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.

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

And if you’d like to schedule a complimentary 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.

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

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

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.

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

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

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

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.

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

And if you’d like to schedule a complimentary 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.

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

And if you’d like to schedule a complimentary 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.

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

And if you’d like to schedule a complimentary 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.

My Podcast Appearance on Sustainable Clinical Medicine

I'm excited to share my recent podcast appearance on Sustainable Clinical Medicine with The Charting Coach, a podcast for physicians and others in healthcare hosted by Dr. Sarah Smith. Dr. Smith not only helps physicians who are struggling to keep up with charting, but she also hosts a podcast focused on the ideas and challenges that matter most to physicians and others in healthcare.

Here are three key takeaways from our conversation:

🔑Values Alignment: Discover the power of aligning your career and personal life with your core values.

🔑Saying No and Carving Time: Learn how to set boundaries and prioritize what brings you joy and fulfillment.

🔑Exploring New Avenues: Possibilities open up when you allow yourself to pursue interests outside of traditional medical roles, sustaining and supporting your life in medical practice.

You can take a listen at the link below, or find the podcast on Apple or Spotify.

Journaling for Physicians: Find Balance, Gain Clarity, and Envision Your Future

Journaling can help you to perceive the lines that connect the dots. Through this accessible and time-tested form of self-reflection, you can build stronger connections with what and who matters most, At the same time, a writing practice may help you to give name to the obstacles that may be keeping you from living a life aligned with your values and goals.

In previous articles, we’ve explored the way that journaling can help you think through challenges, reflect on the present, and see yourself through your own words and dreams. In this third and final set of journaling prompts for physicians, I offer prompts that you can use to explore your own definition of balance both now and for the future.

As you gain clarity on the ways the diverse branches of your life intertwine, unexpected or creative ways to bring harmony to your work, your personal life, and your passion projects may emerge. Through journaling, you'll gain a deeper understanding of how you want to shape the life you envision. You may even rediscover a path that you lost sight of years ago and find that it is ready to be explored once again.

Finding Balance

1. How do my work, personal projects, family, and relationships influence each other? Are they currently in harmony? If not, what might need to change?

2. What does a balanced and fulfilling life look like to me? How close am I to that vision? What small steps might I take to start the journey?

3. Are there areas of my life (work, personal projects, family, or relationships) that I feel are receiving too much or too little attention? How can I redistribute my time and energy?

4. How do I prioritize between competing demands from work, personal projects, and loved ones? Is this system serving me well?

5. What is one thing I could change this month to better integrate work, personal projects, family, and relationships?

Creating Alignment

1. How do my work and personal projects align with my values and the type of life I want to build for myself, my family and/or my relationships?

2. What shared values or goals do I want to cultivate in my family and/or relationships, and how can my work and personal projects support these?

3. Are there ways I can involve my loved ones in my personal projects or bring my personal passions into my professional life?

4. Are there personal projects that I enjoy or aspire to that could open the door to new and sustaining relationships or communities? If so, how might that look?

Evaluating Impact

1. How does my work affect my personal projects, family, and relationships? Are these effects positive or negative? What adjustments could I make so that the impact is positive and sustaining?

2. How do my personal projects enrich my work, family life, or relationships? Are there new projects I could pursue to strengthen these connections?

3. When was the last time I felt deeply connected to both my professional and personal life simultaneously? What factors contributed to that feeling?

Fostering Connection

1. How do I make space for meaningful connections with my family and/or relationships despite work and personal project commitments? Is there one thing I could do this week to foster a deeper connection?

2. What specific actions can I take to ensure my loved ones feel valued and supported while I also pursue my work and personal goals?

3. How can I communicate my professional and/or personal aspirations and priorities with my family and relationships in a way that strengthens our connection?

Reframing Challenges

1. What challenges arise from balancing work, personal projects, family, and/or relationships? How can I view these challenges as opportunities for growth?

