Be The Doctor Who Thinks Differently

I can summarize the most successful people I’ve ever known with one trait: the willingness to challenge mainstream ideas.

An Uncommon Guest Post by Leo Babauta

This has been the key to everything good in my life too:

I changed my health and drastically reduced my carbon footprint when I stopped eating like everyone else around me and became vegetarian (and eventually vegan).

I simplified my life when I stopped believing what the majority of people believe, that buying stuff makes you happier, more secure, look better in the eyes of others, etc.

I improved my health and reduced our carbon footprint when I went car-free.

I changed my career by blogging differently than others (on simplifying rather than doing more) when I started Zen Habits.

And there are many more examples, but you get the point. This isn’t a post to brag about all of that — it’s to share what I believe is a real key to life: the willingness to think differently than most people. It means you have to be willing to question what most people do and what the majority will tell you. It means you have to have the courage to try something different. It means you have to be brave enough to stand out from the crowd and not take the safe route.

The Safe Route

Most people take the safe route, because they’re afraid of being different and failing. If you do nothing amazing but you go with the crowd, then you don’t look stupid. But then you miss out on the amazing. If you never stand out from the crowd, you will always be average. True being an average physican is no small achievement but that's not the right way of looking at it. The question should be are you living your dreams are you passionate about your day to day activites? 

The people who stand out are the ones who make a mark, who innovate and discover, who learn the freedom of exploration and invention. If you stand out when you apply for residency or a job, you’ll be more likely to be noticed. If you don’t, and you play it safe, then they’ll likely ignore you. If you stand out when you start a business, people will be curious and check you out. If you’re just one of many businesses doing the same thing, why should others care about you? Why should they choose you?

And yet, most people play it safe:

Most people go to school and then college then because that’s what everyone else does. They don’t know what they really want to do, so why not take the traditional route? And that’s fine, but it’s good to look into other options. Most people get a job and stick to it because that’s the traditional way to make a living. Others might be a solo entrepreneur or start a small business and dare to create something new and live a life they’re passionate about.

Most people eat meat and dairy and eggs because that’s how they were brought up, and eating differently is weird and unthinkable. “I love my ribs too much!” But then you miss out on a whole world of healthy, delicious food, and the opportunity to change the planet and your own health. 

Most people drive a car, because that’s what everyone else does — and changing it is too difficult. And yet, cars pollute and cost a lot and make us less healthy and make the streets less safe for our communities and take up most of our public spaces.

These are just some examples in my life, however the need to play it safe turns up in every part of our lives.

Learning to Think Differently

When you hear an idea that’s different than what you’re used to, pause. Instead of rejecting it outright, consider it — is there some merit? What are the arguments, the evidence? Let go of the emotions that come up, the defensiveness. Many people, when presented with ideas conterary to their belief feel they must lash out and attack. And yet, if you set aside those emotions, and look at the arguments, you might learn to think differently — and that applies to all ideas. Looking at the world, and especially your career as a physican, through these lenses can radically change your outlook.

When you are told that this is the way to do things, take a second look. Is this really the best way? Are there other possibilities? If no one has thought of them, can you? Just because an idea is different, don’t just accept it. Look at the bulk of the evidence, and learn to spot flaws in reasoning.

Test out different ideas.

Just because most people don’t do it, doesn’t mean it’s wrong. They might all be wrong, and this might be better. No better way to find out than to test it. If it’s not a good idea, drop it and move on. Learn to be proud of your ability to test things that people traditionally believe in, and not to worry so much if you stand out. In fact, learn to see standing out as good — not just to stand out, but to forge new ground, to challenge ideas, to express your individual voice rather than blending in.

 ____________________________

Become a writer on Uncommon Student MD: Submit a Guest Post.

Uncommonly Savvy, International Medicine

"Travel is fatal to prejudice, bigotry, and narrow-mindedness...Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one's lifetime.”

-Mark Twain

An Uncommon Guest Post by Bjorn Karlman a Swede with an American accent, an Asian childhood, a British adolescence, French and American tertiary education and international work experience spread across three continents. He speaks four languages and blogs at CultureMutt.com.

