Setting SMART Goals: A Guide for Physicians

If you’re a physician, you’re no stranger to goal setting. You wouldn’t have gotten to where you are now without setting some very specific and actionable goals.

But once you’ve made it through your training, landed a position in your specialty, and begun the process of living your own life, your goal setting muscle may have atrophied a little. What’s more, no matter where you are now and where you might want to be in the future, there’s no longer a prescribed set of steps to get you there.

If you seek growth or change, creating the map is up to you. Unlike the well-worn trail you may have followed in the past, the direction you will take is based on your own unique talents, interests, and visions. As Joseph Campbell warned, in his book The Power of Myth, “If the path before you is clear, you're probably on someone else's.” And starting this adventure begins with setting goals.

Choosing, planning, and carrying out your own goals can feel daunting. Whether professional, financial, personal, physical, or even spiritual, it can all seem like a lot. Where to start? And what can you expect along the way? As with so many other life skills, it’s likely that no one ever taught you how to set goals.

Fortunately, there’s a template that you can follow that breaks the goal-setting process down into clear and accessible parts. Innovators and movers in the business world have been using this tool for years, and it’s something that can work for physicians as well. In this article, I’ll walk you through the process of setting SMART goals that matter to you.

Defining and setting your goals will pave the way for your ultimate success. For instance, a study of medical students undergoing a surgical clerkship found that those who set clear and specific skill-related goals were more likely to get the outcomes they desired than those who just hoped for the best.  And goal setting may also reduce your cognitive load, meaning that you have exert less mental effort to get the work done.

Writing out your goals by hand is more likely to ensure that you stick to the process compared to typing them into a document or entering them into an app.

Give yourself an uninterrupted stretch of time to really think through the goals that you want to set, and the outcomes you hope to achieve. And then map it out using the SMART template. You may be surprised by what you’re able to achieve, and by what you discover about yourself along the way.

Specific

Get as specific as possible about your goal. As author Jack Canfield puts it, “vague goals produce vague results.”   Define your goal clearly and succinctly. It should be something that you can describe in one to two sentences.  

To make it clearer and more engaging, phrase your goal in positive terminology.  This has the added benefit of making it more likely that you’ll get it done. For example, instead of deciding you want to get out of an unhappy work environment, you might reframe this to a desire to get into a more fulfilling position.

Measurable

You should be able to objectively track your progress, whether that’s a checklist, a habit tracker, a set of numbers, or anything else that gives you a way to measure your efforts towards the goal.

Achievable

Choosing a realistic goal that is within your control is important, since you want to set yourself up for success. Choose a goal that requires a moderate stretch, but that you know is achievable.

The magic of the process is that once you reach that goal, other possibilities that are currently out of reach may open up. In the words of writer Joseph Campbell, “Follow your bliss and the universe will open doors for you where there were only walls.”

Relevant

Get in touch with your core values and ask yourself how this goal aligns with your personal vision. The goal should matter to you, not just to your friends, family, or administrators. It’s great if the goal will make everyone happy, but if it’s not your own, you’ll be less likely to commit to it.

Time-Bound

Unless you set a deadline, or a series of deadlines, you may find it hard to get started. That’s just human nature. When you set and commit to a target date, you’ll be more likely to bring your goal to fruition.

Once you’ve identified your goal, break it down into “micro goals” that you can complete within a very short period of time. This progress of completing will help propel you forward, keeping the momentum going.

Don’t forget to celebrate your wins, even the small ones. Calling a friend, going out for dinner, savoring a cookie, listening to music, or even taking a walk are all ways to honor the effort that you’re putting into the process.

Goal setting is naturally tied to effective use of your time. Looking at a big goal can seem daunting, but simply devoting ten to fifteen minutes several days per week can move you forward.

If you struggle with time management, I have a number of articles available on the website that may be helpful. They focus on issues that are specifically relevant to physicians and medical practice. If you’re looking for more guidance, my Four Week Focus Shift course is a self-guided way to find focus for the goals that matter. I also offer 3 and 6 month Time Management coaching packages for physicians.

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

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

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

References

Campbell, J., & Moyers, B. (2011). The Power of Myth. Anchor.

Doran, G.T. (1981) There’s a SMART Way to Write Management’s Goals and Objectives. Journal of Management Review, 70, 35-36.

Etkin, J. (2019). Time in relation to goals. Current Opinion in Psychology, 26, 32–36. https://doi.org/10.1016/j.copsyc.2018.04.013

Gardner, A. K., Diesen, D. L., Hogg, D. C., & Huerta, S. (2016). The impact of goal setting and goal orientation on performance during a clerkship surgical skills training program. ˜the œAmerican Journal of Surgery, 211(2), 321–325. https://doi.org/10.1016/j.amjsurg.2015.07.028

Locke, Edwin & Latham, Gary. (2002). Building a Practically Useful Theory of Goal Setting and Task Motivation: A 35Year Odyssey. American Psychologist. 57. 705-717. 10.1037/0003-066X.57.9.705.

Nebel, S., Schneider, S., Schledjewski, J., & Rey, G. D. (2016). Goal-Setting in educational video games. Simulation & Gaming, 48(1), 98–130. https://doi.org/10.1177/1046878116680869

Oscarsson M, Carlbring P, Andersson G, Rozental A. A large-scale experiment on New Year's resolutions: Approach-oriented goals are more successful than avoidance-oriented goals. PLoS One. 2020 Dec 9;15(12):e0234097. doi: 10.1371/journal.pone.0234097. PMID: 33296385; PMCID: PMC7725288.

Van Der Weel, F. R., & Van Der Meer, A. L. H. (2024). Handwriting but not typewriting leads to widespread brain connectivity: a high-density EEG study with implications for the classroom. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1219945

Optimizing Patient Flow: Time-Saving Tactics for Physicians

One of the biggest pain-points for physicians is the paucity of time allowed for patient visits in the office. Unless you own and manage your practice, it’s likely that someone else controls your schedule.

Despite these constraints, there are some fairly simple things that you can do to optimize the time that you have available.

By focusing your attention on taking care of your patients, empowering your staff to manage routine tasks, and automating some of your EHR processes, you may be able to free up valuable time. Over the course of the work day, these small gains can improve your ability to care for your patients, reduce your wait times, and end the day feeling more in control of your time and attention.

 Pre-visit Information Collection

• Assign your medical assistant (MA) to briefly gather basic symptoms, including duration and intensity, before you enter the room. This has the added benefit of making the MA a valued part of the care team.

• Have your MA ask patients to list their top three questions and concerns. This way, you can start with pertinent issues, and be aware of any unexpected concerns. This won’t eliminate the “by-the-ways” doorknob questions, but it can help.

• Review these issues before walking into the room so you are prepared and can direct the conversation appropriately.

Standardization and Checklists:

• Develop simple checklists for common diagnoses to help guide your patients through symptom description, potential treatments, and follow-up steps. This documentation may also help when it comes to pre-authorization.

• Use protocol and instruction lists for routine procedures, common surgeries, or testing to streamline the process and maintain consistency.

Efficient Communication Techniques:

• Make use of the Teach-Back Method to confirm patient understanding quickly by having them repeat back information about their diagnosis or treatment plan. It might take an extra minute or so, but you’re likely to save time in the long run by addressing misunderstandings at the outset.