2. How do I handle moments when one area of life feels overwhelming and starts to impact others? What strategies or boundaries might help?

3. Are there sacrifices I’m making in one area of life for another? Are those sacrifices necessary or avoidable?

4. Is there something that I should let go of in order to give space for other opportunities, or for my relationships?

Visioning the Future

1. What would an ideal day look like if I seamlessly integrated work, personal projects, family, and/or relationships? What steps can I take toward that vision?

2. How do I want my work, personal projects, family, and relationships to evolve in the next 5-10 years? What specific actions can I take to guide this evolution?

3. Imagine celebrating a major milestone in my personal or professional life with my loved ones. What does that moment look and feel like, and how can I create more of those moments?

Reflecting on Fulfillment

1. What brings me the deepest sense of fulfillment? How can I prioritize those elements so that it encompasses the people and things that matter the most to me?

2. How do I ensure that my successes in work and personal projects don’t come at the expense of meaningful relationships and family life?

3. What legacy do I want to leave behind in my career, personal life, and relationships? Are my current efforts moving me toward that legacy?

I hope that you’ve enjoyed this journaling series. If you have any prompts that you’d like to share, 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.

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Bike Shedding for Physicians: Avoiding Trivial Time Wasters

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

Your time is a precious commodity, but if you’re like many physicians, you give it away freely. In all likelihood, you're juggling multiple priorities at any given time, trying to get it all done while striving to stay on schedule and keep your patient satisfaction scores high.

Sometimes it’s the most trivial issues that seem to claim the most attention. But as a physician, the work you do has value, and your best work often takes time. Protecting your attention is critical. That’s why it's important to be able to focus on the things that really matter, and avoid getting dragged down into the weeds.

In thinking about the way you use your time, it can be helpful to consider the phenomenon known as bike shedding. The concept isn’t new, but it may be unfamiliar if you don’t hang out with business gurus. The term was coined by C. Northcote Parkinson, a British management expert and naval historian, in the 1950s. In introducing the idea of bike shedding, he described a committee meeting that is called to discuss a specific financial agenda. On the agenda is:

• a nuclear power plant costing tens of millions of dollars

• a bike shed for the plant costing a few hundred dollars

• a coffee budget amounting to about twenty-five bucks

The nuclear power plant is way out of anyone’s comfort zone, and no one wants to look ignorant or ask too many questions. So they quickly approve the budget and proceed to focus on the more familiar topic of the bike shed. After extensive discussion, argument, and finally compromise and agreement, they complete the deliberations over the bike shed with a feeling of satisfaction. They round out the meeting with an hour-long debate over the coffee budget, a topic on which they all have a strong opinion.

How Doctors Fall Victim to Bike Shedding

In a nutshell, bike shedding is a term used to describe the tendency to spend disproportionate amounts of time and energy on relatively minor issues, while neglecting more important but complex concerns. If you’ve spent any time in hospital committee meetings, you can probably relate to this phenomenon. Issues such as EHR functionality and staff management can sometimes fall into this category.

But bike shedding can also happen in your personal life. For example, you might spend hours researching the perfect running shoes, instead of focusing on your training plan. Or you might spend days agonizing over the color scheme of your living room, while putting aside more important but complicated family issues at home.

It’s natural to want to escape from stressful decisions by focusing on things that don’t really matter. And the importance of taking time to step away from the chaos of the day cannot be overstated. But spending that precious time perseverating over things that are not meaningful can be counterproductive.

The bigger problems are still looming. What’s worse, these are the issues that tend to build up steam the longer they are ignored. Eventually you may find that you are pushed or dragged into action, whether you feel ready or not.

From Spinning Wheels to Forward Motion

So how to shift gears and get back on the road? Here are some tips to help you identify and avoid bike shedding, whether at work or at home:

Identify your priorities

🚳What's most important to you? Once you know your priorities, you can make decisions more easily and avoid getting bogged down in trivial matters and unnecessary conflicts.