The Pain

“I hate that my pay and my whole family’s standard of living is tied to my working crazy hours and then being on call. If I stop doing this day in and day out, we’re screwed.”

“How can I escape my self-made prison?”

“Why did I choose to become a physician?”

“I want out!”

We’ve all heard the above sentiments repeated ad nauseum by physicians. The news gets even worse for medical students. There has never been a bleaker time to graduate from med school. The economy is still in the tank. Reimbursement is dropping and is going to go down further with Obamacare. Physicians all over the country are shuttering in their private clinics and downsizing their homes.

“Hell no!”

I asked a physician friend from Hong Kong who practices in Northern California if he planned on encouraging his kids to become doctors. “Hell no!” he exclaimed without a moment’s hesitation. I work in health care philanthropy and am forever hearing the exasperation of the physicians around me and the gloominess they feel about the future of their profession.

Time to reframe

I really think it is time to look at this whole narrative differently. I am not going to promise hope and change because I am not running for office:) But I do think that it is time for some innovative, international, solution-focused tinkering. It was downright refreshing to poke around in the “About” section of Uncommon Student MD and see that this online medical community is “not interested in the useless hand-wringing that populates so much of medicine and that so many physicians have bought in to.”

Savvy, global do-gooding

I write the blog CultureMutt.com and am obsessed with what I call “savvy, global do-gooding”. I am absolutely convinced that a laser-sharp focus on understanding the culture of various people groups through international travel and service lies at the heart of helping to solve our collective problems. I think it could really benefit the American medical community. A broken culture drives the negativity in American medicine. The future craves a more culturally-savvy, international approach to medicine. I realize that this is a broad statement to make.

Allow me to focus it a little by outlining four ways we can put smiles back on some faces through “global” thinking:

1) International Sleuthing Trips - As much as it is true that America still is home to some of the most advanced medicine in the world, other developed countries often have a far better handle on actual health care delivery. To learn efficiencies and to learn how to do more with less, American medicine should not indulge in further navel gazing. It is time to give more thought to other models of health care internationally. We should aggressively fund more international study trips to examine global best practice in everything from direct treatment to preventative care and lifestyle medicine. The goal here is not some flimsy “experience”. It is to learn how to deliver better health care at less cost.... and travel the world!

2) International Socialization - I remember the day one frustrated health care exec told me that she believed the emotional maturation process of future physicians ended the day they began their pre med studies. That is a little harsh. But seriously, I work with a lot of physicians and many are very socially awkward. Long work hours and little play reinforce this problem. International travel and study on the other hand, are incredibly broadening. International service work should be mandatory for med students. Especially, for the really nerdy ones. We love you but it’s a quality of life thing - for them and everyone that has to endure them!

3) Red Carpet Medicine - Medical tourism is on the rise. What am I talking about? Well, Brits are going to France, Western Europeans are going to the former Eastern Bloc, Americans are going to Australia and Mexico, etc. Why? Financial reasons. There are top-notch medical clinics especially set up for this kind of medical tourism. They cost less than home and it’s a hell of a lot more fun to go to southern France for treatment than Jersey. I am talking about boutique medicine. Enterprising med students should be visiting some of these clinics for business concept harvesting purposes. Why not make the transition to high-end boutique-style medicine catering to wealthy clients in the US? My aunt works at just this kind of a practice in the Napa area. Very lucrative and based on a smart business model that doesn’t run physicians ragged. Do your market research! Success in medicine is more than just science. It is art.

4) Humanitarian Trips - Finally, a good humanitarian trip or “medical mission” abroad does wonders for your appreciation of home as well as for your overall perspective. As a young doctor, my mom worked in Nigeria for three years. The pay was horrible, the country unstable and the heat was often unbearable. But she grew so much. When you give of yourself on this level, you often become a much happier person as a result. If the doom and gloom of American medicine start to mess with your inner balance too much, a solid trip to Haiti might be just what the doctor should have ordered:)

Alright...

You see where I am going with this. We have a long way to go if we are serious about improving the American health care environment. But we can start with being purposeful about creating a more internationally-rounded vision of the medical field. And what better way to do that than to rack up some frequent flyer miles!