• Implement closed-loop communication techniques to ensure tasks like tests ordered or referrals made are understood. In closed-loop communication, the person receiving information repeats it back to make sure the message is understood correctly, and the sender confirms to “close the loop.”

Technology and Tools:

• Utilize EMR templates and macros for common visit types to expedite documentation

• Recommend or create patient education resources to reduce time spent on common issues, reduce post-visit in-box messages and focus more on specific concerns.

Delegate Simple Tasks:

• Delegate routine prescription refills and diagnostic test orders to nursing staff or MAs to free up time for complex decision-making.

• Assign follow-up tasks, such as checking if a patient has completed a test or started a medication, to designated team members.

Optimize Scheduling Practices:

• If possible, incorporate short buffer times every couple of hours to handle any overflow or unexpected delays.

• Whenever feasible, schedule patients with similar needs in consecutive slots to minimize mental switch costs and preparation time.

Structured Patient Interactions:

• If possible, sit down facing the patient to create an impression of focus and interest.

• Begin each visit by asking the patient what they aim to achieve during the appointment, directing the conversation efficiently. This also lets the patient know that you are focused on their needs, and can help to build trust. Over time, that may also reduce unnecessary messages to your inbox.

While you may not be able to fully control your schedule, putting these strategies into play can significantly free up some of the limited time you have with each patient. As a result, you’ll enhance both patient satisfaction and the quality of your care. And ultimately, your own satisfaction may improve.

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.

Five Simple Ways Busy Physicians Can Save Time

Time is a precious commodity, but there’s only so much of it to go around. Your patients, your administrators, your family, your community—everyone wants some of it. With just 24 hours in a day, it may seem that there simply isn’t time to give everyone what they need, let alone take care of your own needs.

The reality is that, especially if you work in primary care, you might actually need 27 full working hours each day to get everything done that’s expected of you. And that’s before taking care of yourself, your personal relationships, and those who depend on you.

Ironically, despite your many years of school, training, and continuing education, you were probably never taught time management. Somehow it was just expected of you. Yet as the demands of medical practice have continued to rise, administrative burdens have increased and managing time is now critical to simply getting through the day.

Unfortunately, there is no way to magically manifest more time. You might be tempted, or even encouraged, to multitask. But it’s important to realize that you can truly only do one thing well at a time. In fact, an Australian study found a nearly two-fold risk of errors with multi-tasking.

As a Physician Coach with additional certification in Time Management Coaching, it’s been my experience that when you improve your time management skills, you’ll experience greater control and clarity over the direction of your life. You’ll strengthen your own well-being. And you’ll create the margin that you need to pursue your passions and reach the goals that matter to you.

Time management doesn’t have to be complicated or convoluted. Simply starting small can lead to big improvements.

In this article, I’ll tell you about five simple ways to reclaim wasted time. These are battle-tested strategies that served me well over many years as a busy cardiologist, and have helped many of my clients as well.

1.       Organize your physical and virtual workspaces.

Make it easy to find all the tools you need for your daily routine. Don’t forget to put them back in place at the end of the day to avoid having to hunt for what you need the next morning. As simple as it sounds, an organized workspace helps to set the stage for a well-ordered day.

Keep your computer files tidy as well, and organize your “smart phrases” in your EHR. Take advantage of any available technical support at work to make things run more efficiently. Developing a system that makes sense to you means less friction in your daily routine.

2.       Commit to only touching each piece of paper or emailonce.

Block time to tackle your virtual and real-life inbox, and complete whatever task is required before moving on to the next. Even a 5- 10 minute block can make a difference. Delete (or recycle) whatever is unnecessary, and organize your virtual and real-life inboxes.

Chances are you get dozens if not hundreds of emails daily along with piles of paper. Most of it is likely unnecessary and distracting, but other documents are time-sensitive and important. Organize your inbox so that your attention is focused on those more critical communications, and let the others drop into a secondary file or forward them on to someone who can take care of them.

3.     Get your charting done before moving on to the next patient.

When you do your charts as you go, you’ll remember the details that you need to make the note accurate, and you’ll be less likely to forget to include things like orders, refills, and instructions. Patients will appreciate it, and you may have fewer requests for clarification after the appointment. I learned this early on, and it made all the difference.

Consider using AI to help with your notes if a good system is available. A scribe (or virtual scribe) can also be a valuable asset. It can be a little tricky to get up to speed with your charting, but I promise it will save you time and aggravation if you can manage to do it efficiently. The next tip will help with this.

4.       Automate and delegate your common phrases and tasks.

Use smart phrases in your EMR for common scenarios. And do your best to stay out of the weeds by delegating administrative tasks to your office staff whenever possible. Make it easy for them to know what you need. Smart phrases can be helpful here as well. And when you empower your staff this way, they may feel more connected and engaged.

5.      Streamline Team Communications

Efficient communication with nurses, assistants, and other team members can significantly reduce time spent on back-and-forth clarifications and miscommunications. Establish clear, direct, and respectful communication. Take the time to create protocols to handle common situations that don’t need your direct input. This proactive approach can foster teamwork, reduce errors, and keep your patients happy.

If you’re like most physicians, you are probably pulled in many different directions at once. It should go without saying that healthcare systems need to step up and reduce the burden on physicians. In fact, there is growing recognition that the current demands on physicians are unsustainable. But meanwhile, if you can create a little more margin in your day, you may find that you reduce your stress and have a little more time to devote to your patients.

An earlier version of this article appeared on this site in October 2022.

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

Hodkinson A, Zhou A, Johnson J et al. (2022) Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis BMJ

Porter, J., Boyd, C., Skandari, M.R. et al. (2022). Revisiting the Time Needed to Provide Adult Primary Care. J Gen Intern Med (2022)

Westbrook JI, Raban MZ, Walter SR, et al. (2018) Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Quality & Safety

Stop Being So Hard on Yourself: Five Reasons To Celebrate Physicians

If you’re like many physicians, it may be easy to lose sight of your value. Healthcare today faces unprecedented challenges and stressors, and it’s sometimes hard not to take it personally.

Physicians in particular are some of the worst at self-flagellation. It’s common to feel frustrated and disappointed when you feel as if you haven’t lived up to your own ideals, or those that are imposed on you. Some days it can seem as if being a doctor is a thankless task. Doctor’s Day comes once a year, but your work is never done. So I’d like to share five reasons that you deserve to be appreciated and celebrated every day.

You Want to Do Good in the World

Medical practice is a field that naturally attracts individuals who are both highly intelligent as well as driven by a desire to impact the world positively. But wanting to do good and actually doing the work are two very different things. You do the work. Although your efforts may not always be acknowledged, your actions, big and small, directly affect the health and well-being of your patients and your community.

You Do Hard Things Every Day

Physicians face an array of challenges daily, from navigating complex medical and social issues to making life-saving decisions under pressure. On top of that, societal, economic, and administrative pressures may add levels of frustration that test your empathy and determination. The work of a physician requires an extraordinary level of resilience and fortitude, especially when, despite your best efforts, things don’t always turn out as you’d hoped or expected. It is no exaggeration to say that this level of commitment and grit far exceeds that of most other professions.