Delegate

🚳If you can delegate tasks, do it. Delegation is important both at home and at work. This will free up your time so you can focus on the things that matter most

Remember the big picture

🚳When you're feeling overwhelmed, take a step back. What are your long-term professional goals? What do you want to achieve in your personal life? How can you break that down into achievable steps? Keeping your goals in mind will help you to stay focused on the important things.

Set boundaries

🚳It's important to set boundaries so that you spend your time purposefully. This could mean saying no to extra work commitments with little upside so that you can make time for yourself and your loved ones. Or it could mean giving up your spot on the neighborhood committee that causes you stress and lost sleep, when you’d really rather be gardening.

It’s natural to default to bike shedding. It’s a way of avoiding stress and putting off difficult questions. But it's something that you can learn to recognize, navigate, and redirect.

If you find yourself getting caught up in bike shedding, tap the brakes and ask yourself if it's really worth your time and energy. If not, let it go and move on.

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.

Journaling Prompts for Physicians: Rediscovering Your Personal Life

In an earlier article, I explored the way that journaling can help you to reconnect with your inner wisdom, helping you to find a path forward when you feel stuck or uncertain. In that article, I delved deeper into the practical mindfulness of journaling, and the benefits of writing by hand, whether in a conventional notebook or a handwriting tablet .

Journaling has been called the “paper mirror.” It reflects back to you, the writer, what you might not see of yourself. Yet unlike a true mirror, the journal’s mirror is private and personal. Given this introspective aspect, it’s not surprising that studies of people engaged in journaling have reported evidence of improvement in both psychological and physical well-being.

Of course, journaling can also resurface unpleasant thoughts and memories. That’s not always bad. Some people find the safe space of their notebook to be a perfect container for catharsis. Getting the words out of your head and onto the page can be uncomfortable, but the process may allow you to let go of those thoughts and fears that are holding you back, freeing up mental space. If it feels right, you might even want to ceremonially destroy your journal once the “bad” stuff is out.

But if it feels overwhelming or resurfaces trauma that you’ve suppressed, then journaling may also be the nudge you need to begin working with a therapist who can help you process complex memories and emotions.

In this article, I am offering prompts that will give you space to dive into your life outside of work. Let them be a scaffolding that helps you to explore the ways that personal projects, family, and relationships might intersect in your life. By intentionally putting your thoughts on paper, you may uncover ideas for mindful action that begin to align these aspects of your life with your ideal self.

Exploring Family Through Journaling

1. How do I currently nurture my relationships with my family? What more could I do?

2. What values do I want to model for my family? How can I live those values more fully?

3. What are some of the most meaningful moments I’ve shared with my family recently? How can I create more moments like those?

4. If I could describe the ideal dynamic I want with my family in one sentence, what would it be?

5. Are there any unresolved tensions or conflicts in my family relationships? How might I approach them with compassion?

6. How does my professional life affect my family life, and are there changes I could make that might bring greater harmony?

7. What are some small ways I can show appreciation to my family this week?

Journaling to Strengthen Relationships

1. Which relationships in my life feel most nourishing? What makes them important to me? How can I deepen those connections?

2. Are there relationships that feel draining or misaligned with my values? What boundaries might I need to set?

3. What does a fulfilling relationship with a romantic partner look and feel like to me? How about a friend? How do my current relationships align with that vision? How can I create more of that?

4. When was the last time I expressed gratitude or love to someone important in my life? How did it feel?

5. Who do I turn to for support, and how can I show them appreciation for being there for me?

6. Are there people I’ve lost touch with who I’d like to reconnect with? What’s one small step I can take this week to reach out?