_________________________________________ 

Become a writer on Uncommon Student MD: Submit a Guest Post.  

4 Years In Medical School Is Wasting HealthCare Resources

Ezekiel J. Emanuel MD, PhD and Victor R. Fuchs PhD want to speed up the clock in medical school and residency.

If you think 10 to 15 years of training to become a doctor is nuts but decided to go for it regardless, I have some bad news. According to recently published article in JAMA, you where right, it is nuts! More than that, it may be a place to look for cutting unnecessary costs in healthcare. This article calls to question some of the most basic assumptions central to becoming a physician.

The Death of The All Knowing All Powerful Physician

The picture of the lone physician hero fighting off death and disease may seem inspiring but is really just ignorant and impossible in healthcare today. No matter how many of your internal medicine attendings puff up their chest and say "I don't need to get consults" it does not change the fact that we can no longer effectively practice medicine in a vacuum. Learning to work closely with our colleges is something that competition in medical school has suppressed but it is a skill that future physicians need to develop.

The consequence [of trying to train one all knowing doctor] is a broad training regimen... [it] emphasizes the autonomy of the physician rather than team-based care. The new model recognizes that with increasing clinical and scientific complexity, no physician can be a competent triple threat; that few clinicians will also be investigators; that no single clinician can know everything even in his or her own specialty; and that effective care requires collaborative, multidisciplinary teams.*

Less Time In Medical School and Residency Makes Better Doctors

At first this seems like a paradox, but when you consider the time spent learning outdated and extraneous facts or working hard to efficiently take care of more and more useless paper work, it begins to make sense. What if the right of passage was something besides showing how well one can fill out reams of paper work on patients. I guarantee any intern will tell you this takes up most of there waking moments during the first year of training. The current system has evolved to fit this waste and has little reason to correct course because, "that's what interns and medical students are for". However this drives up education costs for new physicians and increasing educational debit also limits the career options for graduating doctors. We are all inherently practical and when faced with a mountain of debt, grabbing a job with the highest pay and benefits will win. Following your desires to work in an undeserved area or taking a risk on a new business venture is a cost that many will not take.

There is substantial waste in the education and training of US physicians. Years of training have been added without evidence that they enhance clinical skills or the quality of care. This waste adds to the financial burden of young physicians and increases health care costs. The average length of medical training could be reduced by about 30% without compromising physician competence or quality of care.*

Read the full article here: Shortening Medical Training By 30%

*Emanuel EJ, Fuchs VR. Shortening Medical Training by 30%. JAMA. 2012;307(11):1143-1144. doi:10.1001/jama.2012.292.

Endurance Training During Medical Training

9 tips for any medical student thinking about doing a marathon, triathlon, or even Tough Mudder?

A guest post by Brad Harris, a Medical Student and Ultramarathoner currently attending Loma Linda University School of Medicine.

People always ask me how I find time to train for 50 mile races while juggling a full schedule as a medical student? It's not a difficult as it sounds but it does take some work and planning.

Here is what I've learned....

Make it fun.

The most important thing is to incorporate activities you enjoy doing into your workouts. Find something that you just can't wait to get home to do then use that for motivation.  Remember, training doesn't have to be boring. Maybe you have a frozen yogurt craving. Instead of driving, run down to the local FroYo establishment, indulge, and run back home. Just make sure to make it something you look forward to. Enjoying your workouts is a mindset.

Find your pain cave, and crawl inside.

The pain cave is an uncomfortable place to be. It's a mental state that makes you feel fatigued and want to quit. Sometimes medical school pushes you into the pain cave. Find your personal pain cave and get comfortable with feeling uncomfortable. It is through stressing our bodies that we become stronger.

EXPLORE!

Grab a map, be prepared for the conditions, and go see what's around the next corner. Never stop exploring. Where does that trail go that's behind your house? How do you get to the top of that mountain? What's it like to run through the middle of skyscrapers in the big city? During my time in SoCal I've really enjoyed finding new trails in the local mountains, its actually become a hobby of mine. Don't be afraid to wander and explore new places from time to time.