You Are Passionate About Your Work

Passion is the lifeblood of innovation and motivation. Physicians often pursue their profession because of a deep-seated passion for healing and discovery. This enthusiasm is often what spurs you to continually learn, grow, and push the boundaries of what is medically possible. Even on days where you feel less than enthusiastic, your years of focus and commitment drive you to do your best work.

You Come from All Walks of Life

Each physician comes to the profession with a unique array of backgrounds and experiences. Whether you come from a rural town or a large urban community, from a US metroplex or a country thousands of miles away, each physician carries a distinctive set of perspectives and skills. This diversity enhances your ability to connect with and care for a wide range of patients with a rich mix of cultures and viewpoints.

You Are a Change-Maker

Physicians are often at the forefront of change, not only in their clinics or hospitals but also in the broader context. Collectively, you have the power to initiate significant health policy reforms, improve patient care standards, and lead community health initiatives. What you do makes a difference in ways, big and small, that ripple out into the world.

As a doctor, you are not just a healthcare provider or a widget in a faceless system. You are a resilient, passionate, and dedicated professional committed to making the world a better place, one patient at a time. Most importantly, the work you do matters.

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

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

My Podcast Interview with Digital Diagnostic’s John Bertrand

Artificial intelligence is making its way into healthcare at a rapid pace. By harnessing its benefits while at the same time recognizing its limitations, we have an opportunity to improve and expand access to care for a wide range of people.

This was a thought-provoking podcast conversation with John Bertrand of Digital Diagnostics about the practical and potentially life-changing uses of AI for early detection of diabetic retinopathy. The beauty of the process is the fact that it can be used virtually anywhere, and does not require a highly skilled technician to acquire the data.

Getting Unstuck: How a Simple Mind Shift Can Move Your Life Forward

If you’re a physician, you’re probably juggling patient care, administrative tasks, and personal responsibilities like a boss. But when you feel the need for something beyond the daily routine, it can feel daunting.

Whether it’s getting up to speed with a new procedure, launching a research study, trying to get some time for self-care, or considering making a complete change of practice or location, it’s easy to feel like you’re stuck in an endless loop, unable to break free.

In my practice as a physician coach, I frequently encounter these common challenges. It can seem overwhelming from the inside looking out. But there is a way through, and it begins with understanding why you feel stuck.

In this article, I’ll explore common reasons that physicians feel immobilized, and I’ll offer you some strategies that will get you moving forward with purpose.

Break the Cycle of Repetition

Doing the same thing over and over, expecting different results, is not only the classic definition of insanity but it’s also a common trap. Whether it's procrastinating on completing notes, avoiding difficult conversations, or never saying no, these habits can perpetuate your feelings of frustration and stagnation.

Routine can be comforting, since you know what to expect, but it may also be a barrier to growth. When you’re caught up in an endless cycle of repetitive tasks, it’s easy to lose sight of what matters the most to you.

Strategy: Starting small can open up a crack that allows you to see a little more light. As simple as it sounds, begin by introducing small changes in your routine. This could mean taking a different route to work, setting aside just 10 minutes a day to walk or stretch, or incorporating new learning into your practice. Sometimes, the smallest adjustments can lead to significant shifts in perspective and outcomes.

Spring Free of the Inaction Trap

If you don’t take action, you will not get yourself unstuck. It’s that simple. But the fear of making the wrong decision often squashes the potential for change. That doesn’t mean it’s not important to think through your decisions. Be thoughtful and judicious, but don’t get stuck in an infinite cycle of analysis. Realize that taking action can mean taking the smallest of steps.

Strategy: Embrace the concept of ‘progress, not perfection.' Understand that inaction is a decision in itself, and it can be more harmful to your wellbeing and your future opportunities than making an imperfect decision. Start with very small, manageable actions that align with your goals and gradually increase the stakes as you build confidence.

Unaddressed Issues

Not dealing with problems as they arise means that they are given free rein to accumulate. Eventually these unresolved issues may begin to feel overwhelming. And as a consequence, this drag on your energy will make it harder to move forward. Whether it's patient care issues, administrative challenges, or personal matters, avoiding problems doesn't make them disappear.

Strategy: Commit to a proactive approach. Tackle important issues as they arise. You don’t need to solve every pressing problem on the fly. But by putting it in its place, it won’t be overlooked. That could mean delegating, scheduling committed time to address the issue, or even saying no. This not only prevents important issues from escalating but also builds a habit of facing challenges with purposeful action.

The Burden of Incomplete Tasks

Like unresolved issues, incomplete notes and tasks can be a significant source of mental load, leading to a feeling of being perpetually behind and unable to move forward. This is a very common issue for physicians, and one of the most important ones to get a handle on quickly. Your own well-being as well as your patients’ care depends on it.

Strategy: Get those notes done. Use templates, smart phrases, and any other resources available to you to make your notes concise, accurate, and useful. Prioritize and delegate the other tasks crowding your in-box. Addressing each task once and moving on, keeping your responses brief and succinct will help you get through your list. Consider adopting time management techniques, such as the Pomodoro Technique or time-blocking, to efficiently tackle your workload.

The Value Dilemma

Objectively, you probably know you’re valued. Despite the turmoil that many physicians face every day, your patients need you, and the work you do makes a difference.

But it’s easy to undervalue yourself, undermining your self-confidence. You’re not alone. Not believing in one’s own value is a common issue that affects how many doctors perceive their abilities and their worth. And as a result, you may miss opportunities, fail to stand up for yourself, put up with toxic working conditions, or take on projects that go against your won best interests.   

Strategy: Practice self-reflection and affirmation. Remind yourself of your achievements and the unique value you bring to your patients and the medical field. Journaling can be a very useful exercise. Keep a folder or a box with notes from patients and others who express appreciation and give yourself a few moments to revisit this when you’re feeling down.

Seek feedback from peers and mentors when you need it and consider engaging with a coach to build self-confidence and set achievable and meaningful goals.

Conforming to Expectations

Playing to other people's narratives is a common trap that can lead you down a path that doesn't align with your values or aspirations, leaving you feeling stuck in an unfulfilling or ill-fitting role. This is another theme that plays out for so many physicians. It often begins with family expectations, and it may eventually become a way of life.

Strategy: Define your own success. Take time to reflect on what success means to you, independent of anyone else’s expectations. Setting personal and professional goals based on your values and aspirations will ensure that your actions align with who you are and how you want to live your life.

Moving Forward

Feeling stuck doesn’t have to be a way of life. By understanding the underlying reasons and adopting targeted strategies, you can navigate your way out of the quicksand of stagnation.

Take the time to understand your value and remind yourself of the resilience that got you this far. Think of change as a catalyst. Create and then begin to implement a plan to take action, one step after another. Remind yourself that fulfillment is a process that can lead to unexpected growth and opportunities.

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

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

My Podcast Interview with AI Pioneer Dennis Cogan of Caresyntax

It’s no secret that artificial intelligence (AI) is rapidly becoming a powerful tool in healthcare and medical science.

As a TechLink Insights podcast host, I enjoyed this very forward-thinking and inspiring conversation with Dennis Kogan of Caresyntax, a company pioneering the use of AI in surgical practice.

