Maximize Your Time: Essential Toolkit for Physician Time Management

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

Physicians aren’t magicians, but the demands of the job often make it feel like you’re expected to conjure time out of thin air. It’s not your imagination. A recent study found that in order for a primary care physician to provide guideline-recommended care and communication, they would have to work nearly 27 hours every single day.

With burnout impacting more than half of US physicians, much of it related to these unrealistic demands, some healthcare systems and many medical associations are beginning to take note. System-wide commitments to streamline tasks and automate simple processes are beginning to take hold. But true reform is likely to be several years away.

In the meantime, when every minute of your day feels like it belongs to someone else, managing your own time isn’t a luxury. It’s essential. Yet time management is rarely taught in medical training, leaving many of us to figure it out the hard way.

During my years as a busy cardiologist, I became fascinated by productivity strategies. I learned from the best in the field, and I discovered that with the right tools, I could work more efficiently and create space for what mattered most outside of my practice. That included time with friends and family, creative pursuits, and re-energizing with physical pursuits like riding my horse and practicing yoga. That extra space in my life helped me to stay energized and focused so I could keep showing up fully for my patients.

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

Start a Bullet Journal

A bullet journal is one of my favorite time savers. This analog notebook is far more than a traditional planner. It’s a personalized system that blends task management, reflection, and goal tracking. Here’s how it can work for you.

✅Customizable Layout: Design your bullet journal to fit your needs, whether that’s jotting daily to-dos, tracking long-term projects, or creating space for self-reflection. Don’t worry about making it look pretty, unless that’s something you enjoy. Mine is simple: a basic checklist and scattered notes throughout the day. No artistry required.

✅Mindfulness Practice: The act of writing by hand boosts memory and mindfulness. It can also help you to prioritize tasks. I like to take 10 minutes every evening to set up my plans for the next day. Even if I don’t check off every box, simply writing them down creates an intention and makes it more likely that I’ll eventually follow through.

✅Bonus Tip: Use color coding for the win. Assign different colors to specific types of tasks or appointments—like blue for meetings, green for personal time, and red for urgent deadlines. It’s a quick way to visually organize your schedule and makes it easier to remember what’s important at a glance.

If you want a deeper dive into bullet journaling, check out The Bullet Journal Method, by Ryder Carroll. There’s no rush to get through it. For me, ten minutes a day was enough to build lasting momentum.

Commute with Audiobooks

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

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

✅Four Thousand Weeks by Oliver Burkeman is a thought-provoking exploration of time, productivity, and the modern obsession with getting everything done. Rather than offering hacks to do more, Burkeman challenges us to embrace the limitations of the human lifespan, roughly 4,000 weeks, and focus on what truly matters. It’s a refreshing, philosophical take on time management that encourages purpose over perfection and presence over productivity.

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

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

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

Recharge with App-Based Yoga and Fitness

Taking care of your physical and mental well-being is one of the most powerful ways to clear your head, enhancing your ability to manage time. As a registered yoga teacher, I’m a big fan of online yoga classes—not just for the practice itself, but for the flexibility they offer.

✅Flexibility: Yoga apps let you practice at your convenience, fitting sessions into a busy schedule. . Whether you have 10 minutes or a full hour, there’s something that fits your schedule. I like DownDog, AloMoves, and YogaWorks. All three also offer options besides yoga, including strength training and meditation. And some offer live options as well.

✅Stress Relief: : Yoga, like many forms of movement, is a way to reset both body and mind. If you're just starting out, or if your time is limited, keep it simple. Commit to just 10 minutes twice a week and build from there. Sometimes the hardest part is simply beginning.

✅One quick tip: If you’re new to yoga, Pilates, weight training, or any other form of movement, consider a few in-person sessions or private lessons. Learning the basics from a skilled teacher helps prevent injury, boosts confidence, and makes the experience more enjoyable.

 Save Time with a Time Tracking App 

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

✅Identify Time Drains: Tracking your time online can help you spot activities that sneakily eat up more time than you realize. That doesn’t mean you need to give up email or social media altogether—but when you see where your time is going, it becomes easier to make intentional choices that align with your priorities and values.

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

✅Batch Your Tasks: By committing to focus on one type of task at a time, your efficiency will surge. For example, use a dedicated block of time for phone calls, charting, or emails. You’ll find that when you’re not skipping from one modality to another, you’re able to get more done, even if all you have is 10 minutes.

Click on “Do Not Disturb” Mode

Your attention is one of your most valuable resources. Pre-scheduling Do Not Disturb mode on your phone, computer, or both can protect your focus during critical windows of the day. Of course, being unavailable isn’t always practical, so be strategic in how you use this function. Here’s how it can help:

✅Fewer Interruptions: Silencing notifications during focus blocks helps reduce distractions and boost efficiency.

✅Protects Your Boundaries: Sending calls to voicemail or messages to “later” mode gives you breathing room for deep work, rest, or patient care.

✅Easy to Set Up: Most smartphones and operating systems allow you to automate DND based on time, location, or calendar events.

Pro tip: Let colleagues or assistants know when you’ll be in DND mode, so they can support your boundaries rather than bypass them.

Free Yourself with App Limits

Many apps, especially social media, are designed to control your attention. When you set a time limit (available in your phone’s settings), you can begin to take charge of this most valuable resource. Here’s why it works:

✅Raises Awareness: You may not realize how often you scroll until you get a daily report or hit a time limit.

✅Encourages Intentional Use: Setting a 15-minute cap on apps like Instagram, TikTok, or news sites helps you check in without falling down a rabbit hole.

✅Built Into Your Phone: Most smartphones include screen time settings where you can create limits for individual apps or categories (like entertainment or social media).

Take One Simple Step

You don’t need to overhaul your entire routine in order to optimize your time. Instead, pick and choose what works best for you, or let these ideas spark some options of your own. The important thing is to commit to making at least one change. When you invest a little time and energy to get started, you may be surprised by how much you get back.

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

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

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

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

The “Done” List: The Simple Motivation Booster Your To-Do List Is Missing

I am a firm believer in my daily Bullet Journal to-do list.  It’s a multi-tasking analog tool that keeps me on track towards my goals, reminds me to stop by the dry cleaner, and prompts me to stay connected to my friends and family. And I love that satisfying zing I feel every time I check off a completed task.

As a physician coach with a special interest in time management, I know that conventional advice often focuses on what you haven’t done. Maybe it’s your nagging inbox, those unfinished notes, or the incomplete plans for the rapidly approaching family vacation. Checking those tasks off the list is not only satisfying—it’s also necessary. But sometimes, the most powerful shift comes from celebrating what you have accomplished.

This is where the “Done” List comes in. It’s a surprisingly effective, low-effort tool that can help you feel more in control, less overwhelmed, and even more productive, without adding one more thing to your to-do list.

 What Is a “Done” List?

A Done List is exactly what it sounds like: a short, running record of tasks you’ve completed throughout the day or week. It might include big wins like finalizing a research draft, or small victories like responding to a tough patient message with compassion. Maybe it’s fitting in a workout. It could even be something as small but impactful as picking up your shoes from the cobbler.

Unlike a to-do list, which is future-focused and often stress-inducing, the Done List is a tool for self-reflection that builds your confidence, momentum, and motivation. It’s a low-key way to celebrate your daily wins, acknowledging your efforts and helping you to unwind.

Why the Done List Works: The Science Behind It

Research in neuroscience and psychology tells us that recognizing small wins triggers a dopamine release, reinforcing behavior and increasing motivation. Over time, this contributes to a more positive outlook, increased resilience, and stronger follow-through.

It’s more than conjecture. Here are a few key findings that support this affirming practice:

✅The Progress Principle: Harvard researchers Teresa Amabile and Steven Kramer found that of all the factors influencing motivation at work, making progress in meaningful tasks was the most powerful—even more than recognition or incentives.

✅Positive reinforcement: Small accomplishments signal success to your brain, and this positive reinforcement can help you build momentum and sustain focus.

✅Burnout buffer: Studies on physician well-being have found that a sense of personal accomplishment is a key protective factor against burnout.

 How Physicians can Use a “Done” List

Don’t overthink it. You can start using your Done List immediately—no special tools required. Here’s how to make it work:

⭕Add a “Done” section to your existing system

If you use a bullet journal, planner, or notes app, create a small section labeled “Done Today” or “Wins.” Jot down what you complete throughout the day or at day’s end before bedtime.

For example. in my Bullet Journal, I have a page with a single line devoted to each day of the month. Every evening I list a few things that I’ve done, no matter how seemingly insignificant. Over time, these small wins add up.

⭕Keep it short and sweet

There’s no need to track everything. Just 3–5 items is plenty. Focus on meaningful actions—even small ones. Here are a few examples:

• “Had a hard conversation and connected with empathy.”

• “Closed all charts before leaving.”

• “Meditated for 5 minutes.”

• “Said no to an extra commitment I didn’t have capacity for.”

• “Walked the dog and chatted with the new neighbor.”

⭕Reflect at the end of the week

Take 5 minutes on Friday or Sunday to scan your Done List. For me, this weekly check-in feels motivating and affirming. Looking back over the month I can see just how much I’ve accomplished, even if the day-to-day felt scattered or incomplete.

Try It This Week

Give your done list a trial run. You don’t need to write much—just a line or two will do. At the end of the week, check in with yourself:

❓Did it make your day feel more manageable?

❓Did it shift how you think about success?