Give each workout a purpose.

I, like most people, get bored simply going out and pounding the pavement for 3 miles every morning in order to check off the exercise box on the to-do list. Build variation into your workouts. Warm up and just run hills one day. Find a running track and do repeats of 2-8 minutes of sprinting with a 2 min recovery after each. Find an elliptical trainer or treadmill at the gym and set it to a random setting while you review notes or flash cards. Seek out new workouts to push yourself and keep it exciting.

Add minutes or even hours to your day.

Wasting time on the internet is something that we all do. By limiting time on the internet with a program like StayFocused, you'll be surprised how much more free time you have for exercising. Plan out your internet usage before getting on your computer and set a time for each task. You will be surprised what you can accomplish with an extra 30 minutes in a day?

Listen to review sessions while exercising.

A few of my classmates would audio record every lecture during the first two years of med school. I know some med schools do it for each class, either way, this is a great way to maximise study time.  Goljan audio review was my running companion for most of 2nd year. This is a great way to avoid feeling guilty about exercising when the pressure is building before exams.

Rest.

Lay low every once in a while. Take mental breaks, both from studying and training periodically. I have found that taking one day off a week from studying (I know they may sound like nonsense to some, especially those with gunnorrhea) did wonders for my focus and provided opportunities to maintain sanity and balance during times of stress. The body also needs rest. Don't be afraid of taking time off from exercise to let your body recuperate.

Plan long workouts on the weekends.

If you are looking to run a 10k, half marathon, or marathon - plan your long runs for the weekends or off days when you'll have more time. If you don't plan them, they won't happen! Also, try to make them an adventure, not just a slog. Proper planning and mindset will both make a huge difference.

Exercise after tests.

Maybe you missed some of the gimme questions that everybody else in the class said were easy on your most recent exam. Getting out and exercising after a stressful test is a great way to clear the mind as well as isolate yourself from frantically looking up every question you think you missed. Exercising will allow you to burn off some frustration and rejuvenate your mind to allow for more efficient studying.

Train with friends.

Some of the best conversations come during long training runs. Invest time forging bonds with new friends and reconnecting with old ones. They will keep you motivated and push you as well. Also having someone that is counting on you to show up for a run is great for accountability.

Hope these tips help! My endurance training has truly made a big difference in my medical school experience and I believe it will make me a better doctor as well. If you have any other great tips for training leave me a comment and let me know.

Medical Student and Ultramarathoner: An Interview with Brad Harris

Anyone thinking about a marathon during medical school? This guy eats them for breakfast!

Brad Harris is a 3rd, soon-to-be, 4th year medical student at Loma Linda University. When he is not rocking the wards he's probably in the mountains, pushing his lactate threshold to the limit.

Tell me about your last race?

My last race was the Old Goat 50 miler on March 24. It was a trail race on 75% singletrack trails in the beautiful coastal Santa Ana Mountains. It was a tough course with 13,000 feet of climbing. Ninety-five percent of the course was either going up or down. The physical side of running an ultra race proved to be much easier to train for than the mental side. At some points in the race all I wanted to do was stop and stretch, just so I could have a good excuse to stop running. By the end it became a battle to find motivation to finish. Overall, it was great experience and a good challenge mentally. I finished with a smile on my face.

What did you feel like after finishing a first 50 mile run?

HUNGRY! I subscribe to the theory that your body tells you what it needs through cravings so that meant that I ate nachos, chili, pancakes, gatorade, chocolate milk, salty potato chips, and grilled cheese all within the first 10 hours after the race. And it was all guilt-free eating. Of course, crossing the finish line was a lifelong goal for me and brought a tremendous feeling of accomplishment, but stuffing my face sure brought a lot of satisfaction as well.

When did you get into running?

My high school biology teacher got me into long distance running in 9th grade. I have since transitioned to more trail running. After moving to Southern California for medical school, I found the local mountain trails lots of fun to play in. Running has become a way of life now.

Ok, I know you like pain, was that what inspired you do pursue medicine?