It’s normal to feel uneasy about these new technologies. But AI is already here, and it’s up to physicians and others in healthcare to guide its implementation and develop reasonable safety rails to protect our patients. Having met with a number of pioneers in this space through the podcast, I believe that the future looks bright for innovations in care when AI is applied thoughtfully and collaboratively.

Why Should Healthcare Systems Invest in Coaching?

Changes in the administration of medical care have accelerated at a frenetic pace over the past decade, amplified by changes in practice ownership, healthcare law and COVID-19. With a few exceptions, the time of the solo practitioner, or even the single-specialty group practice, is well past. A recent report from Avalere Health noted that by January 2022, nearly three quarters of all US physicians were employed by hospitals or corporations, with a 19 percent increase over the preceding 3 years.

This consolidation of care comes with important benefits, including cost savings, ease of quantification and other metrics, and streamlining of care. Yet whether they intended to or not, large healthcare systems have also taken on an enormous responsibility for the satisfaction and well-being of their employed physicians.

Although healthcare administrators are a diverse group, and many have some background as healthcare professionals, they may not fully understand or embrace the qualities that lead individuals to pursue the life of a physician.

In general, physicians are highly intelligent, extremely motivated individuals. That’s individual with a capital I. Physicians are typically empathetic yet driven perfectionists. Many see their profession as a personal calling. While admirable, this may put them at risk for exploitation, since physicians with this mindset may find it difficult to say “no” to added responsibilities.

Recognizing these character traits makes it all the more concerning that in a recent survey, nearly half of physicians reported burnout in 2022, compared to about 25 percent in 2000. COVID is partially to blame, but so are systemic changes in healthcare, including less autonomy and greater documentation demands.  

Clearly, our healthcare systems bear a substantial responsibility for the amelioration and reform of many of these underlying factors. This includes workload, clerical and documentation burdens, and leadership culture.

How can coaching help?

Coaching is not the answer to burnout, but it’s an important tool. A study from the Mayo Clinic found that after 6 coaching sessions by credentialed coaches, the rate of burnout decreased by over 17 percent. In the control group, burnout actually increased by nearly 5%. And rates of emotional exhaustion dropped by nearly 20% in the coached group but increased 10% in controls.

Beyond addressing burnout, coaching can help physicians navigate the challenges of daily practice. Discovering the underlying causes of inefficiencies and working through time management practices with coaches may help physicians stay more organized and reduce wasted time. This in turn can improve quality of life for physicians as well as foster patient engagement, staff satisfaction, and timeliness of medical records.

Burned out, dissatisfied, and disconnected physicians are more likely to leave healthcare, which is expensive and disruptive for the system. According to the American Medical Association, it may cost anywhere from $500,000 to $1 million to replace one physician. And burned-out physicians may increase healthcare costs and decrease patient satisfaction. Ultimately this results in lost revenue and loss of social currency. More importantly, quality of care may also suffer and medical errors increase.

As hospital and healthcare systems navigate the years ahead, retaining high quality, satisfied, and engaged physicians will become increasingly important. An investment in coaching is a tangibly supportive and mutually beneficial use of resources.

Coaching alone won’t solve the problems facing healthcare. But when used as part of a comprehensive strategy to enhance physician well-being and streamline efficiency, coaching may ultimately improve patient care and satisfaction, enhance teamwork, and foster a happier, healthier medical staff.

An earlier version of this article originally appeared on this site in August 2022.

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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.

What if You Don’t Know What You Want Next: A Physician’s Guide to Finding Direction

As a physician, you've dedicated years of your life to the practice of medicine. You spend the better part of your waking hours staying current on the latest research, honing your skills, serving your patients with compassion and care, and collaborating with your colleagues and staff.

But, like many doctors, there may come a time in your professional trajectory when you feel a need for change and a yearning for something different. Maybe you feel stuck, unfulfilled, or underappreciated. Or perhaps you simply crave a change of scenery.

In this article, I’ll give you some strategies that will help you to gain clarity and direction when you’re not sure what you want next.

Sometimes the direction to take is crystal clear, but it can often be difficult to envision what that change should or could look like. From medical school to residency and beyond, your path up to this point has probably been clearly marked. As you reached one milestone, the next was likely in view.

It can be comforting to know where you are going next, but it’s not uncommon to find yourself longing for a shift in your professional life that doesn’t conform to the well-worn trail. Whether you're considering changing the way you practice, adjusting your working hours, exploring opportunities outside of clinical medicine, or even contemplating retirement, the uncertainty can be daunting.

Change is often uncomfortable and unsettling, especially when you’re blazing your own path. It's essential to remember that this feeling of ambiguity is a natural part of any career evolution. It’s easy to get stuck at this point, instead of recognizing that this period of contemplation is the first step in a new direction.

Although it’s important to think things through, I’m a firm believer in the adage that action creates clarity. Action however, does not have to mean commitment or a big shift. Giving yourself time and space to actively explore what is possible can make your next steps more clear.

If you’re feeling like you’ve come to a standstill, here are some ideas that can help pull you out of the rut and find some serious traction that will move you forward.

1. Reflect on Your Values and Goals

Take some time to reflect on what truly matters to you, both personally and professionally. What are your core values? Have you identified specific long-term personal and career goals?

Understanding what drives you and what you hope to achieve can provide valuable insight into the direction you should take. If you’re unclear on how to express your personal values, my Values Workbook can help.

2. Assess Your Skills and Interests

Consider your strengths, skills, and areas of interest outside of medicine. Are there particular aspects of your current practice that you enjoy the most? Are there skills you possess that you haven't had the opportunity to fully utilize? Or maybe you’re curious about acquiring new expertise.

Exploring these ideas can help you identify potential career paths that align with your strengths and interests. Don’t be afraid to consider possibilities that may not obviously relate to the practice of medicine. Simply asking yourself what lights you up may spark new ideas and connections. One exercise that can help you discover these connections is a mind map.

3. Seek Guidance and Support

Reach out to mentors and trusted colleagues. You might also choose to work with a coach. Sometimes, an outside perspective can provide valuable insights and help you see possibilities that you may not have considered on your own. While a coach will not tell you what to do next, a coach will help you uncover your own answers. That’s because coaching is a supportive process designed to accelerate your capacity to explore your options and take effective action.

4. Explore Your Options

If you're unsure about the specific direction you want to take, make some time to explore different opportunities and try out new experiences. This could involve taking a course or attending a meeting focused on anything that interests you, volunteering, traveling, or joining an organization or group that resonates with you.

These explorations don’t have to have an obvious connection to the practice of medicine. Experimenting with a variety of options can help you clarify your priorities and identify what intrigues and inspires you.

5. Embrace Flexibility and Adaptability

Your path doesn't have to follow a linear trajectory. It's okay to pivot, change direction, or investigate new opportunities at any stage of your life. Be true to yourself, but keep in mind that it’s always a good idea not to burn any bridges along the way.

When you embrace flexibility, you’ll often find unexpected and even surprising opportunities that may otherwise have gone unnoticed.

6. Take Small Steps

Thinking about a professional change can feel overwhelming, especially for physicians. More than most other professions, we often feel defined by the work that we do.