❓Did you notice patterns that could guide your priorities?

❓Did you learn something new or surprising about yourself?

Bottom Line

The Done List is a simple routine, but its effects can be powerful. It can help you see your progress, acknowledge your hard work, and reframe your days through a lens of accomplishment, not just obligation.

When time is tight and expectations run high, this simple ritual can help you regain perspective and show yourself some compassion. As a result, you’ll be setting the stage for greater focus, motivation, and joy in all facets of your life.

---

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.

Brain-Computer Interfaces and Mental Focus: My Podcast Interview with Ramses Alcaide of Neurable

On a recent episode of the TechLink Health podcast, I had the chance to speak with Ramses Alcaide, CEO and founder of Neurable, a leading company in the brain-computer interface (BCI) space. Our conversation was a deep dive into how neurotechnology is opening up new possibilities in healthcare, productivity, and mental performance. This includes EEG-enabled headsets like the MW75 Neuro, which Ramses is sporting in the picture below.

These advanced EEG wearables are designed to enhance cognitive focus, promote well-timed mental breaks, and minimize distraction—functions that may be especially relevant for physicians and others facing constant demands on their attention. Even a couple of years ago, this might have seemed quite futuristic, but the Neurable headset now has real potential to become a practical tool for managing cognitive load and maintaining well-being.

I was fascinated to learn that the company makes it easy for researchers and tech developers to access the technology, opening up the potential for a wide range of applications. Ramses also described Neurable’s commitment to maintaining users’ privacy, which I believe is crucial for companies developing wearables in this space. Tune in to the podcast to learn more about it!

You can find the podcast on Spotify, Apple Podcasts, and other podcast platforms, or take a listen through the link below.

My Podcast Interview with Ramses Alcaide of Neurable.

Master Your EHR: Proven Strategies to Take Back Your Time

I still remember my first day in clinic as a cardiology attending. I was eager, definitely a little nervous, and determined to provide the best care possible to my new patients.

Back then, we were still using paper charts. They were far from perfect, but in hindsight, those analog files had their advantages—no endless clicks, no after-hours inbox, just a straightforward way to document and move on. But I digress.

That day, one of my more seasoned colleagues pulled me aside and gave me a piece of advice that, over time, became ever more valuable:

"Whatever you do, don’t let your charts get out of control."

At the time, I didn’t fully grasp the weight of his words. But it didn’t take long to understand.

Fast-forward to today, and the electronic health record (EHR) dominates medical practice. It’s here to stay, but it comes at a cost. A study of over 200,000 EPIC users found that physicians spend nearly six hours in the EHR for every eight hours of patient care. That’s almost an entire workday devoted to documentation, order entry, inbox management, and other digital tasks.

While awareness of this issue is growing, and new tools are emerging to help, the reality is clear: the EHR will continue to demand a significant share of your time and attention. You may not be able to escape it, but you can take control of it. The key is to be intentional about the way you use your time.

Six Essential Strategies to Keep Your EHR Under Control

Here are six key strategies that have helped me, and many of my clients, take control of the EHR. I hope they’ll help you do the same, freeing up more time for what matters most.

Make a Plan And Stick with It

Your EHR workflow should be intentional. Whether it’s blocking dedicated time for documentation, setting clear start and stop times, or batching tasks, having a structured plan prevents endless charting after hours.

While you can’t control every aspect of your day, deciding in advance when and where you will complete documentation keeps you on track.

Minimize Task Switching

It’s tempting to juggle patient care, inbox messages, and documentation all at once, but constant switching fragments your attention and slows you down. This is what is known as attention residue.

Instead of struggling to do everything at once, try to dedicate specific blocks of time for notes, messages, and testing review. Batch similar tasks together, even if you’re only spending 15 minutes on them.

When possible, set clear expectations with your staff and patients about response times to minimize interruptions. You might also include setting a defined limit on the number of back-and-forth messages you exchange with patients. After a specified number within a given time frame, consider if an office visit or tele-visit is required.

Setting aside time to tackle your in-basket before or after clinic can also make a big difference. When you handle these tasks during these quieter times, you’re less likely to get interrupted. You’ll also be protecting your time at home. Even a focused 30 minutes per day will help you to stay on track while lessening the impact of work on your personal life.

Use Smart Phrases and Macros

Most EHR systems allow you to create shortcuts for frequently used phrases, reducing typing and dictation time and improving efficiency. Develop smart phrases for common explanations, patient instructions, and standard findings to streamline your workflow without sacrificing quality.

If you have access to a “super user”, or an EHR specialist, make use of them. These individuals can help you navigate the fine points of your EHR and make your work more efficient.

Make Templates Work for You

Templates are invaluable for structuring your notes efficiently. Whether you modify existing ones or create your own, templates ensure consistency, save time, and reduce cognitive overload. By having a template, your notes will make sense and you’ll ensure nothing is left out.

Keep in mind that a good template should be readable, relevant, and concise. No one benefits from pages of repetitive text or unnecessary jargon. And since patients have access to your notes, including unclear verbiage can trigger more messages in your inbox.

Create a Problem List

One important aspect of your EHR strategy is an accurate and updatable problem list. By keeping the list complete and up to date, you will save yourself untold hours of frustration. That’s because repeatedly scrolling through a chart trying to cobble together a current history is a waste of precious time, both during office visits and when trying to put test results into context.

When you use a well-curated problem list, you’ll also inspire greater confidence. When you have all the relevant information at your fingertips, it will be clear to your patients that you are up to date on their health concerns, testing, and any surgeries or procedures.

An important caveat: you can’t always depend on the EHR to generate a factual or relevant problem list. This is something that may require some work on the front end.

Explore AI and Automation

If your EHR offers AI-powered documentation tools, voice recognition software, or automation features, consider incorporating them into your workflow. While technology won’t solve every issue, it can significantly reduce time spent typing and organizing information.

Just be mindful that AI isn’t perfect, and it’s no substitute for clinical judgment or personal attention. Always review its output carefully before sending it out into the world with your signature.

Take Back Your Time

EHR-related burnout is real, but it isn’t inevitable. By implementing simple, consistent strategies, you can regain control over your documentation.

You’ll free up valuable time for patient care and enhance your professional fulfillment and joy. Plus, you’ll break free from the cycle of late-night charting, creating more space for rest and balance. Instead of feeling tied to your screen, you’ll have more time to recharge and be present for yourself and for the people that matter most to you.

What strategies have helped you manage your EHR workload? Drop me a note. I’d love to hear from you!

---

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

And if you’d like to schedule a complimentary coaching discovery meeting, click the button below.

Overcoming Your Roadblocks: A Physician's Guide to Navigating Change When it’s Time to Move On

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

If you’re feeling stuck in your practice, torn between your current role and the pull toward something different, you’re not alone. In the old paradigm, physicians assumed they’d join a practice after training and remain there until retirement. Especially in private practice, moving locations, switching roles, or stepping away from clinical work altogether was rare and even stigmatized.

But the landscape has changed. Across every sector, more physicians are re-evaluating what fulfillment means—and realizing that staying true to your values may require reimagining your role, whether within your current system or beyond it.

It’s a deeply personal realization, and one that can feel both unsettling and energizing. And it’s becoming increasingly common.

In fact, a recent Mayo clinic survey reported that one in five physicians plan to leave their practices within the next two years, and one in three expect to reduce work hours. A second study found that amongst academics, one in three felt a moderate or greater intention to leave. And a 2023-2024 AMA survey of nearly 18,000 physicians from more than 100 health care systems reported similar finding across all physicians. What’s more, the number may be closer to 40 percent in some specialties, including Anesthesiology, Radiology, and Vascular and General Surgery. Burnout, excessive EHR requirements, and lack of support from their organizations were primary issues cited in these studies.

All of this is to say that if you're considering a change, you’re not alone. But that doesn’t make the decision easy. Physicians are often motivated by loyalty and compassion. But we are also creatures of habit, and veering off the well-worn path can feel daunting.

You’re someone who’s used to thinking independently and making critical decisions, but it’s likely that your roadmap was clearly defined from the start: college, medical school, residency, maybe fellowship. As long as you followed this straight and narrow track, and nothing unexpected knocked you off course, you would make it down the road. Waiting for you at the end of the trail would be a satisfying profession, a place of respect in your community, and a happy home life to balance it all out.

Over the past decade, that promise has faded for many physicians. Burnout due to lack of autonomy, higher patient demands, a sicker and older population, falling reimbursements, the unrelenting pace of EHR tasks: all have contributed. So have our increasingly disconnected healthcare systems. It’s not surprising that more and more doctors are reflecting on what they want from their careers, and what might need to shift.

Moving on is sometimes the best and healthiest choice. But change doesn’t always mean leaving your organization or giving up your practice altogether. Sometimes transformation begins by renegotiating how you work: seeking new roles, advocating for flexibility, or crafting a job description that better aligns with your strengths and goals.

Still, thinking about change of any type can feel like stepping into the unknown. The hardest part is often getting started. It may even feel as if your feet are stuck in quicksand. That’s normal. But once you begin, you’ll discover that your momentum will build and possibilities will unfold as you continue to move forward.

In this article, I’ll give you seven actionable steps that can help you move forward when you’re feeling stuck.

1. Self-Reflection

Before deciding what’s next, take time to reflect on what matters most, both professionally and personally. You don’t need to know the final destination yet, but clarity around your values, interests, and strengths is essential.