7. What qualities do I bring to my relationships that make them stronger? How can I lean into those strengths?

8. How can I better communicate my needs, desires, and feelings in my closest relationships?

Empowering Personal Projects

1. What personal project excites me the most right now? What about it feels important or meaningful to me?

2. Are there projects I’ve set aside that I would like to revisit? What’s holding me back?

3. How do my personal projects reflect who I am and who I want to become? Where might they lead me?

4. Is there a skill I’ve been meaning to learn, a book I want to read, a trip I want to take, or something else? What small step can I take this week to make progress on something that I care about?

5. If I had unlimited time and resources, what would I pursue? Why? How might that change my life?

6. How do my personal projects bring a sense of balance to my life, and how can I prioritize them more effectively?

7. What have I learned about myself through my personal projects? What strengths or interests have I uncovered?

Integrating Self, Family, and Community

1. How do my personal projects, family, and relationships influence each other? Are they in harmony or competition?

2. How might the personal projects that inspire me connect me more deeply with people who share my passions and values?

3. What would it look like to balance meaningful work, personal growth, and rich relationships all at once?

4. What’s one thing I can do this week to bring these aspects of myself into greater alignment?

5. How do I want the people closest to me to remember me, and what can I do now to honor that vision?

I hope this list has inspired you. In the next article in this series, I’ll provide you with a series of prompts that will help you go deeper into creating balance, fostering connections, reframing challenges, and envisioning the future.

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

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

Using the Language of Art to Create Work-Life Balance

An earlier version of this article was published on KevinMD.com in 2023

For most physicians, achieving work-life balance is a top priority. But what does balance mean? And is it even possible?

In this article, I propose that there is more than one way to conceptualize balance. Before we explore these new perspectives, it’s important to address a common alternative: the concept of work-life integration.

Because the concept of balance often feels unattainable, and perhaps even undesirable, some argue that “work-life integration” is the better term. This popular terminology implies that somehow work and personal life should seamlessly intertwine, one gently flowing into the other.

It’s a trendy buzzword in managerial circles, but for physicians, work-life integration is often not a choice—it’s a given. And between taking call, attending after hours committee meetings, slogging through the EHR, and making time for CME and recertification, what’s labeled as “personal time” often gets consumed by work-related demands.

That’s why the work-life integration construct for physicians often means no real boundaries at all.

In this model, work doesn’t just blend into your personal life—it takes over. And yet, the reverse is rarely possible. There may be no space in the work day for your own needs.

Let’s be honest: it’s rare that you can realistically bring family or personal responsibilities into the hospital or clinic. For most physicians, that’s neither practical nor desirable.

So where does that leave us? I believe that work-life balance—not integration—is still the better goal. But the way we think about balance is often flawed.

When we picture balance, most people imagine a seesaw or a perfectly balanced scale, where equal weight on both sides creates harmony. It’s a tidy image but one that’s unrealistic for most lives, especially for physicians.

Instead, there’s a deeper, more creative way to think about balance—one that borrows from the language of art. By embracing this alternative perspective, you will discover a dynamic and fulfilling concept of balance that can help you to create a more sustainable and happy life.

Before we go any further, it’s valuable to think about work-life balance as more than simply “work” and “life”. Work is an important part of life, and perhaps even a defining feature of the life you’ve chosen. But “life” isn’t just what’s left over after work. It can be useful to think about life as a array of different elements. Broadly speaking, these may include

• Family

• Friends

• Leisure

• Self-Care

• Anything else that’s meaningful to you

 Equalizing all of these factors our using traditional concepts of balance is virtually impossible.

But if we borrow the concept of balance from art theory, it all starts to make more sense.

 Concepts of Balance

In art, balance can be

• Symmetric

• Asymmetric

• Radial

• Crystallographic (Mosaic)

Let’s take a little detour into art theory so I can show you what this means.

Symmetric

• Think of the typical balanced scale, or a mirrored pair.

• This is the traditional way that we think of balance.

Thomas Nordwest, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

Asymmetric

• The perception of weight across the composition may be balanced, but each element has a different size or mass.

• This form of balance tends to create more interesting and dynamic images.

