want to know. Write as if you’re having a conversation, and then stop after a few hundred words.

There are all sorts of options for free or low-cost websites on the internet. It’s great to be consistent, but don’t beat yourself up if you can’t do this regularly. Once a month is a good way to start.

Reach out to a wider audience.

Once you’ve written a few pieces and have your bearings, consider reaching out to your local newspaper to share one of your posts or offer your services. You can also offer your expertise to services like Connectively, where journalists are often looking for quotes.

Consider writing brief pieces to post on LinkedIn under your own account. This can be especially useful if you are able to discuss new research or health conditions that appeal to a broad audience.

Consumer health magazines or online resources may also be interested in your work. Check their websites for submission details. I found my current writing gig with GoodRx.com on a physician job board, and have been writing for them consistently since 2021. I love working with the editors and improving my work. And it’s great to be able to share my knowledge and insight with a wide public audience.

Consider an e-book.

Self-publishing is a much bigger industry than it was just a few years ago. The downside is that you will need to pay for an editor to review and help you refine your work. Or you can enlist a colleague or trusted friend to proof-read and make suggestions.

Find a publisher.

Writing a book is not for the faint of heart. The hours you put into it may never be compensated. But there is nothing like the feeling of your own book in your hands. If you are really intent on working with a traditional publisher, you will need a literary agent. Resources such as Publisher’s Marketplace and Writer’s Digest can help you drill down your options.

Conclusion

You probably won’t get rich as a medical writer, and you may not even make minimum wage when all is said and done. But you will enrich your experience as a physician, become a better communicator, and create opportunities you may not have even considered. Writing can be a path to lifelong learning, and patients and other physicians will appreciate your expertise. Not to mention, you’ll meet a wide range of people whose paths you may not ever have crossed otherwise.

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’re interested in learning more about my coaching program, you can schedule an introductory meeting by clicking the link below.

My Podcast Interview with Dr. Kevin Smith

This was such an interesting conversation with facial plastic surgeon and ENT Dr. Kevin Smith for TechLink Health! I was fascinated to learn about the link between migraines and nasal health. Dr. Smith’s journey from college athlete to cutting edge surgeon gives him a unique perspective, which he shares on the podcast.

Dr. Smith's story shows how the combination of clinical excellence, curiosity, and persistence can impact patients' lives in meaningful ways and spark new innovations.

Maximize Efficiency and Achieve Work-Life Balance: The Time Priority Matrix for Physicians

Do you ever finish the day feeling as if the time raced by, but instead of making progress on your goals, you’ve just been putting out fires?

With a constant surge of urgent issues, combined with your daily responsibilities and opportunities, it can be challenging to prioritize effectively.

Using the Time Priority Matrix can help you to visualize not only where but how you are spending your time. By categorizing your daily activities, you will discover how your attention is being directed, and where you might be able to streamline and optimize the way you use this most valuable and limited resource.

This tool is also known as the Eisenhower Matrix. Former US President Dwight D. Eisenhower didn’t create the idea, but he famously referenced Dr. Roscoe Miller, a former president of Northwestern University, when he said: "I have two kinds of problems: the urgent and the important. The urgent are not important, and the important are never urgent.”

The matrix was subsequently popularized by Stephen Covey in his landmark book The 7 Habits of Highly Effective People.  It’s something that’s often taught to business leaders, but the concepts can easily be applied to physicians and anyone else seeking to take back some control of time and attention.

How to Use the Time Priority Matrix

Quadrant I tasks are both urgent and important. Ideally these are limited, but as a physician, these tasks are part of daily life.

The critically ill patient, the urgent report, the call from a worried family member. Often these issues are out of your control. But sometimes there is a way to mitigate the urgency, and that's where Quadrant II comes into play.

Quadrant II: Preparation, planning, and prevention fall into Quadrant II. By working in this quadrant, you anticipate and trouble shoot before trouble arises. That's what preventive care is all about.

You can also apply this idea to your own life. For example, if you're studying for your boards, taking a set amount of time every day for a few months will get you much farther ahead than waiting until the last couple of weeks to study. And learning a new skill or technique and making the time to practice it will ensure that when you need it, you'll be more confident and prepared.

Building trusting relationships with patients and colleagues also falls into Quadrant II. By taking the time and putting in the work at the outset, you’ll build trust and confidence. Ultimately that will enhance your ability to provide care more efficiently and collaboratively.

Work in this quadrant might not always be exciting or immediately fulfilling, but it will keep you on track to accomplish the goals that are meaningful to you.

You can apply Quadrant II ideas to your personal life as well. Think about your relationships, family, and other interests. What can you do to ensure that the things that matter to you outside of work are cared for and able to flourish?

Quadrant III is more problematic. In this quadrant, you're dealing with things that are not particularly important, but which require some urgency to complete.