Journaling for a few minutes each day can help. Ask yourself:

❓What are my defining values? How do I want to manifest those values in my daily life?

❓What aspects of my current role energize me—or drain me?

❓What skills do I love using? And what would I be happy to give up?

❓How do I want to feel at the end of each day?

❓What would I regret not doing, both personally and professionally?

❓How will any change I make impact my loved ones, either positively or negatively?

Making time for self-reflection will lay the foundation for building a more aligned, satisfying professional life, whether that’s in a new place or a new role within your current setting.

  2. Recognize Your Triggers and Limiting Beliefs:

When you’re contemplating change, it’s natural for doubts to arise: “I can’t start over,” “I’m too far along,” “What would my colleagues/ family/friends think of me?” or “I’m lucky to have a job—why rock the boat?”

Instead of pushing these thoughts aside, examine them:

❓What stories am I telling myself?

❓What are these beliefs protecting me from?

❓Are they actually true—or just familiar?

❓What would it take to feel more confident in exploring a new path?

❓If there are meaningful limitations that are holding me back, how can I close the gaps?

Acknowledging and challenging these beliefs is a key step toward moving forward.

 3. Seek Guidance

 Talk to mentors, colleagues, or others who’ve made career shifts, whether big or small. You may be surprised by how many have reimagined their roles without leaving their organizations. Others may have made audacious shifts and found greater fulfillment. And some may have dealt with regrets and learned from their mistakes. The point is not to recreate anyone’s story, but rather to understand that your own possibilities may be more expansive than you realize.

Tapping into others’ experiences can offer both perspective and inspiration. Just be thoughtful about whom you confide in—especially if your plans are still unfolding.

 4. Set Achievable Goals

Break your career change into smaller, manageable goals. This not only makes the process less intimidating but also gives you a way to envision the road ahead.

Rather than winging it and hoping for the best, create a timeline with defined milestones. These might include:

✅Gaining specific qualifications or licensure

✅Attending relevant conferences,

✅Researching places you might want to live

✅Identifying internal opportunities that might better align with your goals

✅Exploring part-time or leadership roles within your system

✅Updating your CV or LinkedIn profile

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

Use the SMART framework—Specific, Measurable, Achievable, Relevant, and Time-bound—to track your progress and stay motivated.

 5. Reframe Setbacks as Lessons

 Rejection can sting. And not every door will open right away. Setbacks are part of any meaningful journey. Instead of seeing them as failures, view them as data.

What did you learn? What might you do differently next time? What can you take with you to the next opportunity?

Stay rooted in your “why,” and let that guide your next move.

 6. Get Comfortable with the Unknown

 Uncertainty is normal. It’s uncomfortable, especially if you’ve grown accustomed to defined pathways. But the unknown becomes less intimidating when you ground yourself in research and preparation.

If you’re exploring a nonclinical role, learn the landscape. If you’re considering a new position, understand the expectations, workflows, and culture. And if your skills need to be refreshed, find out what you need to do to make that happen, then make a plan to get it done.

The more you know, the more confident you’ll feel taking the next step.

 7. Keep an Open Mind

You don’t need to have everything figured out right now. Stay open to possibilities while keeping your perspective grounded. Often unexpected new opportunities will present themselves while you are putting in the work.

Seek input from those you trust, but recognize that you’re the one who knows yourself best. Give yourself the space to grow into what’s next.

Final Thoughts

Redefining your path as a physician takes courage, clarity, and commitment. You’ve honed these skills over the past decades of training and professional practice. Now, it’s about using them to design the life that you want to live. Whether you're stepping into a new career, transitioning into a different role within your current system, or simply giving yourself permission to explore, start by addressing the internal roadblocks that stand in your way.

Be willing to ask bold questions and take thoughtful action. Most of all, trust in your ability to create a more fulfilling and sustainable future.

---

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

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

Your Physician Job Offer Survival Guide: 40+ Questions to Secure the Right Deal

Whether you’re fresh out of training, looking for a new start, or or advancing into the next chapter of your career, it’s essential to know what you’re signing up for before committing to a new job.

Back in the early 1990’s, the managing partner of my first practice seemed taken aback when I asked to review the contract before signing. He muttered something about the good old days, when business was done with a handshake. I doubt that was ever a good idea. But even when you have a contract in hand, it’s important to have a clear understanding of the implications of your decision. After all, it’s likely that you’re not just taking a job— you’re planning to build a life there.

To help you get started, I’ve compiled a comprehensive list of questions that you should consider before accepting a new position. These cover everything from compensation and call schedules to long-term growth opportunities and organizational culture. There is no one-size-fits-all solution. It’s important to understand that every contract and compensation structure is unique. Take some time to clarify what your own needs are, what you’re willing to bend on, and what is non-negotiable.

Even if everything sounds perfect, it’s a good idea to get multiple perspectives from current and past physician group members whenever possible. By asking the right questions, you can make an informed decision that supports both your career and your well-being. Before signing on the dotted line, always consult with a qualified healthcare contract attorney or advisor to review your offer and ensure your interests are protected.

1. Role and Responsibilities: Know What You're Signing Up For

• What are the specific expectations for this role?

• What is the call schedule like? How often will I be on call?

• What’s the breakdown of clinical vs. non-clinical duties?

• What does a typical day or week look like?

• How is research time and support structured?

• Are there opportunities to shape or evolve the role over time?

2. Compensation and Benefits: Understand the Full Package

• What is the compensation structure (salary, RVUs, bonuses)?

• Is the salary guaranteed or productivity-based? Are there annual increases?

• Are there sign-on bonuses, relocation assistance, or student loan repayment options?

• What are the retirement plan options (e.g., 401(k), 403(b), employer match)?

• Is malpractice insurance provided? What type (claims-made or occurrence)? Is a tail provided if I leave or retire?

• What health, dental, vision, life, or disability benefits are included?

• How is paid time off (PTO) structured? Is it separate from sick leave?

• Is there a maternity/paternity leave policy?

• What are the CME benefits (time off and stipend)?

• Are there additional income opportunities (moonlighting, teaching, consulting)?

• What expenses are reimbursed (licensing, board fees, memberships)?

3. Career Development: Beyond the First Year

• Are there opportunities for leadership roles or academic involvement?

• What is the pathway for promotion or advancement?

• Are mentorship or onboarding programs available for new physicians?

• Does the organization support continuing education or conference attendance?

4. Practice Environment: Assess the Day-to-Day Reality

• What is the patient population like? What are the common conditions treated?

• How are new patients assigned? Can I build my own panel?

• How many patients am I expected to see per day or week?

• What is the support team structure (RNs, PAs, MAs, scribes)?

• What EMR system is used? Are physicians involved in EMR decision-making?

• What quality metrics are tracked? How are they measured and used?

5. Organizational Culture: Find Out What It’s Like to Work There

• How would you describe the culture of the organization or department?

• How is physician well-being supported?

• What is the leadership style? How accessible are department and executive leaders?

• How are conflicts or concerns typically handled?

• How many physicians have left in the past 5 years? Is it possible to contact them?

6. Long-Term Prospects: Look Ahead

• Is there a path to partnership, ownership, or becoming a shareholder?

• If I can’t become a partner, will I still have the opportunity to serve on committees or vote on important changes?

• What are the organization's strategic goals or planned changes over the next 3–5 years?

• Is there flexibility for role changes down the road (e.g., reduced hours, academic time, admin focus)?

7. Community and Logistics: Make Sure It Fits Your Life

• What is the surrounding community like in terms of cost of living, schools, and lifestyle?

• What support is offered for relocating (e.g., temporary housing, realtor support, moving expenses)?

• Are there opportunities for physicians to connect socially or professionally outside of work?

• If you have a spouse or significant other, will the community suit their needs and interests?

• If your spouse or partner needs to find a job, will the organization provide assistance with this?

8. Exit Clauses and Contract Flexibility: Read the Fine Print

• Does the contract include a non-compete clause? What are its terms?

• What happens to bonuses or relocation benefits if I leave early?

• Is there flexibility to renegotiate compensation or scope after the first year?

• Are there limitations on outside paid non-clinical work like medical writing, speaking, legal consultations, or industry collaboration?

• What is the termination process—by either party?

Final Thoughts

Job offers are about more than just numbers. They're about your well-being, your career trajectory, and the life you want to build outside the hospital, clinic, or lab. Leaving a job that’s a poor fit is incredibly stressful, not to mention a financial hit, so take the time and effort to ensure the opportunity aligns with your values and goals.

If you're navigating a career decision and want support thinking through the details, coaching can help. I work with physicians at all stages of their careers to clarify what matters most and move forward with purpose.

---

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 Kristen Jacobsen of RevSpring

The patient's experience after a healthcare encounter is often overlooked, but it can be nearly as emotionally impactful as the office visit, procedure, or hospitalization itself. Physicians often have little influence on the ways that revenue is collected, but from a patient’s perspective, it is part of the same process as the care we provide.

As a podcast host for the TechLink Health podcast I thoroughly enjoyed my conversation with Kristen Jacobsen of RevSpring. Kristen explained how AI and technology integration can enhance the experience, making it clearer and more efficient. She also shared the ways her company compassionately and respectfully engages with patients throughout their treatment path.

You can find our conversation anywhere you listen to podcasts, or through the Spotify link below.