One of the biggest reasons I first decided to go into medicine was to give back to my community. I've been very fortunate to get medical help when I've needed it most. I've been shown compassion and experienced how it feels to receive it. I look forward to being able to this on to others both locally and globally. Another thing that appealed to me about medicine was the opportunity to be a part of a community that constantly strives for excellence and works to improve peoples' quality of life. In addition, I really enjoy the mental stimulation that medicine provides. It's a challenging career that will always be evolving, changing, and making you think. As I started medical school, I became very interested in wilderness medicine and specifically high altitude medicine. I love the mountains so its a pretty natural fit for me. I look forward to incorporating as much medicine as I can into the things I love to do in the outdoors and giving back to the community.

One of my favorite quotes kind of says it all...

What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.

- Albert Pike

What types of races have you done in medical school?

While in medical school, I've done 2 big races (2010 Boston Marathon & 2012 Old Goat 50 miler), a few smaller races, and am constantly coming up with entertaining endurance challenges with friends on the weekends to challenge ourselves. My goal throughout med school has been to get out into the wilderness at least once a week to run, rock climb, or backcountry ski. Its a great way to clear the mind and a good motivation to be efficient with studying.

How do you keep up with medical school and have time to train at such a high level?

I try to maintain a focused yet flexible training schedule with a lot of variation, but some times school doesn't comply with my training schedule. Check out my guest post on Endurance Training During Medical Training.

Has your running life opened any doors in you medical career?

I've made great friends and met all kinds of interesting people that are in the medical field at races and while out training, but the most direct way that running has opened doors is that it provides an easy icebreaker to start up conversations with residents, attendings, and patients on a day-to-day basis. Its fun for me to find out what other people like about running and create a common bond. I've found that the shoes that people wear in the hospital tend to be a great conversation starter.

So what’s next for your running career?

My most important goals are to continue to stay healthy, push myself, and meet fun, interesting people through running. In addition to these goals, I keep a google doc chocked full of future adventures. It's a dynamic list that helps keep me focused and  keeps me dreaming. I highly recommend this type of adventure list to anybody that enjoys the outdoors.

A few running adventures on my short list for the next couple years include:

1. 100 mile trail race,
2. Running up Mt. Whitney,
3. Running the West Coast Trail in BC Canada
4. Running the Rim to Rim to Rim of the Grand Canyon.

How has staying connected to this passion helped you in medical school?

The biggest way running has helped me in medical school is it has allowed a time for me to clear my head and remember that life is much bigger than the current landry list of stressors I may be facing in my life.

Do What You Love Guide: Tips On Keeping Dreams Alive During Medical Training

"Reality is merely an illusion, albeit a very persistent one."- Albert Einstein

From the outside looking in, becoming a medical student is not unlike scoring one of Willie Wanka's golden tickets. Most people see you as someone who is on the fast track to living a life of your dreams. They hear you are going to be a doctor and already picture you healthy and happy, with a condo at the beach. Sadly, the burnout rates and frustration amount physicians are on the rise, especially in primary care, and this trend does not seem to be changing any time soon.

Medicine is a culture with very rigid structure. Each type of physician is supposed to fit into a predetermined personality, way of practice, and even work schedule. There is a certain amount of brainwashing that is built into the system and it can be difficult to dream big and chart your own path in this sort of environment.

We are well into the graduation season and this means there will soon be many med students embarking on a new journey as residents, and many college grads preparing to hit the books as medical students. I thought this would be a good time for some tips on Doing What You Love.  For that we turn to someone who has helped many people follow there dreams...

Enter Leo Babauta, the founder of ZenHabits.

I wrote the first words of ZenHabits more than five years ago, I had no idea those few keystrokes would change my life.

I thought I was doing nothing more than reflecting on the changes that had been happening in my life, sharing a bit about what I learned with a handful of friends. I thought those tinkling of computer keys would fade into the void, as most of my thoughts had before that.

I never imagined that a year later, I would have 26,000 people reading my blog (and eventually a quarter million subscribers), that I’d finally be out of debt, that I’d have my first book publishing contract, that I’d happily hand in my resignation for my day job. All of that was out of the realm of possibility.