Radial balance

• This type of balance uses a central focal point

• Rays, spirals, or ripples radiate outward

Fragment, Peru c. 1000-1476 AD, Kate S. Buckingham Endowment, Art Institute of Chicago

Crystallographic (Mosaic) balance

• A large number of elements share equal weight

• There is no single focal point

Choosing Asymmetry

Any of these constructs may work for you. For many physicians, an asymmetric concept of balance can be especially useful. Think about the way you might create a rock garden. With asymmetric balance, you have wide latitude to play with different scale and elements. There is no exact formula, but you feel it when it’s right.

Compared to the symmetric form of balance, where both sides hold equal weight, asymmetric balance falls apart when the elements are too similar.

In asymmetric balance there is usually a dominant element, with the other components playing a supportive or bridging role. Often two smaller elements work harmoniously to balance a larger one. In an asymmetric painting like Van Gogh’s Starry Night, there may be some tension, but the image still feels complete.

Starry Night, Vincent van Gogh, 1889. Public domain, via Wikimedia Commons

Asymmetric balance can be interesting to play with. Moving one element often means that the others must also be moved in order to maintain a sense of harmony. This new configuration might strike a different, even unexpected, chord and create different relationships between the pieces.

When thinking about creating your own work-life balance, asymmetric balance may be a good starting point to consider.  As your priorities shift over time, your vision of balance may also change. At any time, you can rearrange the elements to make them work for you.

How do you begin to define your own work-life balance? Take another cue from the art world. Sit down with pen and paper and sketch it out in words or pictures. This form of reflection is a great way to get clarity on your own ideas so you can create your vision for the 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 coaching discovery session, click the button below.

References

Fallon-O’Leary, D. Work-Life Integration Is the New Work-Life Balance. Is Your Team Ready? CO. July 2021.

McManus, I. Symmetry and asymmetry in aesthetics and the arts. European Review, October 2005.

Meyer, I. Balance in Art – Exploring Different Types of Balance Artworks. Art in Context. August 2023.

Saley, C. Survey Report: Millennial doctors still finding jobs the old-fashioned way. CompHealth Blog. April 2018.

Vincent van Gogh, The Starry Night. MOMA.org , 2019.

Connecting With Your Inner Wisdom: A Journaling Guide for Physicians

With countless demands on your time and attention, it’s easy to lose touch with yourself as you slingshot from one task to the next. This can get you through the day, but after a few months, years, or maybe even decades of living this way, it can be difficult to find your way back to your true self.

I know this, because I experienced this sense of disconnection firsthand. From starting medical school in 1984, through decades of practice, I felt as if I was on a treadmill. I was constantly striving for the next level, whatever that was, and rarely taking a chance to pause or to celebrate. I stayed active, had hobbies and friends, but it all felt pretty frantic. As I began to contemplate my life after cardiology, I wasn’t exactly sure who the “real” me was, or what she wanted next. That’s when I began journaling as a regular practice.

As a full time cardiologist with a busy practice, my days and evenings were highly regimented, with little room to add on yet another task. I was getting nowhere with perseverating over what was making me discontent, and I knew that I needed a way to sort things out.

Journaling was something that I played with over the years, but the habit had never stuck. To be honest, the empty pages always felt a little daunting. So this time, I made a commitment to myself to spend just 10 minutes a day sitting with my thoughts.

The Power of Journaling: A Path Back to Your True Self

Every evening I would pose questions to myself, trying to unravel the knots that I had tied over the years, until I rediscovered the threads that could lead me to my next steps. And remarkably, the process worked! Through introspection and time, I developed a set of goals and a sequence of tiny little steps that got me farther than I ever could have imagined.

This article is the first in a three-part series. In each one, I’ll share a different collection of journaling prompts designed to help you to connect your own dots and rediscover what truly matters to you. Whether you’re exploring a new professional path, planning for retirement, or seeking greater happiness and satisfaction in your life, these prompts will guide you towards clarity and self-awareness.