My Podcast Interview with Kristen Jacobsen of RevSpring

“Doctor, You Just Don’t Have Time for Me Anymore”

An earlier version of this article appeared on Doximity.com in 2023 where I was an Op-Med Fellow (2022-2023).

“Doctor, I feel like you just don’t have time for me anymore.”

My 92-year-old patient Mr. Gray peered at me through his thick glasses, his bushy eyebrows knitted together. I felt my breath catch in my chest.

Mr. Gray was right. As the constraints of medical practice had tightened over recent years, time had become a limited commodity — and something I had lost control over. I did my best to make the brief encounters that now passed for office visits feel like something more, but a threshold had clearly been crossed.

It had not always been this way. Over the 20 years that I had cared for Mr. Gray, my medical practice had changed almost unimaginably.

We had gone through three iterations of the EHR, each more onerous than the last. Like many other groups faced with the economics of 21st century health care, my large cardiology practice had been acquired by a health care system several years prior. Over that time, we had gradually ceded control.

Several more patient slots had been added to the morning and afternoon schedules, meaning less flexibility for those who needed a little more time. And our scheduling department was in the process of being moved out of our office and into the larger system for the sake of efficiency.

Following our very first encounter when he was hospitalized with a cardiac illness, Mr. Gray had become a regular in my clinic. I was always happy to see him on my schedule. He might have been a little cantankerous, but he was never afraid to speak his mind. And I felt that we had achieved a great partnership.

Despite his age and long list of health issues, his mind was bright. He always asked great questions, and he loved to challenge me, but he was usually willing to accept my recommendations after we had talked things through.

Reeling from the sting of his accusation, I promised Mr. Gray that I would make the time for him. I assured him that he was important to me, and I apologized deeply.

Although I had not created this situation, I was determined to make sure that I repaired it to the best of my ability.

Mr. Gray was not the only one who had noticed this constriction of time, and ultimately he wasn’t the only patient for whom I surreptitiously bent the rules.

But his age and his medical complexity made the idea of what essentially boiled down to far less than 10 minutes face-time patently absurd.

Mr. Gray had the audacity to remind me of my Hippocratic oath. Faced with his rebuke, I felt compelled to go beyond helpless banalities about “the system” and “the computer.”

The current health care system often rewards those who see more patients, spend less time, and generate higher RVUs. A 92-year-old man’s request for physician time might seem inefficient and irrelevant by those standards.

Yet Mr. Gray reminded me of the importance of living up to the principles that had inspired me as a younger and more idealistic physician.

I contacted our scheduling department and cajoled them into placing an alert on Mr. Gray’s chart, noting that two patient slots would be required for his visits. This was not standard procedure, and I knew that it might be considered an inappropriate use of limited office time by the number crunchers in management. On the other hand, as a senior cardiologist, I had worked with the in-house office staff for many years, and my unusual request was granted without question. Mr. Gray understood that I was going to bat for him, and it was clear to me that he appreciated the effort.

From that point on, every visit with him was a reminder of why I became a physician in the first place. Mr. Gray and I were able to discuss his complex health concerns in detail, review the options, and ensure his understanding.

Over this time, I got to know Mr. Gray on a more personal level. An artist since his late 70s, he often brought in paintings that he had made, setting up the examining room as a small gallery. His art would be propped up on the examining table and the desk would be carefully arranged when I walked in. Birds, animals, buildings, historical events — all were subjects that caught his fancy. But he wasn’t only a painter.

Mr. Gray delighted in showing me photos of his raised-bed garden on his smartphone. And over time I learned more about his years in the military and later life as a farmer on the Great Plains. I believe that the trust our relationship created contributed to his longevity.

When Mr. Gray was 95, I decided to retire from my cardiology practice and return to school to study for a fine arts degree in hopes of eventually teaching in the medical humanities. I dreaded having to tell him goodbye.

I checked and rechecked his upcoming appointment, booked for my last month of practice. A few weeks ahead, I saw that a scheduler had moved the appointment to the schedule of one of our practice’s PAs. Although technically this was in line with the practice’s standards, and the PA was very kind and competent, it was not what I had promised Mr. Gray.

By that time, the scheduling department had been centralized and merged with a larger call center serving many different practices. Despite my calls and messages to the scheduling center, the appointment was never moved back to my schedule. Apparently the 30 minutes Mr. Gray required was no longer recognized as a physician appointment by the system.

Nevertheless, I managed to get hold of Mr. Gray that evening by phone. I will always be grateful for that. During our call, I let him know that I would leave him in good hands with one of the other physicians in the practice, and I thanked him for inspiring me.

About six months later, I learned that Mr. Gray had passed away. I was notified when his daughter, whom I had never met, brought one of his paintings to the office as a gift for me.

There may be those who believe this type of care is anachronistic or idealistic. It certainly didn’t optimize revenue, if we look at these longer visits purely from the standpoint of office throughput and RVUs.

But I believe that Mr. Gray’s story is a cautionary tale for these times of metrics and corporate management. When efficiency and productivity take precedence over years of connection and trust-building, we may lose something beautiful and ineffably human. And in the end, the care we provide may itself suffer.

While it may be optimal, offering two blocks of time for complex patients is not always supported by the constraints of the system. Most doctors no longer own their practices, and, as in my experience as an employed physician, they may have little say in the way their schedules are configured.

Fueled by lower reimbursements and a drive for greater profitability, many health care systems demand greater productivity with fewer resources. Meanwhile, the EHR requirements become ever more onerous.

We can’t depend on the systems that control healthcare to make the changes that we seek. It’s up to physicians to collectively lead the way toward making the patient the priority again. No one else shares our unique vantage point, nor our personal investment in the care of our patients. The time we spend with our patients is more than simply interaction and social connection, valuable as that may be.

The doctor-patient relationship is by its nature collaborative. There are tangible benefits to establishing trust. We may unwittingly break those bonds when we are perceived as rushed or pressured.

Patients may not understand the forces that have created these conditions. Instead, they may understandably interpret these experiences as impersonal and incomplete, a failure of the physician to care.

Time is a crucial element that links the science of medicine to the art of practice. As physicians, our strength lies not only in clinical expertise, but in our ability to build meaningful, purposeful connections—channels through which trust, understanding, and optimal care can flow. Without trust, even the most skilled care may be diminished. For patients with complex, overlapping conditions, or those who hesitate to ask questions for fear they'll be dismissed or misunderstood, this connection is a lifeline.

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

And if you’d like to schedule a complimentary coaching discovery session, click the button below.

My Podcast Interview with Rick Sherak of Exogenics

I recently had the pleasure of speaking with Rick Sherak, co-founder of Exokinetics, Inc., for the TechLink Health podcast. It was one of the most thought-provoking conversations I’ve had in a while. In this wide-ranging chat, we explored the story behind the Zeen—a groundbreaking upright mobility device that’s reshaping what’s possible for individuals with limited mobility.

The Zeen isn’t just a mobility aid; it’s a beautifully engineered fusion of form and function that allows users to glide, stand, and sit with dignity and ease. It’s unlike anything I’ve encountered—and the inspiration behind its creation is just as compelling as the device itself.

Unlike a wheelchair, the Zeen allows eye-level interactions. As a cardiologist, I’ve seen the harms that isolation can cause. The internet is great, but one of the many lessons we learned from Covid-19 is that the value of in-person human contact cannot be overestimated.

While the Zeen may not be the right fit for everyone, for many who are homebound or reliant on others to get around, it offers the potential for meaningful mobility and a degree of independence that may otherwise be out of reach.

Rick’s passion for innovation and helping others is truly contagious. Tune in to this episode anywhere you listen to podcasts, or through the Spotify link below.

My Podcast Interview with Rick Sherak of Exogenics

Using Tension as a Tool: Turning Discomfort into Strength

What do you feel when you think of the word tension? Maybe it’s a furrowed brow, a tightening in the shoulders, or a clenching of the jaw? Why wouldn’t you want to avoid such an uncomfortable feeling?

The Miriam Webster Dictionary defines tension as “inner striving, unrest, or imbalance, often with physiologic indication of emotion”, but also as “a balance maintained in an artistic work between opposing forces or elements.”

It’s normal to try to smooth over any sense of discomfort as soon as it arises. But what if you reframed tension as a tool—something to be explored and used to your advantage? Something that might even help you to create balance in your life and greater satisfaction in your medical practice. In this article, we’ll explore the ways that you can make tension work for you.

Tension as a Stimulus

Tension is a natural part of growth. In the body, muscles strengthen when they are challenged with resistance.

In the mind, as with problem solving, scientific research or even art, breakthroughs happen when we hold space for competing ideas and perspectives. And in personal and professional development, tension often signals the moments where change is possible.

Tension as a Signal

As a physician, you may experience tension as a pull between the demands of patient care and personal well-being, or between your role as a trusted healer and the bureaucratic realities of modern healthcare. Instead of always seeing this as a burden, what if you used it as a signal to reassess, reprioritize, and innovate? 

As a coach, I work with physicians who may yearn for immediate relief from career dissatisfaction, burnout, or decision fatigue. But sustainable change doesn’t usually come from escaping tension—it comes from staying with it long enough to understand what it’s trying to reveal.

The tension between wanting stability and craving change, between honoring commitments and protecting personal boundaries, can become the catalyst for transformation when approached with curiosity instead of resistance.