Remember that you don't have to have all the answers right away. Break down your goals into smaller, manageable steps, and focus on taking action consistently. Simply commit to just one small step at a time.

7. Practice Self-Compassion

Be kind to yourself as you navigate this process. It's normal to feel uncertain or indecisive when you’re facing an important change. Practice self-compassion and remind yourself that it's okay not to have all the answers immediately.

Trust in your abilities and know that by putting in the work, you will find your way forward.

As a physician, you have proven that you are resourceful, intelligent, compassionate, and hard working. By taking the time to reflect on your values and goals, seeking guidance and support, exploring and creating your options and opportunities, and embracing flexibility, you will stay open to possibilities, and you will find your way.

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.

Dressing to Inspire Confidence: My Kevin MD Podcast Conversation

On my recent podcast appearance with Kevin Pho, M.D., we talked about the way the clothes you wear can impact the way that you're perceived by your patients, your colleagues, and your staff.

For instance, are your administrators wearing scrubs? Probably not, because they understand the language and the power of clothing and presentation.

There is research on the way that physicians, especially women, are judged by the clothes that they wear. And whether we like it or not, clothing is an important signifier of professionalism to patients and family.

You don't have to be uncomfortable, feel restricted, or spend big bucks for a professional wardrobe. I'll tell you more in the article on the KevinMD website and on the podcast, including simple ways to incorporate professional attire.

Art, Meditation, and Medical Practice: Johannes Vermeer's The Geographer

Art therapy is often used to help to restore a sense of well being in people who are suffering from psychological stress or turmoil. We can experience similar benefits, while at the same time developing a deeper appreciation of our patients as fellow complex human beings, though the mindful experience of art.

Girl with Pearl Earring by Johannes Vermeer, ca.1665; credit Mauritshuis, The Hague

Johannes Vermeer was a Dutch painter in the 1600s. He is particularly known for his interior scenes that depict everyday life in his world. The Girl with a Pearl Earring is probably the most famous of his works. In 1999, a book by the same name, exploring the fictional life of the girl depicted, was published. In 2003, it was made into a movie.

 Sadly, Vermeer was not well recognized or appreciated during his lifetime, and he struggled financially. Vermeer died at the age of 43, leaving his wife with 11 children to care for. The cause of death is unclear, but it was said that stress played a role. Today, only 34 of Vermeer’s paintings are known to exist.  

As a physician, a fine art photographer, and a teacher of mindfulness, I am drawn to Vermeer’s paintings because of his strong connection to his subjects, and his emphasis on their humanity.

Johannes Vermeer, The Geographer, ca: 1669; Image credit Städel Museum, Frankfurt am Main

As a photographer, Vermeer's The Geographer calls to me for its almost photographic frame of reference. This is not surprising, given Vermeer's use of the camera obscura, an early form of photographic projection that creates an image on a wall. As in an un-posed photograph capturing a moment in time, The Geographer appears to be unaware of the painter, and engrossed in his thoughts.  

Vermeer uses the light and shadowing to shape the space of the gentleman's study, creating a strong left-to-right diagonal perspective. Diagonals are important in art, because they often suggest action and energy.

Your eye might first notice the illuminated face of the man, then it may travel from left to right as the line of the light echoes the diagonal of his desk, the movement of the shadow behind the cabinet and even the pattern of tapestry that is draped over the table. The instrument he casually holds in his hand repeats this same diagonal and intentional feeling. 

The Geographer's face is illuminated in much the same way as the globe above him, and his Japanese style robe tells a story of a man who has a wide and diverse experience of life.  

The colors in this painting serve to unify the composition and create a soft sense of boundary in which this man lives and works. The gorgeous oranges and blues, as complementary colors, create a lush and intimate feeling. We see them in his robe, the tapestry, the small chair in the background, and in the shade of the light entering the room.  

In color theory, blue evokes the mind, reflection, serenity, and the intellectual, while yellow is a color of creativity and confidence. The orange speaks of passion, but perhaps of frustration as well. And the soft brown conjures nature and quiet. 

The variety of textures in the textiles and furniture elevates the sense of intimacy and deepens the richness of these colors. There is a sense of balance between the foreground and the background, holding The Geographer in the middle of the painting, and setting him firmly in the world.

Experiencing art mindfully

Art can be a way to access mindful exploration. Sometimes this is called slow looking. You don’t have to be an expert in art or a mindfulness practitioner. Even just a few minutes with a work of art can allow your mind to clear and give you space to create a sense of connection to another human being. The Geographer is a perfect stepping off point for this kind of exploration.

To drop into a meditative mindset, allow the experience of Vermeer’s painting to guide you into a sense of tranquility and space. Notice your breath as you spend time with this work of art, paying attention to your slow inhales and exhales. Feel your body loosen, even just a little.

Of course, you don’t have to turn to the Old Masters to experience the meditative power of art. If you’ve ever lost yourself in a song, you know that to be true. Abstract art, photography, sculpture—all can be portals to mindful exploration.

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.

An earlier version of this article originally appeared on this site in July 2022.

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

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

My Podcast Interview with Tax Expert Alexis Gallati, MBA

I really enjoyed my conversation with Alexis Gallati, EA, MBA, MS Tax, CTS for TechLink Health. This was such a practical and well explained deep dive into tax strategies for physicians.

Alexis is married to a surgeon, so she has seen firsthand how little education most of us have in financial strategies, and how this lack of knowledge can hurt us and leave us vulnerable to bad advice.

This podcast addressed financial strategies related to side gigs, managing independent practices and more. Alexis is an engaging speaker and shares a wealth of practical insight.

From Conflict to Collaboration: Overcoming Challenges with Your Staff

As a cardiologist in practice for nearly 30 years, I was fortunate to work with a fantastic team of nurses, medical assistants, and office staff. I give much of the credit to our no-nonsense in-house nurse manager. But not all physicians are so lucky. And even one bad apple can make going to work a miserable experience.

Although medical training involves teamwork, it’s uncommon for physicians to learn managerial or business skills during medical school or residency. If you’re learning on the job, getting off on the right foot can impact your experience at work for years to come.

Until my practice was acquired by a larger organization, I served as chairman of our Human Resources (HR) committee for a number of years. So if you’re a physician dealing with challenging staff members, I’ve got some expert tips and insight to help you get to the other side of this common problem.

First, a little perspective. In years past, most physicians owned their practices. So in these situations, the physician or a trusted administrator typically did the hiring and firing. And the staff understood that keeping up good relations with their physician-employers was vital to maintaining happy employment. Now that most physicians are themselves employees, the relationships have become more muddied. And the truth is that depending on your organization, you may or may not have much say in the way the practice is run.

Be that as it may, as a physician, your leadership is crucial to maintaining a good working environment. Whether it is implicitly stated or not, your staff should understand that their job is to support the work that you do. And ultimately, that means providing optimal care and a supportive experience for your patients.

Whether you’re employed or not, your patients depend on you for your expertise and your care. Your employment status is irrelevant to them, and they view your staff as an extension and a reflection of you. That means that if the practice feels chaotic and uncomfortable, your patients are likely to feel unsafe and unwelcome.

It’s likely that most of your staff will appreciate a physician who is kind, principled, and clear. Most people who work in healthcare take pride in their jobs and care about the people they serve. But unfortunately, you can also expect to encounter some difficult folks along the way.