Getting Started with Journaling

Journaling is a wonderful way to access your own thoughts and values, getting in touch with what matters most to you. It’s a form of mindfulness that doesn’t require any skills or knowledge. All you need is a pen and paper and as few as five minutes.

Why do I say pen and paper, and not a keyboard? Because research has convincingly shown that writing by hand is far more activating for the brain than typing. Newer devices that save and transcribe handwriting, like the reMarkable, may help to bridge the gap between analogue and tech. If writing doesn’t come easily, you could also experiment with dictation. Most important is that you find something that works for you and feels comfortable and natural.  

Journaling to Uncover Your Next Steps

This series of prompts will help you to reflect on your values and your sense of purpose, realigning the trajectory your life into something that feels resonant and clear.

For a kick start, if you haven’t already completed the Values Workbook, this is a great time to begin that exercise. You can get your free copy through my website.

Don’t feel as if you need to take on every prompt. There’s a lot to ponder here! Perhaps choose one or two for the week and see where it takes you.

Exploring Your Values

1. What do I value most about my role as a physician? Are these values reflected in my daily work and life? If not, what changes would need to happen in order for my values to be aligned with my work?

2. If I could describe the legacy I want to leave in one sentence, what would it be? How do I want people to remember me?

3. When have I felt most fulfilled in my career? What about those moments made them meaningful?

Clarifying Your Purpose

1. Why did I choose to become a physician? Does that "why" still resonate with me today? If it has changed, does it still feel true? And if not, what is missing?

2. What parts of my work energize me the most? How can I focus more on these aspects?

3. How does my work align with my personal definition of success? Where am I now in relation to that definition?

Evaluating Your Current Path

1. If my current career trajectory continued for the next 10 years, would I feel proud and content with my life?

2. What sacrifices am I making to sustain my current career path, and are they worth it?

3. Are there aspects of my personal life or passions that I’ve neglected? How can I reintegrate them?

Imagining the Future

1. If I could design my ideal work-life balance, what would it look like? What small steps could I take to get closer to that vision? What could I do today that would start to change things?

2. Imagine a day in your dream life. What are you doing, who are you with, and how do you feel?

3. What skills or interests do I have that I’m not currently using in my career? How might I incorporate them? And what skills do I wish I had? Are they important enough that I want to explore how to acquire them?

Confronting Barriers

1. What fears or doubts are holding me back from making a change I know I need? Are these fears grounded in reality? If so, is there something within my power to change?

2. Who or what am I afraid of disappointing if I follow my heart? How might I address that fear?

3. What is the worst that could happen if I pursued a career change or took on a new role? What strategies could I take to mitigate that? Are there other opportunities that outcome might open up for me?

Building Resilience and Courage

1. When have I faced significant challenges and grown from them? What strengths did I discover?

2. What does courage look like for me right now? How can I embody it in my decisions?

3. Who in my life inspires me to live authentically? What lessons can I learn from them?

Finding Alignment

1. Are there moments in my work when I feel disconnected from my authentic self? How can I realign?

2. How do I want to feel at the end of each day? What changes would help me experience that feeling more often?

3. What small, actionable steps can I take this week to bring more meaning into my work and life?

Cultivating Gratitude and Joy

1. What aspects of my career am I most grateful for? How can I focus more on these positives?

2. When was the last time I felt joy in my personal or professional life? What contributed to that moment?

3. What can I do today to make space for more joy and connection in my life?

In the next article in this series, I’ll share prompts to guide your exploration of personal projects, family connections, and meaningful relationships. The final article of the series explores journaling to envision your future.

If these prompts have been useful, or if you have some of your own that you’d like to share, drop me a line! I’d love to hear from you.

This post contains Amazon affiliate links. I may earn a small commission when you click on the links, at no additional cost to you. These commissions help to support the website.

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

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