Tension as a Creative Tool

Tension in a work of art—whether through contrast, unexpected juxtapositions, or asymmetry—creates interest. A perfectly balanced, symmetrical photograph might be beautiful, but it can also be forgettable, lost in a sea of similar work. It’s the unexpected tension in a frame that pulls the viewer in, making them linger and engage. 

The same is true in problem-solving. Whether you are navigating career decisions, leadership dynamics, or personal dilemmas, the most creative and impactful solutions often emerge from the friction between opposing forces. This idea can also be applied to patient care, for instance when trying to devise a complex treatment plan for a patient with competing health and personal issues.

When you try to escape tension, it can be tempting to settle for the easiest answer instead of the best one. Instead, if you stay with the discomfort a little longer, you may allow space for deeper insight and more creative approaches.

Using Tension Intentionally

Just as yoga can teach you to breathe through physical tension rather than fight it, we can apply the same principle to mental and professional challenges. By leaning into discomfort with awareness, you allow yourself room to experience growth.

Pause Instead of Reacting

When you feel tension -- whether in a difficult conversation, a contentious committee meeting, or an internal conflict—take a moment to pause. Instead of immediately resolving the discomfort by taking the path of least resistance, ask yourself “What is this tension telling me?”

Reframe Tension as Information

Instead of trying to scape it, view tension as a source of data. If a decision is difficult, what values or priorities are in conflict? If a conversation is uncomfortable, what truths might need to be acknowledged? 

Use Tension to Expand Possibilities

In my coaching practice, I often ask my clients “What if you didn’t have to choose one or the other? What if both things could be true?” Tension can lead to a binary mindset, an either/or perspective, but staying with it can reveal more nuanced, integrated, and interesting solutions. 

Apply Tension to Leadership and Communication

Great leaders use tension productively. Instead of avoiding difficult conversations or suppressing dissent, they recognize that discomfort can lead to clarity, deeper alignment, and stronger teams. Productive tension—when handled with respect—can push individuals and teams toward innovation and better decision-making that makes room for everyone’s perspective.

Let Tension Strengthen Your Work

Whether you’re navigating a career transition, leading a team, or developing a new project, tension signals that something important is at stake. Instead of smoothing things over too soon, ask yourself: How can I use this tension to create something better?

Leaning into Tension

When used mindfully, tension can deepen your thinking, sharpen your skills, and lead to better outcomes in virtually any aspect of your life. 

Instead of asking, How do I get rid of this tension? try asking yourself, What can this tension teach me? That shift in perspective might be the key to unlocking your next breakthrough.

---

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

And if you’d like to schedule a complimentary coaching discovery meeting, click the button below.

Creating Boundaries and Reclaiming Values: My Podcast Appearance on Dr. Bill Lombardi’s Journey to Better

I recently had the great privilege to be invited back to trail-blazing cardiologist Dr. Bill Lombardi's Journey to Better podcast. This is truly one of the best physician-focused podcasts out there.

Bill is a fantastic and thought-provoking interviewer! We discussed a wide range of issues facing physicians today, including

⚕️The importance of setting boundaries

⚕️How to integrate the experience of the arts into medical practice

⚕️The crucial role of effective and engaged leadership

⚕️Why defining your personal values can help you to make better decisions for yourself and your practice

⚕️How coaching can work for physicians dealing with challenges of transitions, time management, and leadership opportunities.

You can find our conversation wherever you get your podcasts, including Spotify and Apple Podcasts, or take a listen below. And if you want to listen to my first podcast appearance on the show, you can find it here.

My second podcast appearance on The Journey to Better with Dr. Bill Lombardi

Physician Stress and Burnout: How Mindful Coaching Can Help

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

Although physician burnout has probably existed for decades, it’s only recently that it has taken on the notoriety of an epidemic. A visit to PubMed.gov tells the story. In 2024 alone, 872 academic papers were published on physician burnout. Compare that to just 129 in 2011—or 4, the year I entered medical school in 1984.

Many factors have contributed to the rise in burnout, both inside and outside the institution of healthcare. Some are relatively new, such as the rapid rise of disinformation and disrespect, while others, including diminishing reimbursement for services and corporate takeover of practices, have been slowly gathering momentum. For years no one talked about it. Today burnout is out in the open, yet a clear path to meaningful prevention remains elusive.

What Burnout Really Means

The term “burnout” itself may sound a little nebulous, but there are methods to measure and define it.

The Maslach Burnout Inventory defines burnout as “a psychological syndrome” that occurs among people who work with others—particularly in high-demand environments such as healthcare.

The key symptoms?

🩻 Emotional exhaustion – feeling like you’ve got nothing left to give

🩻 Depersonalization – distancing yourself from patients, often with growing cynicism

🩻 Reduced personal accomplishment – feeling ineffective, even hopeless

Although it can give you the blues, burnout isn’t a psychiatric disorder. It’s a normal human response to an abnormal, high-stress environment.

We all have tough days, so how can you recognize burnout? One important clue is that when these symptoms become persistent and all-consuming, burnout is likely at play.

The Data Behind the Epidemic

A 2023 Mayo Clinic survey of over 7000 US physicians found that more than 45% reported symptoms of burnout. That’s down from the pandemic high of nearly 63% in 2021—but still higher than pre-pandemic levels.

Burnout rates were highest in:

🤕 Emergency Medicine

🤕 Internal Medicine

🤕 Neurology

Other studies have shown elevated burnout in

🤕Critical Care

🤕Ob-Gyn

🤕Infectious Disease

🤕Family Medicine

It was notable that in the Mayo study, subspecialty surgeons reported lower-than-average rates.

Risk factors: Not Just About Workload

The biggest contributors to burnout will sound familiar to anyone in healthcare.

⭕ Bureaucratic tasks

⭕ Lack of respect

⭕ Long hours

⭕ Lack of autonomy

These align closely with the six factors associated with workplace stress identified by the British workplace health and safety regulatory agency:

⭕High work demands

⭕Low control over workload and process

⭕Inadequate support from management and colleagues

⭕Poor workplace relationships

⭕Lack of clarity regarding professional role and responsibilities

⭕Poor management of change within the organization

Personal factors matter too. The Mayo Clinic study found that women physicians are about 30% more likely to report burnout. And those with strong support at home—often reflected in marriage status—tend to report lower burnout rates.

Why This Matters: Beyond the Statistics

Burnout doesn’t just make you miserable. It affects your confidence, your relationships, your clinical decision-making, and your ability to experience meaning at work.

And while it feels like everyone is talking about burnout, it often seems like nothing is being done about it.

Which brings us to the next question: What can we do?

Beyond Bubble Baths—Real Tools to Tackle Physician Burnout

We’re not going to yoga or om our way out of this mess. It’s a far more tangled web than that.

And let’s be clear: the responsibility to fix burnout should not rest on the shoulders of burned-out physicians. We wouldn’t expect that of our patients. The source of suffering needs to be addressed before meaningful change can happen.

To ensure sustainable and high quality care for patients, including an engaged and committed medical staff, healthcare systems must lead the charge in addressing root causes. But while we wait for structural change, there are tools that can make a meaningful difference. Among the most promising? Mindfulness and coaching.

Mindfulness: More Than a Buzzword

Mindfulness is often dismissed as fluff—but it’s more than the popular notions of deep breaths and apps.

As a certified mindfulness meditation teacher, I define mindfulness the way my mentor Sean Fargo does:

“Paying attention to the present moment with curiosity and non-judgment.”

It’s not about escaping stress, but building awareness of how we relate to it. In other words, it’s about simply being present.

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

In a 2020 meta-analysis of randomized controlled trials involving medical students, mindfulness programs led to significantly lower stress scores—even months later. Techniques included:

🌻Body scans

🌻Awareness of thoughts and emotions

🌻Breathing exercises

🌻Walking and sitting meditation

🌻Group sessions and mobile apps

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

Mindfulness isn’t magic. You won’t suddenly be living in a blissed-out state of ease. But mindfulness can create a powerful shift in your patterns of thought and open possibilities for new and supportive ways to navigate stressful environments.

Coaching: A Practical, Personalized Intervention

Coaching offers another evidence-based path forward—one that’s personalized, practical, and action-oriented.

In a 2019 randomized trial from the Mayo Clinic, physicians who received six coaching sessions by phone experienced:

📞17% drop in burnout (vs. an increase in controls)

📞20% drop in emotional exhaustion

📞Improvements in job satisfaction, engagement, and meaning at work

Other studies, including one from Duke University, have shown benefits for physicians at all stages—from residents to senior leaders.

Coaching gives you a supportive structure to clarify your values, reset your goals, and regain agency. Sometimes, that means discovering a way to achieve a better balance in your current role. Other times, it means exploring new positions. For some, it means leaving clinical practice altogether.

Mindful Coaching: Where Awareness Meets Action

When mindfulness and coaching intersect, physicians get the best of both worlds:

❇️ Awareness of what's depleting your energy

❇️ Clarity around what matters most

❇️ Practical tools for taking aligned, meaningful action

This is not about telling physicians to fix themselves. It’s about providing a safe space to reflect, reset, and reconnect with purpose..

A Call for Change

Although mindful coaching can help you rediscover your own strengths, burnout is not a failure of individual resilience. It is a consequence of a system that demands too much and gives too little. But within that system, you can still reclaim clarity, agency, and connection through personalized support that connects with your own value system and aspirations.

Systemic change is essential, but it begins with the individual. When you advocate for your own well-being, you’re also shaping a more humane and sustainable future for healthcare.