That’s the amazing realization here: that we rule out the possibility of great change, because it doesn’t seem realistic. For nearly two decades I focused on going to college, and working at a day job that I sometimes enjoyed but often dreaded, because that’s what we expect should happen. Starting my own business, pursuing my dreams, doing something I loved? Crazy talk.

Crazy talk is what I’m going to give you today, in hopes that perhaps one of you will expand your possibilities. It is possible — I did it, all while working a full-time job, doing free-lance writing on the side, and having a wife and six kids. I did it, even if I never dared to dream it for the first three decades of my life.

I am not someone who likes to give career advice, or teach people to be entrepreneurs. So I’m not going to do that here. I’ll just tell you this: it’s possible. And I’ll share what I’ve learned, in small snippets of goodness, about doing what you love.

If you don’t think it’s possible, do a small easy test.

Don’t think you can start a big/impossible idea? Start small. Take one small step in the direction of your dream. You don’t even need to tell anyone about it. It costs nothing, risks nothing, takes almost no time. But you will learn you can do that one little thing, and if you pass that test, you now know your theory of impossibility was wrong.

Expand your tests.

If you pass the first test, do another small one. Then another. Keep going and notice your confidence grow. Your skills grow along with the confidence. It’s amazingly simple. Iterate and re-iterate as long as you are having fun.

If you don’t know exactly what you love, don’t worry.

There’s no need to figure that out right away. Try something that someone else is doing, and see if you think it’s fun. The real fun part, btw, comes when you start to get good at it, so perhaps stick with it for awhile and enjoy the learning, then enjoy being good at it. If that first try doesn’t work, try something else. You don’t have to commit to one thing for your entire life. You can do a dozen a year if you want, for a decade. You’ll probably find something by then.

Find inspiration.

Think about what will inspire you 10 years from now. Who else is doing what you love doing? Who is excited about it most? Follow them. Learn about them. See what path they took. Watch closely how they execute, what they do right. Learn from the best.

Reach out to a mentor.

Of the people who inspire you the most, try to make contact with a few of them. If they never respond, try a few more. See if you can buy them lunch or coffee. Don’t pitch them on anything. Just ask for their help, and say you’d love for them to mentor you in a way that won’t take up much of their time. Don’t demand a lot of time, but go to them when you’re having trouble making big decisions.

Choose one passion at random.

Some people have many interests and don’t know where to start. Pick one or two randomly if they’re all about equal, and just get started. Don’t let choice paralyze you. Get started, because in the end it won’t matter if you started with the wrong passion — you’ll learn something valuable no matter what. Read more.

Get good at it.

You get good at something with practice. Allow your friends and family to be your first audience, readers, customers. Then take on a few others at a low cost, or increase your audience slowly. But always have an audience or customers if possible — you’ll get good much faster this way, with feedback and accountability. Read about it. Watch videos. Take a class. Join a group of others learning. Find people to partner with. Before long, you’ll be good at it.

Help others.

One of the best ways to get good at something is to help others learn. Making someone’s life better with your new skill is also an amazing way to get satisfaction out of what you do, to love what you do. Help as many people as you can in any way possible — it will pay off.

Find your voice.

Eventually, as you master your skill, you will learn that you are different than the thousands of others doing it. You will find your uniqueness. It’s not necessarily there at first, because you might not have the technical skills to express yourself. But eventually, find that voice. Find the thing that sets you apart, that helps you to stand out from the crowd. Then emphasize that. Read more.

It’s the doing and loving that matters.

Many people focus on growing, or hitting goals, or making money, but they forget what matters. What matters most is loving what you do. If you love it, and you’re doing it, you’ve already succeeded. Don’t worry so much about achieving certain levels of success — people push themselves so hard to reach those things that they forget to enjoy what they’re doing, and in the process they lose the reason they’re doing it in the first place.

Dream bigger.

Once you’ve overcome the initial fear and started to become good at something you love, dream bigger. The first stage is small steps, but don’t stop there. You can change lives. You can change the world. Doing so will change you.

9 Reasons For Physican Burnout, And One Way To Avoid It

"The burnout epidemic amongst our physicians is a predictable result of the medical training and the generally accepted definition of “success” amongst doctors."