To maintain your sanity, your ability to provide care for your patients, and your role as a team leader, it’s important to have a clear plan for dealing with troublemakers.

Some people may be negative or disruptive, others may be passive-aggressive, and some may simply be incompetent. You may even encounter employees who delight in getting you upset. Regardless of the type of difficult staff member you are dealing with, rule number one is this: do your best to remain calm, cool, and professional at all times.

When dealing with the inevitable conflicts and other tough situations at work, here are some important things to keep in mind.

• Don’t make it personal

Although it can be tempting to let your emotions take over, the minute you make it personal, the problem becomes about you. This can be very difficult if not impossible to turn around. By keeping it professional, you have a much better chance of remaining above the fray.

• Consider involving HR:

If you have access to an HR staff member or administrator, and you feel reasonably confident that they will support you, it’s best to involve them early on in a difficult situation. This can help to protect you from accusations of harassment or favoritism.

When you try to go it alone, especially as a new physician, there’s a good chance you will end up making some important missteps. Never underestimate the power of a passive-aggressive or disgruntled employee to undermine your reputation. In the worst cases, this could mean the loss of your own job.

• Document everything

Documentation is not necessarily to get the employee in trouble. You’re documenting in order to protect yourself.

Be sure to include the specific behavior that is causing the problem, the date and time of the incident, and any steps that you have taken to address the problem. It’s a good idea to make a note of any witnesses as well.

• Try to understand the root cause of the behavior

Although your practice’s administration is likely responsible for managing the employee and their disruptive behavior, getting a handle on the behavior and its root cause may be helpful. Once you understand this, you may start to develop a plan to turn things around.

For example, if a staff member is negative and disruptive, it may be because they are feeling overwhelmed or undervalued. That doesn’t mean that you need to acquiesce to their demands or accept the behavior. But understanding what might be contributing will make it feel less personal. It may also give you insight into the path forward. And armed with this information, you may be able to work more collaboratively with your administration.

• Be direct and honest. 

If your administration takes a hands-off approach, it may be left up to you to manage the issues. This is often the case for minor procedural problems, lack of education, and misunderstandings.

When you address the problem with the staff member, be clear, calm, and truthful. Avoid being confrontational or accusatory. Instead, focus on the specific behavior or issue that is causing the problem and how it is impacting the workplace.

Consider having a trusted colleague or nurse present for the discussion. That will help to protect you from any undue accusations.

• Be prepared to offer a solution

It may be necessary to work directly with the staff member to resolve the problem. For example, if a staff member is struggling with a particular task, it may be up to you to provide them with additional training or support.

Set clear expectations and provide regular feedback. Sometimes these individuals become the most loyal employees, if they understand that you are on their side.

• Be supportive and encouraging

The process works both ways. By contributing to a work environment where your staff members feel valued and supported, you are more likely to be listened to and treated with respect.

• Be fair and consistent

Treat each of your staff members fairly and consistently. Avoid favoritism and keep your personal life separate. When you spend most of your life at work, it may be tempting to see your staff as friends. This is a pitfall that many early career physicians fall into. Over time this can create divisions and expectations that will only make things more difficult for you.

As a physician, you have the right to expect a positive and productive working environment. If a staff member is making it challenging for you and others to do your jobs, it’s critical to take the necessary steps to address the problem. Whether that means involving administration, providing additional training opportunities, or even terminating the employee, embodying a calm and professional leadership style will help to ensure a safe and supportive environment for you, your staff, and your patients.

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

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

My Podcast Interview with Health Tech Expert Shanil Ebrahim

Shanil Ebrahim is on the cutting edge of healthcare technology, with expertise not only as a scientist but also with meaningful experience in the fields of AI and health equity. His insights are timely and thought provoking.

As a frequent host of the TechLink Health podcast, it's always such a pleasure and a privilege to meet with leading innovators in the health and tech space. The industry is moving at warp speed, and it's great to have a front row seat!

You can listen to the podcast at TechLink Health as well as Spotify and Apple Podcasts.

Managing Uncertainty as a Physician

Uncertainty is a fact of life if you are a physician. Patients don’t always get better, there is not always one best choice or right answer, and sometimes our decisions are affected by factors that are completely out of our control.

Managing uncertainty is a skill set that doesn’t come easy for many of us. Perfectionism is likely a way of life, and to be truthful, that’s not always a bad thing. We want to do the best for our patients, we want excellent outcomes, and we want to be acknowledged for the care we provide. But when we set unrealistic standards, it can actually be a barrier to optimal care and to our own well-being.

A recent study examined the connection between tolerance for uncertainty and burnout in 2000 faculty physicians. Not surprisingly, intolerance for uncertainty was associated with a three-fold increased likelihood of burnout.

As you might expect, those who struggled with uncertainty were much less likely to be satisfied with their career, and tended to be less engaged at work. Factors that correlated with a greater intolerance of uncertainty were

• Female gender

• Primary care

• Earlier stage of practice

• Lack of a trusted advisor.

Although these were important risk factors, many men, specialists, and later stage physicians were also burdened by intolerance of uncertainty.

Burnout and physician unhappiness are crucial pain points in our current healthcare environment. Not surprisingly, stress from uncertainty correlates with depression and low levels of resilience. Intolerance of uncertainty has been linked to poorer outcomes and even to increased healthcare costs. And burned out physicians are more likely to leave the practice of medicine.

Our innate perfectionism combined with the prevailing medical culture of stoicism means that physicians may be reluctant to admit that they are dealing with uncertainty. This makes it all the more important for more senior colleagues and mentors to acknowledge that despite all we know and no matter how hard we try, uncertainty will always be a part of the life of a physician. Simply sharing that insight can make it a little easier to come to terms with the fact that we cannot control everything.

Although becoming comfortable with uncertainty may always be a challenge, managing your response to uncertainty can open up opportunities to react to life’s curve balls in ways that are both positive and beneficial to all involved.

In their thorough analysis of the issue, Samuel Reis-Dennis and colleagues describe “three corrective virtues” that might help physicians navigate the challenges that uncertainty creates. These include:

• Courage: avoiding the tendency to run away from threats by developing strategies to cope with new challenges

• Diligence: seeking guidance from trusted colleagues and staying current on the medical literature

• Curiosity: addressing uncertainty by viewing it as an opportunity to learn and grow

It’s not an easy task to recognize the factors that may be holding you back. And it’s even more difficult to be objective and to find your own way while living the unpredictable and demanding life of a physician. Medical schools are increasingly understanding the importance of teaching these skills, but it’s not always enough once you hit the real world. Working with a coach or trusted advisor may help to get you on track, discovering the solutions and opportunities that best fit your needs.

An earlier version of this article originally appeared on this site in July 2022.