---

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

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

References

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

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

“Death by 1000 Cuts”: Medscape National Physician Burnout & Suicide Report 2021. (n.d.). Medscape. https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456#3

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

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

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

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

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

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

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

Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Wang, H., Carlasare, L. E., & Dyrbye, L. N. (n.d.). Changes in burnout and satisfaction with Work–Life integration in physicians and the general US working population between 2011 and 2023. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2024.11.031

Pursuing Your Passions in Retirement: My Second Podcast Appearance on Michael T. Swartz’s “Health and Wealthness”

It was a pleasure to be invited back for a second conversation on Michael T. Swartz, CFP®, PDC's Health and Wealthness podcast.

Michael has created a fantastic series for physicians called The Physician’s Guide to Retirement. Retirement is different for all of us. I retired after nearly 30 years in practice in order to pursue other passions and interests. Others may practice decades longer, and some may make the choice to retire earlier. No matter how retirement looks for you, you’re likely to find this series valuable and inspiring.

As an invited guest, I shared my ideas and strategies for physicians who are seeking more joy and fulfillment in the years after a life spent in medical or surgical practice. If you think of retirement as a kaleidoscope, this is how you can combine all of your passions into a new and evolving way of life. You can grow into the things that are most meaningful to you, contribute to causes that matter, and live a life that aligns with your own values, on your own terms.

Michael is not only a Certified Financial Planner, but he is also a Certified Physician Development Coach, so he understands the particular needs of physicians who are looking towards retirement. As we discussed in our conversation, it’s never too soon to start thinking about your future. Setting aside even a little money regularly beginning in your 30s will provide you with so many more opportunities as you begin to contemplate retirement in your 50s or 60s.

My second podcast appearance on Health and Wealthness

Rediscovering Your Why: A Road Map for Physicians

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

If you ever find yourself questioning whether you’ve chosen the right job, the right specialty, or even the right profession, it may help to know that you’re in good company.

Most physicians go through cycles of doubt, revisiting old decisions when things aren’t going well. Times of stress, exhaustion, or disconnection often trigger these seasons of questioning. This type of critical reflection isn’t a sign of failure. Instead, it’s an opportunity for growth and realignment. And with time and support, it often opens a door to greater clarity and purpose.

Of course, dissatisfaction today doesn’t always mean that you need to make a drastic change tomorrow. Perhaps it’s a signal that it’s time to take a break. It may even be a reminder to keep pushing through. Avoiding unease is not always the best choice. Discomfort can be a sign of growth, and sometimes short-term pain and sacrifices are necessary to get you where you want to go.

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

Why Your Why Matters

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

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

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

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

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

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

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

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

As Sinek puts it

⭐ Your why is your driving force

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

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

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

Coming Home to Your Why

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

Finding your why involves introspection and reflection. It means clarifying your own unique values, passions, and the impact you want to make on the world. It’s about you, and not somebody else’s version of you. It means going beyond your surface-level goals and digging deeper into the fundamental reasons that drive your choices and actions today.

If those goals and values are different than they were when you started the journey, that’s normal and healthy. Keep excavating until you discover your own truth.

Unearthing Your Why, One Page at a Time

To help you find your why, get a piece of paper or a journal and start writing. You could do this on your computer or your tablet, but writing by hand tends to engage the brain more fully than typing on a keyboard. If paper isn’t your thing, a writable tablet like the Remarkable is a great alternative. Most importantly, choose a method and a time that works for you.

Over the next few weeks, consider taking a few minutes every morning or evening to discover the patterns and thoughts that arise. Here are some questions to get you started. You don’t need to take on all of them. Just pick and choose what is calling to you.

🔍 What do I find fulfilling about my current job?

🔍 What do I not like about my current job?

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

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

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

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

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

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

🔍 What do people thank me for?

🔍 What do I enjoy teaching?

🔍 What do I enjoy learning?

🔍 What keeps me up at night?

🔍 What moves me to take action?

🔍 What is my ideal day?

After sitting with your reflections for a few weeks, try distilling what you’ve discovered into a single, powerful sentence—a personal mission statement that captures the heart of your why. You might start by asking: What do I want to contribute? What kind of impact do I hope to have?

There’s no need for it to be perfect—or permanent. This isn’t about meeting anyone else’s expectations. It’s about articulating something that feels true to you. Your statement may evolve as you allow it room to breathe, but by simply starting, you’ll begin to align your goals with a deeper sense of purpose.

When you know your why, it can shift everything, bringing your actions into alignment with your values and your deeper self. In this way, your own North Star begins to emerge: steady, clear, and sustaining.

---

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

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.

Compassion Without Burnout: How Physicians Can Balance Empathy and Sustainable Practice

Balancing deep compassion with professional distance in the face of suffering and death can be challenging for newer physicians. Learning to care deeply while maintaining emotional boundaries is a skill that takes time to develop. This is the practice of equanimity. For many seasoned physicians, sustaining this balance is a lifelong point of tension.  

Whether you work in a high-intensity surgical or critical care specialty or an outpatient practice in which you nurture long-term relationships with your patients, you are likely to face this challenge many times through your professional life.

Detachment as a Survival Mechanism

Intense suffering, tragedy, and death are circumstances that most people only experience a handful of times in their lives. For many physicians, this is the reality of a normal day at work.

When your job is to make strategic decisions and take decisive action, creating separation from another’s anguish is not a flaw; it is a necessary adaptation. It allows you to effectively care for your patients, alleviating the source of their distress without taking on the burden of every painful story. And it protects your patients, because it means that your decisions come from a place of wisdom and expertise.

At the same time, maintaining an emotional distance can often come across as distant and unfeeling. When it becomes habitual, you may even begin to believe that you’ve lost your ability to experience compassion. It’s a fine line to walk, and it’s something that is rarely taught.

If taken too far, suppressing your inherent pull of empathy can erode patient trust and increase your risk of professional burnout. It may also spill over into your personal life, impacting your ability to connect with those you love and risking your present and future well-being.

One Doctor’s Struggle: When Emotional Armor Becomes a Burden

A highly skilled interventional cardiologist I know recently reflected on the ways that his years of exposure to suffering created a powerful emotional detachment that threatened his health and his marriage.

Early in his career, the heavy weight of each patient’s experience felt overwhelming, as if every tragedy could pull him underwater. He often cared for people who sought him out knowing that their advanced heart disease left them with few remaining options. Many times, the procedures he could offer carried great risk. And while most patients benefited, some did not. There was a high risk of complications, and he knew that a few would die despite his best efforts.

Attempting to protect himself, he grew a thick, protective, rational shell which numbed him emotionally and created an aura of impassiveness that was often perceived as indifference and even coldness. Over time, this self-protection extended into his personal life, putting his marriage and family at risk.

His case-hardened persona was at odds with his personal values and created a feeling of disunity and distress. He was often tempted to numb himself to exhaustion with extreme exercise before going home, even when it was very late in the evening. He eventually realized that change was necessary—not only to sustain his career in interventional cardiology but also to repair and preserve his relationships with his wife and family.

When it became clear that he was about to lose the people who mattered most to him, he reached out for help. Over time, through a practice of mindfulness and self-care, he became able to extend compassion to his patients without becoming emotionally engulfed in each case. As a result, he could nurture his personal relationships without fear that this vulnerability would bleed into his professional role.

Finding a Sustainable Path Forward

How can you begin to find the balance between maintaining compassion and protecting yourself? It can be helpful to remember that detachment doesn’t mean not caring—it means setting boundaries to ensure longevity in a profession that demands so much of you.

Your emotional capacity is rarely infinite. It may help to think of it as an energy bank account that requires careful management. When you worry endlessly about outcomes beyond your control, you’re spending your energy recklessly, draining your account without benefiting yourself or your patients.

Just like a bank account, emotional capacity is not only about withdrawals, but also about strategic savings and interest. This comes through self-care. This might mean practicing mindfulness, connecting with colleagues who understand the emotional toll and have found healthy ways to manage the distress, or engaging in fulfilling activities outside of medicine.

Studies of surgeons engaging in a surgeon-focused mindfulness-based stress reduction program known as Enhanced Resilience Stress Training have shown important benefits. Similar programs are likely to help others who deal with high-stakes situations on a daily basis.

Coaching can also be a meaningful tool, providing a supportive space to reflect, gain clarity, and develop your own path forward.  If the weight of it all feels too heavy, working with a therapist who understands the unique challenges physicians face can provide valuable support.

Compassionate Boundaries

If you’ve ever felt guilty for not feeling deeply every time you witness a patient suffering, you are not alone. This is not a failure of empathy; it is a recalibration that allows you to keep showing up, day after day, for the people who need you. Compassion and detachment are not mutually exclusive, and compassion is not measured by how much suffering you absorb,

By setting boundaries, recognizing your own limits of emotional energy, and applying mindful detachment with care, you will find your way to practice compassionately while protecting your own well-being. You’ll create a meaningful separation between work and home. And you’ll be present and effective for your patients in their time of need.

---

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

And if you’d like to schedule a complimentary coaching discovery meeting, click the button below.

The Power of the Pause: Creating Engagement and Presence

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

If you’re a surgeon or proceduralist, you already know the power of a timeout. That intentional pause before a procedure—where the entire team stops to confirm the plan, clarify roles, and ensure nothing has been missed—is more than a safety checklist. It’s a brief, structured moment of presence.

