Diane W. Shannon is an internal medicine physician and physician coach.
Last week, while on vacation, my husband and I were swimming in a salt-water inlet when a rainstorm hit. (Actually, I was indulging in my favorite leisure-time pursuit: floating prone, chin resting on my forearm, on a lime green inner tube.)
Fortunately, there was no lightning, though there was a bit of hail. We decided to stick it out. Heck, we were already wet.
As we floated along with the outgoing tide, …
Here’s something you may already know. I didn’t until recently, but I sure do now, and it’s a lesson I won’t forget—something I wish I’d known three weeks ago.
Rabbits love cone flowers.
We recently downsized to a cute house with window boxes. I’ve never had window boxes before and am honestly not much of a gardener. I went to the local place where we buy plants and picked out some tall …
Intriguing question: What is one word that can free us?
You might think it is love.
Love is so powerful in lifting shame, sadness, and loneliness, but that’s not the kind of freedom I’m referring to. Instead, I’m referring to the freedom to put aside others’ presumed or verbalized expectations of us and do something in our own best interest.
That magical word is “could.” At first glance, this might not seem like …
This summer, my cousin Cindy has been raising Monarch butterflies. Two weeks ago, when I was visiting her for the weekend, she gave me a chrysalis to bring home. She’d already done the bulk of the work, feeding and caring for the caterpillar. I left with a mesh-sided carrier and an expected due date of 7 days. I was instructed on how to determine the gender and that I needed …
“Physicians have no autonomy.” I read and hear versions of this every day, expressed with anger, resignation, or both. It’s also called agency, control, and power (as in feeling empowered).
I’m the first one to admit that physicians have way less autonomy than in the ten decades that preceded this one. Moving from private practice to employed models, heightened focus on productivity, compensation via RVUs, and mergers have shifted the power …
Our profession often sends the message that we are invincible heroes.
Here’s my vulnerable and honest admission: I lapped that up. There was something so seductive about denying pesky human requirements, like sleep, regular exercise, and time to decompress. I liked being needed more than I liked having needs.
I sublimated mine under my superhero cape right up until the time I hit a kryptonite wall. There …
I’m not an organizational leader, a member of the C-suite, a department chair, or a VP of anything. I’m a coach who guides physicians as they try to provide exceptional care and actually have a life. But I know a lot about setting goals, executing on priorities, and inspiring through vision statements.
Here’s the thing. This is not a successful long-term strategy:
Toward the end of my clinical career, I didn’t feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn’t see anything I could change. Based on my work with physicians as a coach, I think that the sense of powerlessness and being a …
In a previous post, I recognized lactation support for women physicians as an equity issue. Many of the women physicians I’ve interviewed have identified returning to work while breastfeeding as a major challenge and a major source of stress. Providing accommodations to ensure that these professionals have access to the resources they need to do their work is essential to creating an equitable workplace.
Soon after I published …
I’ve been speaking with women physicians about the top challenges they face today. I’ve learned there are many—which honestly didn’t surprise me, given that 48 percent of women physicians report burnout symptoms (compared with 37 percent of their male counterparts).
Several have mentioned the challenge of breastfeeding while working—rather ironic considering what is known about the health benefits for mother and infant. Maybe their colleagues and …
“I no longer start every day in dread,” Sheila (not her real name) told me as we completed a six-month coaching engagement. Her statement initially surprised me because that’s not how she described her interest in coaching when we began. She had simply and unemotionally told me that she needed a career change and didn’t want to jump into another not-quite-right situation. But as I recalled the time we spent …
Health care organizations are moving to address clinician burnout with a real sense of urgency. It is now commonly accepted that burnout is widespread among health care professionals and has serious repercussions for patient safety and the quality of care. A report released by several major Massachusetts health care organizations labeled the situation “a public health crisis” and warned about the adverse impact “on the health and well-being …
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I love the idea of turning a negative approach to improvement in health care — looking for problems — on its head. Appreciative inquiry, a process of focusing on a group’s inherent strengths and fostering positive interactions among group members, is one way of fostering change with a positive approach. Positive deviance (PD) is another.
Basically, PD involves identifying what’s working and usual local solutions owned by the people involved to make …
When I left clinical practice, I thought I was prepared for the change in my identity.
Wrong.
I was shocked by the degree to which my sense of myself and my value in the world were rocked by leaving the profession. After all, I left practice less than seven years after I could legally write MD after my name. In residency and when practicing (and even to some extent as a medical …
In March 2018, The Collaborative for Healing and Renewal in Medicine (CHARM) published an article titled “Charter on Physician Well-being” in JAMA. The piece describes guiding principles and lists recommendations for promoting well-being among physicians. The charter successfully pulls together, in a 2-page document, a comprehensive approach to preventing burnout and fostering well-being among physicians.
One recommendation especially caught my attention. “Anticipate and Respond to Inherent Emotional Challenges …
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In 2017, the flagship multispecialty practice of Oregon Medical Group, moved into its new digs — a 46,000 square foot redesigned medical office building. Practice leaders and the 30-odd clinicians in six different specialties were committed to a coordinated patient experience. They wanted to ensure that patients could move smoothly between sequential visits with different care providers — on the same day. To this end, the group invested in a …
I realize today that shame, and the stigma about needing help if you’re a care provider, profoundly affected my career path and even my sense of identity. When I was overwhelmed, exhausted, stressed, and scared, did I reach out for help? No, I kept going until I hit a wall, burned out, and left clinical practice. After leaving, did I talk publicly about the chaotic conditions and broken system that …
I am very resistant to burnout solutions that focus solely on the individual, as these seem to imply that the problem originates in the affected person. This approach pokes at a sore spot, because of the years I spent secretly worried that the reason I left practice was personal weakness or inadequacy, something I lacked or failed to do.
When in 2013, I ran across the research on burnout, I learned …
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The prevalence of burnout among physicians is estimated to be more than 50 percent and has grown in recent years. This alarming trend is largely due to changing patient demographics, increasing cost constraints, new federal and state regulations, and other external factors that have reshaped the daily work experience of physicians. Too often today, physicians spend more time on data entry than in direct …
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