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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

Allison, J. J., Kiefe, C. I., Cook, E. F., Gerrity, M. S., Orav, E. J., & Centor, R. (1998). The association of physician attitudes about uncertainty and risk taking with resource use in a Medicare HMO. Medical decision making : an international journal of the Society for Medical Decision Making

Begin, A. S., Hidrue, M., Lehrhoff, S., Del Carmen, M. G., Armstrong, K., & Wasfy, J. H. (2022). Factors associated with physician tolerance of uncertainty: an observational study. Journal of general internal medicine

Berg, S. (2020). Feeling burned out? Try picking up the phone to call your coach. American Medical Association

Cook, J. (2022). Forget resilience, improve your uncertainty tolerance. Forbes

Iannello, P., Mottini, A., Tirelli, S., Riva, S., & Antonietti, A. (2017). Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians. Medical education online

Reis-Dennis, S., Gerrity, M. S., & Geller, G. (2021). Tolerance for uncertainty and professional development: a normative analysis. Journal of general internal medicine

Simpkin, A. L., Khan, A., West, D. C., Garcia, B. M., Sectish, T. C., Spector, N. D., & Landrigan, C. P. (2018). Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study. Academic pediatrics

Sinsky, C. A., Brown, R.L., Stillman, M. J., & Linzer, M. (2021) COVID-related stress and work intentions is a sample of US health care workers. Mayo Clinic proceedings

My Podcast Appearance with Kevin MD on Meditation and Mindfulness

I enjoyed my recent conversation with Kevin Pho, M.D. We discussed how mindfulness can have far-reaching effects not only for yourself, but for those you care for. We also discussed the best times for meditation, when you might want to avoid it, and how a brief meditation can impact your sense of well-being.

As a physician coach, I love sharing this story, because it encapsulates how such a simple and brief practice can have a meaningful impact.

Despite often heavy-handed corporate efforts to the contrary, mindfulness is not a bandaid to fix all that is wrong with healthcare. And it’s not a substitute for the meaningful change that is so desperately needed. Instead, it’s a reminder to be present and engage with what is happening right now, without judgement or reactivity.

Through mindfulness, you are can find a way to take a moment in the middle of the daily storm to re-center and reset. And for physicians, that can go a long way towards building stronger relationships with patients and staff based on trust and respect.

HALT: A Self-Coaching Stress Management Tool for Physicians

As a physician coach specializing in burnout and professional transitions, I've seen firsthand how the current state of healthcare can push even the most resilient doctors to their limits. Unchecked anger, frustration, and passive aggressive behavior can often be symptoms of the times.

By now you probably know that burnout is not your fault. Nor is it a mental health issue. Instead, it’s the consequence of a broken system.

At the moment, this is the system we are living in. While some headway is being made, the forces that are driving the burnout epidemic are not likely to improve overnight. And while it can be tempting to lash out when you’re stressed, it’s likely to make the situation worse, straining your relationships with colleagues, staff, and patients.

Beyond burning your bridges, the effect that an emotional outburst can have on your own well-being is profound. What’s more, healthcare systems are cracking down on behavior that’s deemed inappropriate or unprofessional.  

Although you didn’t cause the problem, it’s important that you remain mindful of the far-reaching implications of your communications and actions, regardless of the high quality of care that you provide.

To get you back on track, the simple acronym "HALT" – Hungry, Angry, Lonely, Tired – can be an important tool for self-awareness and self-care.

HALT was originally developed by David Streem, MD, a psychiatrist and addiction specialist, as a reminder to stop and identify the triggers that might lead to a relapse.  But for physicians, the acronym is also an intuitive tool that can remind you to mindfully take a pause and check in with how you’re feeling, and why, when something or someone triggers a reaction.

By using HALT, you can slow your roll before impulsively acting in ways that might harm your personal and professional relationships.

Here's how HALT works:

Hungry

When you're hungry, or “hangry”, even small problems can feel overwhelming. Hunger can make your patience wear thin and your trash your tolerance for stress and difficult interactions.

If you’re like many physicians, being hungry may be your default mode. Although it shouldn’t be the norm, it’s painfully common for physicians to skip meals or eat irregularly due to hectic and overbooked schedules.

Junk food from the snack machine or physician’s lounge might fill you up, but it can make you feel even worse. One straightforward strategy that can help is to pack simple but healthy food for the next day each evening.

But hunger isn't just about food. It's often about other unmet needs, whether emotional, physical, or intellectual.

Take action on hunger by getting in a 10–15-minute break to reset your mind and body once or twice daily whenever possible.  You’ll probably find that when you fill up the tank, even out your blood sugar and slow down your sympathetic nervous system, you’re able to maintain a more balanced mood and energy level.

In the long run, the few minutes you set aside to care for yourself will pay off in more respectful relationships, improved productivity, and better health.

Angry

Anger is a natural emotion, but how you handle it in the workplace is crucial. Unchecked anger can lead to conflicts with colleagues and unpleasant meetings with administrators. When it carries over to the bedside or operating room, it may impact the doctor-patient relationship, undermine teamwork, and even affect patient care.

Become aware of this emotion, and how it feels in your body. When you find yourself getting angry, take a moment to pause and step back. Give yourself time to process, reflect, and move on.

Deep breathing, a short walk, or even bluntly but respectfully discussing your feelings with a trusted colleague can open up a fresh perspective and prevent words and actions that you’ll regret later.

Lonely

If you’re feeling lonely, you may react harshly to stress out of a sense of isolation. Although you’re likely surrounded by people all day, medicine, our profession, ironically, can be a lonely one.

The burdens of responsibility, the fear of making mistakes, the ever-present perception of competition, and the need for confidentiality can all leave physicians feeling isolated.

Acknowledging loneliness is the first step towards seeking connection.  Regular interaction with friends, family, and community, even if brief, can hold back isolation and create a sense of belonging. Finding a hobby that gets you out of the doctor mindset or working out with a group of like-minded people can help as well.

Tired

When you’re tired, everything just feels harder. It’s no surprise that fatigue is a common issue among physicians. Long hours, high stress, and fractured sleep while on call mean that more than 40 percent of doctors surveyed report that their work schedule simply doesn’t allow for adequate sleep.

Chronic tiredness can impair your judgment and your empathy. Although it can be hard to feel compassion for your staff and others though the fog of fatigue, noticing what’s driving your irritation can soften your reaction to stress.

How to Use HALT in Your Daily Practice

• Check In: Before reacting, run through your HALT checklist. This simple pause can reset your frame of reference.

• Be Proactive: Make time for healthy meals, use brief but meaningful stress-relief techniques like mindfulness, get regular exercise, cultivate a life outside of work, and do your best to get restful sleep.

• Seek Support: Don't hesitate to seek professional help if you're struggling with anger, loneliness, or fatigue. Therapy, coaching, and peer support groups can all be helpful, depending on your circumstances.

• Communicate with Colleagues: Foster an environment where it's safe to respectfully express what you’re feeling. This openness can build stronger, more supportive team dynamics.

When you’re feeling reactive, upset, or tempted to lash out, use HALT to take a pause. Are you Hungry, Angry, Lonely, or Tired?

Simply becoming aware of your inner state can help you to defuse a situation and craft a different response. It’s also a great reminder that caring for yourself is neither selfish nor optional if you want to work at your optimum.  

When you take care of your own needs, you’ll find that you will be better equipped to care for those whose lives and well-being depend on you.