What if you took the concept of taking a pause out of the OR or the lab and into the other demanding parts of your day? Taking a moment to come up for air between office visits, meetings, or complex patient care could help to clear your mind and reset your focus. But my guess is that very few of us actually do this.

Backed by Data: The Power of a Brief Reset

Research from Microsoft's Human Factors Lab supports the idea that taking a personal pause can not only help you to reset but may even improve your engagement with your next patient or procedure.

Since this was Microsoft, the study looked at the way people engaged in meetings. The 14 subjects were tasked with wearing an EEG while participating in video meetings. Each meeting lasted 30 minutes. On one day, they took part in four back-to-back meetings, without a break. On the other, each meeting was followed by a 10-minute pause. Instead of simply checking their phones, the participants meditated with the Headspace app.

The results were striking: analysis of brain wave activity revealed that even a short meditation pause led to increased engagement in the meeting that followed.

Conversely, with no pause, there was EEG evidence of greater stress during the next meeting.

We often equate productivity with hours slogged and logged. But this study—and others like it—suggest that sustained engagement may be a more meaningful, and healthier, metric.

The business world may embrace concepts like mindful pauses, but applying them in healthcare can be more challenging. Between the unending inbox, your dwindling support staff, and the push to do just one more thing, the pace can feel relentless.

But that’s exactly why building in brief, intentional moments of stillness—even just a breath between tasks—can be so powerful. These moments give you a chance to regather and reharness your energy and your focus.

Practical Strategies for Pressing Pause

How can you begin to practice taking a pause? It’s not always practical to take a 10-minute break for meditation in the middle of a busy day. But even a few mindful moments can help. Here are a few practical tips that can help you to create a little breathing space for yourself and to be more present for your patients:

Breathe Mindfully

Take a few deep, intentional breaths before going in to see a difficult or complex patient. Focus on the sensation of the breath entering and leaving your body. This simple act can help anchor your awareness to the present moment.

Body Scan

Conduct a quick body scan to release tension. Start from the top of your head and gradually move down to your toes, paying attention to any areas of tightness or discomfort. Allow these areas to relax, even if it’s just a little.

Mindful Observation

Take a moment to observe your surroundings without judgment or reactivity. Notice the colors, textures, and sounds in your environment. This brief shift in attention can provide a mental break and promote a sense of calm.

Name What You’re Feeling

Before moving on to the next patient or task, pause to mentally name what you’re feeling. That could be anything. Perhaps it’s overwhelmed, focused, frustrated, or calm. It doesn’t really matter whether it’s positive, negative, or neutral. This brief check-in helps increase your emotional awareness and gives you a chance to reset before shifting gears.

Feel Your Feet

As you’re walking down the hall or in from the parking lot, take a moment to bring your awareness to the sensation of your feet on the ground. Feel the pressure and the contact as your shoes connect with the floor. This small act of grounding can quickly bring you back to the present.

Set an Intention

Before a meeting or procedure, pause for a few seconds and mentally set an intention. Perhaps it’s “Stay focused,” “Listen with awareness,” or “Lead with presence.” A clear intention can shape how you show up, even in high-pressure moments.

Hand Over Heart

If you’re feeling overwhelmed or scattered, place your hand over your heart and take a few deep breaths. This simple gesture engages your parasympathetic nervous system and can create a sense of grounding and self-compassion.

From Personal Practice to System Shift

Taking a mindful pause is not just a momentary escape from a hectic schedule. By taking a few moments of stillness to reset, you access a powerful way to recharge your energy, sharpen your focus, and deepen your connection with the people you care for. Over time, these brief pauses become an investment in your well-being and in the quality of your presence.

It’s time for healthcare organizations to embrace what companies like Microsoft have already realized: sustainable performance requires space to pause. These moments can’t just be the responsibility of the individual—they must be supported by the system. When organizations stop trying to fill every second and instead allow time for reflection and reset, they empower physicians to stay engaged, energized, and able to deliver their best care.

---

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

And if you’d like to schedule a complimentary coaching discovery session, click the button below.

Making Early Decisions for a Successful Retirement: My Podcast Appearance on Michael T. Swartz’s “Health and Wealthness”

I thoroughly enjoyed my conversation on Michael T. Swartz, CFP®, PDC's Health and Wealthness podcast.

Michael has created a fantastic series for physicians called The Physician’s Guide to Retirement. Retirement is different for all of us. I retired after nearly 30 years in practice in order to pursue other passions and interests. Others may practice decades longer, and some may make the choice to retire earlier. No matter how retirement looks for you, you’re likely to find this series valuable and inspiring.

As an invited guest, I shared my personal experience and my ideas around ways that physicians can create a sustaining and exciting life after retirement from medical practice. This is the first of two episodes. If you're curious about what life might look like on the other side, take a listen!

Michael is not only a Certified Financial Planner, but he is also a Certified Physician Development Coach, so he understands the particular needs of physicians who are looking towards retirement. As we discussed in our conversation, it’s never too soon to start thinking about your future. Setting aside even a little money regularly beginning in your 30s will provide you with so many more opportunities as you begin to contemplate retirement in your 50s or 60s.

My podcast appearance on Health and Wealthness

The Myth of Multitasking: Why It May Be Hurting Your Efficiency and Patient Care

Multitasking is often considered an essential skill for physicians and others in high-stakes professions. From my earliest days in medicine as an intern on the HIV wards in the late 1980s, those who could juggle the most tasks at any one time were considered the true heroes. And those who balked at the notion were considered dinosaurs or even slackers, out of touch with the reality of modern medicine.

Like many doctors, I embraced the challenge during the years and decades that followed. With ever-growing patient care demands, constant interruptions, and endless inbox messages, doing more things at the same time seemed like the only way to keep from stalling out. It was a point of pride, and it gave the illusion of intense focus and efficiency.

It’s now clear that the reality is starkly different: multitasking often leads to increased errors, inefficiency, and heightened stress.

A study of Australian emergency physicians found that ER doctors are interrupted nearly 10 times per hour. In this study, the more physicians were interrupted or attempted to multitask, the more medication errors they made. This effect was even more pronounced when the physicians were sleep-deprived. The researchers found that below-average sleep led to a disturbing 15-fold increase in clinical errors.

As you would expect, the ER is an ideal place to study the impact of multitasking, and other studies in theses settings have come to similar conclusions.

The same phenomenon plays out in the hospital. Picture this:

You’re on rounds in the CCU. A critically ill patient just had a rhythm change, your phone buzzes with a consult request, and you’re simultaneously reviewing morning labs, finalizing a discharge summary, and answering a staff question about another patient’s medication dose. You’re flipping between screens in the EHR—labs, imaging, notes, inbox, and back again—trying to keep up. Then suddenly, you realize… you almost signed off on the wrong discharge med for a different patient. Sound familiar?

In that moment, one thing—the critically ill patient—needs your full attention. The other tasks are important, but they are not urgent. Yet, the mental overload from constant task-switching makes errors more likely, slows you down, and increases stress.

Why We Think We’re Good at Multitasking

Physicians are trained to process multiple inputs under pressure—responding to pages while reviewing labs, answering questions during procedures, thinking three steps ahead during a patient encounter. It feels like multitasking, and you probably get praised for doing it well. But research shows that what we call “multitasking” is actually task-switching, and this constant shifting leads to cognitive overload and more mistakes.

The illusion of productivity masks the toll it takes on your attention and performance. Over time, this constant mental shifting can erode not just your focus, but also your well-being and sense of control.

Practical Strategies to Reduce Multitasking and Increase Focus

While we can acknowledge the harm it may cause, the truth is that multitasking is not going to completely disappear. In healthcare, where dealing with the unexpected is part of the job, it’s not realistic to think that you can avoid multitasking completely. But you can limit it, and you can plan ahead so that the impact is minimized and your focus is protected. Here are some ideas to get you started.

✅ Complete Before Moving On

Before EHRs, a common efficiency tip was: “Touch each piece of paper only once.” Although paper charts are long gone, the same principle applies in today’s digital world. It means that whenever possible, close out one task before moving to the next. Protecting your attention in this way reduces mistakes, improves your workflow, and most importantly, helps you stay fully present for your patients.

• Click it, complete it, close it. Whenever possible, finish one task before starting the next.

• Batch related tasks to stay in flow. Group similar activities—like reviewing imaging, responding to messages, or finishing notes—into dedicated blocks of time to minimize context switching and boost efficiency.

✅ Prioritize Tasks by Urgency and Importance
Emergencies deserve immediate focus. Everything else? It can often wait. Develop the habit of quickly categorizing tasks so you can allocate your mental bandwidth accordingly.

✅ Break Large Tasks into Smaller Steps
A massive to-do list creates overwhelm, increasing the temptation to multitask. Instead:

• Focus on one completable step at a time.

• Track your progress to build momentum and reduce unfinished-task anxiety.

✅ Delegate When Appropriate
Trying to do everything yourself leads to burnout and inefficiency. For example, one of my coaching clients, a highly skilled proceduralist, was constantly behind on his work—not because he lacked skill, but because he spent too much time checking his staff’s work instead of delegating. His inefficiency put his job at risk, and it frustrated his staff. Learning to delegate strategically got him back on track. When done right, delegation builds trust and camaraderie while freeing up your cognitive resources for what matters most.

• Delegate lower-stakes tasks that don’t require your expertise.

• Trust but verify—educate your team, give them a reasonable degree of autonomy to carry out their assigned tasks, but maintain a structured review process.

