I was recently doing some home shopping in Target. It was peak time and fairly busy. After I was done, I walked towards the front of the store and approached the counter area to pay. But alas, there appeared to be hardly any manned registers. Lots of people were strolling up and down, trying to do the same as me: find a real person to help us check out. We …
What health care can learn from what’s happening at Target
When I first started writing and speaking about physician burnout, I focused most of my efforts on the female physician — after all, most of my work stems from personal anecdotes, and I am of course a female physician. I could probably give a talk about women physicians and burnout in my sleep at this point.
Rightfully so, though, as my work spread to wider audiences, more and more men started …
An excerpt from the Docs Outside the Box podcast, episode 2: How a physician found success and fulfillment living outside the box
Dr. Nii: I have an exciting guest that I want to showcase for you. Her name is Dr. Melanie Watkins. She’s a psychiatrist who’s practicing in California. I’ve been following Melanie for quite some time on Twitter. She’s been known to have very poignant Twitter messages — whether they are …
How a physician found success and fulfillment living outside the box
As many of you know, I am a big fan of side hustles. I see them as a financial independence superpower that not only leads to increased revenue and diversification, but also joy and passion. I am not, however, unaware of the fact that many feel they are a waste of time. The case against side hustles is real. There are many reasons why an individual may decide …
The case against physician side hustles is weak
The first time I was asked to provide a bio — in this case, it was to appear on my residency’s website — I wasn’t sure what to include. It was supposed to be short, not really an autobiography or memoir and it was supposed to make our program look approachable, impressive and balanced. I gave a quick summary of my background, my education, my interests, why I picked the …
Managing your freedom after residency
I’ve always likened the job of a primary care physician to that of a chief executive officer of a small business. Family doctors manage the “business” of delivering and coordinating care for more than a thousand patients at an average cost, in the United States, of $8,500 per year: an $8 to $12 million business. Because the actions or inactions of the PCP impact the need for, and cost of, …
Both physicians and CEOs need time to think
One of my best friends recently sent me an article from the Wall Street Journal discussing the generation that is about to enter into retirement. The article highlighted how this generation will have an unacceptably high proportion of people who are unable to retire. Following a generation that had guaranteed pensions, this left them with the reassurance that they would someday have one, too. Left ill-prepared for retirement, this …
Learn from the prior generation that left little for their own retirement
Repercussions.
Every action that is taken, especially when it comes to healthcare, has ripple effects, which often end up being more far more significant than we anticipate, turning that ripple into a tidal wave.
Every time somebody besides actual health care providers steps into the mix and tell those of us taking care of patients that there is “something else that we have to do,” we often see it open up a …
Why are we treating outpatients like inpatients?
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 …
Why physicians need disclosure coaching
I got together this past weekend with a few of my medical school classmates and ahhh, the memories. Being in the trenches together, just like in residency, tends to create a bond that remains throughout time. We picked up right where we left off and talked about the good ol’ times, how life used to be, and how it is so different now, especially because we now all had families.
That …
A medical student’s side hustles
My (sometimes solicited, but often unsolicited) advice for graduating medical students, residents, and fellows:
June is one of my favorite times of the year. One, because it’s summer, but also because it’s graduation season. I love seeing and hearing about everyone’s accomplishments, and seeing years of hard work come to fruition – although if I’m being honest, it’s bittersweet, because it’s also a reminder of how I’m getting older.
This year, I’ve …
6 pieces of advice for graduating medical students and residents
A recent post by the White Coat Investor got me pretty fired up. Dr. Dahle spoke about three of the main financial enemies that face physicians. The third one that he mentioned had something to do with medical culture. The gist of it was that talking money in academic medical centers is considered taboo. While I think WCI is right, it really made me angry. As an academic …
It’s time for academic attendings to teach personal finance
An excerpt from 7 Ways to Stop Drama in Your Healthcare Practice.
Although the ability to initiate difficult conversations is part of good leadership, I’ve never met a leader who enjoys it. Whether your conversation is about body odor, rude behavior, dress code, personal conduct or performance issues, difficult conversations are …
8 steps to have those difficult conversations
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No news attracts attention like a physician who’s in trouble with DEA or their state medical board. So, how does it happen, what are the common issues and what can a physician do to safeguard themselves?
First, let’s look at what the numbers and the research tell us.
The Federation of State Medical Boards (FSMB) tells us that 4,091 physicians were disciplined during …
10 ways to stay out of the DEA’s crosshairs
I have neck pain. It’s been going on for years. Usually, I get sore stiff muscles once a week and a headache. This is the consequence of having a big bobblehead on a pencil thin, weak neck. In the throes of pain, I have thought many a time about doing the right thing, and going to see a physical therapist. But then I get a heating pad, take a Tylenol, …
One day, I was full of moderate despair, overworked, befuddled by the EHR with a tinge of burnout, staring at my computer, I treated myself to something I’ve not done before. It was my 62nd birthday that day, and I gave myself a birthday present. Before rising from that swivel chair, I had written down on a sticky pad the day that would be my retirement date, exactly one year …
An excerpt from the Docs Outside the Box podcast, episode 1: When the going gets tough… MOVE!
Dr. Nii: All right, well thank you very much for joining us on the Doc’s Outside-the-Box podcast. You are our first guest — first victim, I guess. It’s the inaugural episode, so I just wanted to thank you for joining us. I know you are in New Zealand, which is roughly 18 hours away.
Dr. Brown: It’s …
A conversation with a doctor who was tired of feeling burned out
In medicine, this is the time when one season ends and another begins. New doctors graduate from medical school. They are excited and, at the same time, scared as they enter into residency training. Interns become residents. Senior residents celebrate moving into attending positions or look forward to subspecialty training in fellowship programs. It’s the excitement of completion combined with the uncertainty of charting a new course in medicine. Each …
3 steps for doctors to move into the next level of career growth
“Sorry, I’m running late … sorry, to keep you waiting.” How many times a day do I say that? Sometimes it is every time I walk into a patient’s room as if it is a normal greeting. Sometimes patients respond with: “Oh, you aren’t late” or “I haven’t been waiting long.” I can be so obsessed with not being late that I don’t realize I’m actually running on time! But …
Come see for yourself why medicine rarely runs on time
I lost a friend this month. She was a surgeon; she was one of us.
We lost her.
So did her patients. All the ones she helped. The ones she saved.
So did her hospital, her nurses, her techs.
So did her family. All the love, coming to a screeching halt.
Another friend lost. Another brilliant healer in medicine — gone. Another one I will now refer to as “she was …” when I talk …
Address physician well-being as we would any other disease
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