-Dr. Dike Drummond MD Founder of TheHappyMD.com

Dr. Dike Drummond is a Mayo trained Family Practice Physician who has experience in medicine, coaching and personal improvement, and business development. His expertise in personal change was developed over 15 years as a family practice doctor and 8 years as a business coach working with physicians and startup entrepreneurs.

When I met Dr. Drummond, we discussed the reasons why so many physicians get burned out. He asked me how most doctors measure success? “Do they have a busy practice?” The answer popped out of my mouth instantly; it was almost a reflex. This is something you hear all the time. “She is doing well, working in a busy practice,” or “his surgery schedule is booked solid; he must be doing great.” This seems to make sense; after all, we are doctors, and doctors are busy. However using this one tool as your main metric of success can become a recipe for disaster. Unfortunately, this is not the only reason physicians get burned out, but the good news is, there is a solution.

Enter Dike Drummond

What follows are 9 facts about the practice of medicine that lead directly to burnout. The good news is you can do something about it.

1) Being a Doctor is Stressful. Period

The "most stressful" professions are those characterized as having a high level of responsibility and little control over the outcome. We are not selling widgets in medicine. This is a tough job that saps our energy every single day.

2) We Work with Physically and Emotionally Sick People All Day Long

Our days are filled with intense encounters. We spend our time treating sick, scared, and hurting people. In addition to the physical ailments, there are many emotional needs that come with any illness. Physicians do not receive proper training on creating boundaries; our energy can be severely tapped by these emotional needs alone.

3) Balance, What Balance?

Medicine has a powerful tendency to become the “career that ate my brain." Pushing all other life priorities to the side is something that we have ingrained into us during medical school and residency. As we get older, with more family responsibilities, the tension between work and our larger life is a major stressor for many. Training on healthy boundaries would help here too and is rarely available.

4) A Leadership Role with no Leadership Skills

You graduate into the position as leader of a healthcare delivery team without receiving any formal leadership skills training. By default we learn a dysfunctional "Top Down" leadership style. (Medicine and the military are the only professions where the leaders "give orders.") This adds additional stress.

5) The Doctor is the Bottleneck

The team can only go as fast as we can, and we are often behind schedule. Pressure mounts to perform at full steam all day long.

6) Who's Paying for This?

The financial incentives are confusing at best. The patient is often not the one paying for our services, and many of them receive their care with no personal investment on their part. You may have to deal with over a dozen health plans with different formularies and referral and authorization procedures ... of which the patient is blissfully unaware.

7) Medical Practice is A Lawsuit Waiting to Happen

The hostile legal environment causes many of us to see each patient as a potential lawsuit. This fear factor adds to the stress of all the points above.

8) Politics and "Reform" Political debate drives uncertainty about what our careers will look and feel like in the future.

All the pundits share the same complete lack of understanding about our day to day experience as providers in the trenches of patient care. There is no track record of common sense. We simply don’t know what to expect.

9) Things Eventually Get Stale

The ten year threshold when your practice suddenly seems to become much more of a "mindless routine" losing its ability to stimulate your creative juices each week is a shock. All of a sudden it seems as if medicine is “no fun any more."

The Solution

Keep your connection to "WHY" we are a doctors; to your Purpose.

The quality of this connection varies day-by-day; however, it is a source of immense power and endurance when the connection is clear. As physicians, we must deliberately work to keep that connection alive and well. When you have invested over a decade of your life in medical training, it's easy to feel stuck when you think your reason for becoming a doctor is gone or not possible. It's imporant to remember you have a great skill, with more opportunities than you probably know. Keep searching out and pursuing the opportunities that ignite your passion, and do not be afraid to ask for help. Sometimes another perspective can open your eyes to opportunities you did not choose to consider. 

When you notice the three cardinal signs of Burnout

     1) Exhaustion

     2) Cynicism (especially in men)

     3) Questioning the quality of your work or whether you make a difference in the world.

     (Sounds like medical school and residency)

It's time for a break, some balance, to take really good care of yourself, spend some time with your family and even ask for support. You’ve earned it.

To learn more from Dike Drummond visit The Happy MD