✅ Use Time Blocking to Protect Deep Work
Scheduling dedicated time for specific tasks—such as charting, reviewing imaging, or preparing for boards—helps maintain focus and reduces cognitive switching costs.

• Communicate your schedule with your team or family to minimize unnecessary interruptions.

• Create a “protected time” window for deep work whenever possible. Turn off notifications, put hard limits on your social media use, set boundaries, and commit fully to the task at hand.

Final Thoughts

Multitasking isn’t a badge of honor—it’s a hidden drain on your performance. In a busy medical practice or an intense hospital environment, it can’t always be avoided. But by prioritizing effectively, reducing task-switching, and implementing strategies like delegation and time blocking, you can work smarter, reduce your stress, and improve both efficiency and patient care.

---

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

And if you’d like to schedule a complimentary coaching discovery meeting, click the button below.

When Physicians are Disrespected: My Guest Appearance on the Podcast by KevinMD

If you’re a physician, or anyone active in healthcare today, you have probably heard of Dr. Kevin Pho and his KevinMD podcast and website.

Not only does he offer a curated selection of articles tailored to physicians and others in healthcare, Dr. Pho also hosts a podcast for thought leaders in the medical field. I was honored to be invited back as a guest.

In this episode, which originally aired in October 2023, we talk about the epidemic of disrespect faced by physicians today, and clear steps you can take to advocate for yourself and reclaim your dignity.

This is a topic I wrote about in Preventing Physician Burnout: Reclaiming Your Dignity. An earlier version of the article also appeared on the KevinMD website.

When physicians and others in healthcare are treated respectfully, the practice of medicine becomes more sustainable and more inclusive.

My podcast appearance discussing disrespect on the Podcast by Kevin MD.

Thriving Amidst Chaos: Prioritizing Health, Self-Care, and Mindfulness

An earlier version of this article appeared on this website in October 2023

When your days are busy and your evenings are full, making time for your own well-being can sometimes feel like just another thing to check off your endless to-do list. If you’re like many physicians, self-care often falls by the wayside.

The truth is that you need to recharge and refresh in order to be the best version of yourself. And, as important as it is to care for your own health and happiness, it’s not just about you. When you care for yourself, you’ll be better equipped to care for those who depend on you.

In this article, we’ll explore why self-care matters, including the impact of self-care on stress management. Next, I’ll give you some simple steps that will help you to put these ideas into motion. By caring for yourself, you’ll be empowered to thrive amidst the daily storm of medical practice.

The Impact of Stress on Burnout

It’s common to think of stress as harmful and something to be avoided. But stress can affect your health positively as well as negatively.

Positive stress (or eustress) happens when you face a challenge or a deadline that you know you are capable of meeting. It might be a stretch, but you know it’s possible. And importantly, there is a reward waiting on the other side.

While positive stress can propel you towards your goals, negative stress (sometimes called distress) can lead to frustration and burnout. Negative stressors are those forms of stress over which you have no control. A boss (or spouse) who is never happy, a job for which you are never rewarded or thanked, and escalating demands at work without adequate time off to rest and reset are all forms of negative stress.

Constant and unrelenting stress can lead to burnout. The World Health Organization defines burnout as an “occupational phenomenon.” Burnout is characterized by

• Exhaustion and loss of motivation

• Cynicism and negativity

• Inefficiency

Given the current state of healthcare, it’s no surprise that nearly half of physicians reported at least one manifestation of burnout in 2024.

It’s important to remember that burnout is not your fault. By definition, it is a symptom of a dysfunctional system or workplace. Perfectionists, people-pleasers, and so-called workaholics seem to be more susceptible. Not surprisingly, these personality types are common for physicians. But developing some tools to help you get through tough times can lessen the impact and improve your overall happiness and wellbeing.

Self Care and its Benefits

Self-care is not just about pampering yourself. It's about taking care of your mental, emotional, and physical well-being.

Committing to self-care can enhance your focus, improve relationships, lower stress, and mitigate burnout. Acknowledging the mind-body connection is often the first step towards effective self- care.

Nutritional Psychiatry and Stress Management

The new field of Nutritional Psychiatry focuses on the growing body of research that strongly connects what you eat to how you feel. Without a doubt, mental health is complex and multifaceted. Diet is only one part of the big picture.

But when you’re famished and pressed for time, the quickest options can undermine you, sabotaging your best intentions and sapping your energy.

As it turns out, those ultra-processed foods that often pass for nutrition in the doctor’s lounge or office snack machine can raise your risk of anxiety, sleep disturbance, depression, food addiction, alcohol use disorder, and increased inflammation. Artificial sweeteners in particular have been linked to a greater risk for depression.

Instead, consider switching in simple elements of the Mediterranean diet like fruits, nuts, whole grains, olive oil and fish. You probably know that the Mediterranean diet supports heart health and may reduce the risk for certain cancers. But this diet is also linked to improved symptoms of depression and better mental health and well-being. There’s also emerging evidence that a Mediterranean diet can improve perceptual performance.

It might take a little planning, but going Mediterranean doesn’t have to be complicated. Simply packing a nourishing lunch or advocating for healthier options at work can make a difference.

Exercise and Health

You already know that regular exercise will lower your risk for heart disease, cancer, bone disease, and dementia, among other dreaded conditions.

But research has also shown that exercise can reduce anxiety, improve sleep, and improve immune function. It doesn’t take a lot of exercise to reap the benefits. A brisk 15 minute walk a few days a week is a great way to get started.

Mindfulness and Self-Care

"Mindfulness is the awareness that arises when we nonjudgmentally pay attention in the present moment.” These are the words of Jon Kabat-Zinn, PhD., Professor of Medicine Emeritus at the University of Massachusetts Medical School, and the godfather of mindfulness in healthcare.

Put even more simply, mindfulness is undistracted attention.

Practicing mindfulness has a wealth of benefits, some of which you might not anticipate, including

• Healthier lifestyle choices

• Less stress and anxiety

• Greater parasympathetic tone

• Better cardiovascular health

• Improved immunity.

If it all sounds a little woo, know that mindfulness doesn’t have to be about practicing yoga or meditating. You don’t need a special cushion or a meditation app, although those can be nice. Instead, it’s about being undistracted, nonreactive, and fully present in the moment.

Getting started with mindfulness isn’t complicated. Simply set aside 3-10 minutes of quiet time each day to observe the present moment. Notice your thoughts and let them go, returning to the present when your mind wanders.

It is this practice of continually returning to the present moment that develops the “mindfulness muscle.”

When you practice mindfulness, you may find that your presence, and hence communication, with patients and colleagues becomes easier and more engaged.

Create an Action Plan

Creating an action plan will help you to set realistic goals and track your progress. Write out the steps that you need to take to commit to your self-care. And develop a plan that is realistic and actionable.

Consider enlisting a partner or friend with whom you can share accountability to help you to stay committed. Something as simple as a daily reminder on your phone may also keep you on track.

The ripple effect of taking your own self-care to heart will show up in your energy level, creativity, and relationships. You may notice a greater sense of self-compassion and equanimity. And in time, your path forward toward the goals that matter will become more clear.

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

And if you’d like to schedule a complimentary coaching discovery session, click the button below.

References

Adan, R. A. H. et al. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 29(12), 1321–1332.

American Medical Association & American Medical Association. (2024, July 2). Physician burnout rate drops below 50% for first time in 4 years. American Medical Association. https://www.ama-assn.org/practice-management/physician-health/physician-burnout-rate-drops-below-50-first-time-4-years

APA Dictionary of Psychology. (n.d.). https://dictionary.apa.org/eustress

Brulé, G., & Morgan, R. (2018). Editorial Working with stress: can we turn distress into eustress? ResearchGate. https://www.researchgate.net/publication/324531212_Editorial_Working_with_stress_can_we_turn_distress_into_eustress

Davidson, R. J. et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic medicine, 65(4), 564–570.

Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, et al. (2022). Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose–response meta-analysis of data from 1 853 610 adults. British Journal of Sports Medicine 56:1188-1193.

Gilbert, D., & Waltz, J. (2010). Mindfulness and health behaviors. Mindfulness, 1(4), 227–234

Lane, M. M. et al. (2022). Ultra-Processed Food Consumption and Mental Health: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients, 14(13), 2568.

Loucks, E. B.et al. (2015). Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Current cardiology reports, 17(12), 112.

Martinez-Gonzalez, M. et al. (2019). The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circulation Research 124:779-787

Munoz, M.A. et al. (2009). Adherence to the Mediterranean diet is associated with better mental and physical health. British Journal of Nutrition. 101 (1821-1827),

Samuthpongtorn C et al. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Netw Open. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770

Shanafelt, Tait D. et al. (2022). Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clinic Proceedings, Volume 97, Issue 12, 2248 - 2258

Stubbs, B. et al. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry research, 249, 102–108.

World Health Organization: WHO. “Burn-out an ‘Occupational Phenomenon’: International Classification of Diseases.” World Health Organization, 28 May 2019, www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.

Yin, W. et al. (2021). Mediterranean Diet and Depression: A Population-based Cohort Study. International Journal of Behavioral Nutrition and Physical Activity, 18(1). https://doi.org/10.1186/s12966-021-01227-3

Young, H. A. et al. (2022). Mediterranean diet, interoception and mental health: Is it time to look beyond the ‘Gut-brain axis’? Physiology & Behavior, Volume 257.