As a physician, you're probably all too familiar with this quadrant. Interruptions, EHR redundancies and pre-authorization inefficiencies that have to be addressed are daily if not hourly occurrences. Some meetings and much email fall into this category.

Sometimes it can help to work on these things in "chunks" so that your attention is focused and you can be more efficient. This is known as task batching, and it can be a highly effective way to clear out some of the clutter that routinely piles up. Making it clear that these non-urgent issues will only be addressed on a certain day at a given time is one way to not only set boundaries but to limit interruptions.

Delegating whenever possible is an important aspect of Quadrant III management. For example, can someone else be assigned to fill out routine paperwork, leaving only the physician-specific sections for you to complete? Perhaps staff can be empowered to respond to simple patient requests for notes or documentation, or to schedule a visit when it’s clear that a non-urgent call or message requires more than a simple response.

Quadrant IV is where you have the greatest likelihood of clearing out some time and space. Mindless scrolling, low-value emails, watching random TV shows, and stressing over social media are good examples of this quadrant's activities.

Sometimes you need a little downtime, but being cognizant of how you are spending it may help you to gain some well-earned margin for the things that matter most to you.

It can be a great thought exercise to think through the way you are using your time. The Time Priority Matrix is a valuable tool that can help you to manage your workload and your personal life more effectively. By identifying and prioritizing tasks based on urgency and importance, you’ll have a tool that can enhance your productivity, improve patient care, and help you achieve a healthier and more fulfilling work-life balance.

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 Appearance on Dr. Bill Lombardi’s Journey to Better

It was a thrill to appear on 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.

Dr. Lombardi is one of the highest-volume operators for complex PCI and chronic total occlusions in the world. He has been open about his own struggles with well-being in this high stakes and intense field of cardiology. His episodes will resonate for cardiologists, but also for any physician who has experienced the struggles, highs, and lows of caring for patients in today’s world.

Creating Action Steps for Process Goals

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

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

• Specific

• Measurable,

• Achievable

• Relevant

• Time-bound

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

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

Getting Started with Process Goals

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

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

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

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

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

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

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

Outcome Goal: Find a New Job

Process Goals:

• Clarify your values.

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

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

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

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

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

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

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

  • Identify people who are decision makers for the practice.

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

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

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

• Prepare for interviews by creating your personal elevator pitch

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

• Practice for interviews with a friend or coach.

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

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

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

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

My Podcast Interview with Mastek’s Ritwik Batabyal

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

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

Perfectionism, Procrastination, and Fear of Failure

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

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

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

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

Perfectionism, Procrastination, and Imposter Syndrome

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

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

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

Perfectionism, Procrastination, and Fear of Success

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

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

Breaking the Cycle of Procrastination

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

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

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

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

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

1. Medical documentation

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

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

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

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

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

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

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

2. Professional Commitments

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

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

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

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

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

3. Your Personal Life

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

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

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

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

Procrastination and Self Compassion

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

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

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

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

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

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

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

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

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

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

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

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

Understanding Outcome Goals vs. Process Goals

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

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

Process goals are:

• Shorter term (usually less than a week)

• Concrete and realistic       

• Very specific

• Trackable and measurable

• Modifiable

• In alignment with your values

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

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

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

The Benefits of Focusing on Process Goals

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

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

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

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

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

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

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

TechLink Health Podcast on Heart Smart Mindfulness

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

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

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

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

📗 The Bullet Journal Method

📙 Real Change

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

📲 The Waking Up App

📲 Headspace

📲 Calm

📲 Yoga: Down Dog

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

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

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

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

Define Your Values to Create Your Ideal Life a Physician

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

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

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

First, Define Your Values

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

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

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

Next, Put Your Values into Action

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

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

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

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

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

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

Setting SMART Goals: A Guide for Physicians

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

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

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

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

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

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

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

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

Specific

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

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

Measurable

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

Achievable

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

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

Relevant

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

Time-Bound

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

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

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

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

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

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

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

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

References

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

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

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

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

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

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

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

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

Optimizing Patient Flow: Time-Saving Tactics for Physicians

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

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

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

 Pre-visit Information Collection

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

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

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

Standardization and Checklists:

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

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

Efficient Communication Techniques:

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

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

Technology and Tools:

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

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

Delegate Simple Tasks:

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

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

Optimize Scheduling Practices:

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

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

Structured Patient Interactions:

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

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

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

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

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

Five Simple Ways Busy Physicians Can Save Time

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

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

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

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

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

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

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

1.       Organize your physical and virtual workspaces.

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

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

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

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

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

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

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

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

4.       Automate and delegate your common phrases and tasks.

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

5.      Streamline Team Communications

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

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

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

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

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

References

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

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

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

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

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

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

You Want to Do Good in the World

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

You Do Hard Things Every Day

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

You Are Passionate About Your Work

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

You Come from All Walks of Life

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

You Are a Change-Maker

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

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

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

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