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

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

Coaching for Physicians: A Guided Journey to Goal Setting, Overcoming Obstacles, and Finding Fulfillment

If you’re curious about physician coaching, and want to know more, this article is for you. As someone who loves getting outdoors, I like to use the metaphor of a hike or journey when describing my coaching process. In this coaching journey, I serve as your experienced companion, providing support, insight, and encouragement, helping you navigate both familiar and new terrain, and celebrating with you as you discover your destination.

1. The Trailhead: Preparation and Goal Setting

 Just like preparing for a hike, the first step in coaching is to understand where you are right now and where you want to go. This involves an in-depth assessment of your current professional and personal landscape, identifying both the peaks (successes) and valleys (challenges) you face. Whether you’re dealing with burnout, challenges with time, professional transitions, or finding the right work-life balance, together we’ll set specific and achievable goals. You can think of this as choosing the right trail that aligns with your current fitness level and hiking experience. Don’t worry if this is all new to you. You may be surprised at the ways your strength and endurance will naturally grow along the way.

 2. Gathering Gear: Equipping for the Journey

After setting the goals, the next step is to equip you with the necessary tools and skills. This includes exploring techniques for time management, stress reduction, and effective communication. Similar to choosing the right gear for a hike, these tools are personalized to fit your unique needs and circumstances, ensuring you are well-prepared for the journey ahead.

3. The Hike Begins: Embarking on the Journey

With goals set and tools in hand, we begin the coaching journey. This phase is about action and moving forward. Regular coaching sessions serve as checkpoints, where we assess progress, celebrate achievements, and address any new challenges. The journey may involve steep climbs and unexpected obstacles, but with guidance and support, you keep moving towards your goals. 

4. Difficult Terrain: Navigating Challenges:

Just as a hiker encounters rough patches along the trail, you may face challenges in your professional journey. Burnout, difficult workplace dynamics, and balancing personal life are common terrains we navigate. Together, we develop strategies to overcome or get around these obstacles, building strength, creativity, and adaptability, much like a seasoned hiker learns to navigate through challenging paths.

 5. Scenic Views and Rest Stops: Reaching Milestones

Along the way, it’s important to recognize and celebrate milestones. These are like the scenic views or rest stops on a hike, offering a pause to appreciate how far you’ve come, recharge, and reflect on the journey. Although it’s tempting to keep pushing forward, these waypoints are crucial for maintaining motivation and perspective.

 6. The Evolving Trail: Continued Growth and Adaptation

The journey doesn’t end at the first summit. Like a trail that changes with the seasons, your professional life will continue to evolve. Ongoing coaching can help you adapt to these changes, develop new goals, and continue growing. The journey is continuous, and as your coach, I am there to guide, support, and celebrate with you every step of the way.

 7. The Lookout Point: Reflection and Forward-Thinking  

As you reach significant milestones, we’ll take time to reflect on the journey. From this vantage point, much like a lookout on a hike, we’ll assess the path taken, lessons learned, and obstacles overcome. From there, we’ll plan for the next phase of your journey. Together we’ll chart out the travels ahead, including strategies for keeping burnout and inertia at bay. As you move into the future, you’ll be empowered and well equipped to stay engaged, inspired, and energized.

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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.

How to Find Your Creative Spark: A Guide for Physicians

As physicians, we learn to practice from an evidence-based standpoint, checking the data, keeping up with the literature, and following carefully researched guidelines. But as crucial to good patient care as this is, providing the best care requires the ability to go deeper, connecting a series of disparate dots, asking probing questions, and creating trust.

Having your own creative practice can stimulate this stronger connection by giving you tools and insights that come from a less rigid view of the world. It’s not suprising that a British study found that people who engaged in creative activities at home were more likely to discover creative solutions to problems at work.

And at the same time, creativity can be a refuge, offering an escape and a form of mindfulness that is often difficult to access in our precision-driven world.  

You don’t have to have talent or special skills to begin a creative practice. It can be something that you do for yourself alone. But once you get started, you may find that your imagination awakens, opening your mind to new techniques and ideas that might never have occurred to you if not for this artistic exploration.

In this article, I’ll discuss how you can awaken and nurture your inner artist.

1. Just Get Started

Do the work. It sounds simple, but overcoming inertia can be the hardest part. You don’t need a grand plan, a fancy camera, or a fully equipped studio. Just begin and set the wheels in motion. Your first step doesn’t have to be perfect; it just has to be taken.

2. Embrace Imperfection

Check your perfectionism at the door. For people immersed in the creative arts, imperfection is not just accepted; it’s often celebrated. Express, explore, and learn. Give yourself the freedom to make mistakes and be messy. This is a crucial part of the creative journey, and it’s how new ideas are generated.

 3. Inspiration Appears While You’re Working

Waiting for inspiration is like waiting for the perfect moment – it rarely comes when you're idle. To borrow a phrase from mindfulness meditation, creativity is about being in the now. As Picasso is famously quoted, “Inspiration exists, but it has to find you working.” The muse, that elusive spark of creativity, is not impressed by your aspirations. She finds you when you’re in the messy midst of creation. 

4. Set Aside Time for Creativity

Schedule your creative time just like you would for any appointment. Whether it’s 30 minutes a day or a few hours once a week, having a dedicated slot for creativity can open windows in your mind and give you room to explore. If it feels overwhelming, commit to simply 10 minutes each week, and see where that takes you.

5. Explore Different Creative Avenues

Creativity means different things to different people. You might enjoy writing, while someone else might find solace in painting, dancing, or playing an instrument. Simply wandering around intentionally with your phone’s camera can be a form of creative play. If you have time, taking a weekend class in pottery or some other art form could be a fun place to start. If you’re not sure how to start, experiment with different forms of creative expression to find what resonates with you.

6. Join a Creative Community

There's something magical about being part of a community that shares your passion. Look for local art classes, writing groups, photography clubs, or online forums. Share your work, get feedback, and enjoy the collective creative energy. These communities can offer support, inspiration, and a sense of belonging. And unlike your practice as a physician, no one will expect you to be perfect or have all the answers.

7. Pause, Reflect and Adjust

Every now and then, take a step back and reflect on your creative journey. Stay curious. What have you learned? What do you enjoy the most? Where has your creativity taken you? You might choose to keep a creative journal to celebrate your milestones, explore the unexpected detours, and maybe even recalibrate your goals.

Integrating creativity into your life isn’t just about producing something; it’s about the process, the joy, and the journey of self-discovery it brings. It can be a form of meditative practice, and an escape hatch from the rigidity of a schedule and a task list.

As a physician, you have a unique perspective of the world, shaped by your experiences and the people whose lives you’ve touched. Infusing this perspective into your creative endeavors can lead to something unexpected, tangible, and uniquely yours. By exploring your creativity without self-judgment, you may find that the insights you discover enrich and deepen your relationships with others, including your loved ones, patients, and colleagues.

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

Physician Stress and Burnout: How Mindful Coaching Can Help

Physician burnout is not a new phenomenon, but over the past several years, it has become a true epidemic. In 2021, 930 academic papers were published on the topic, compared to 129 in 2011. In 1984, the year I started medical school, a total of 4 articles can be found in the PubMed archives.

Today burnout is out in the open. But the tools to manage and prevent burnout remain elusive.

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 individuals who work with other people”, with symptoms including:

• Emotional exhaustion, feeling unable to give more of yourself

• Depersonalization, resulting in negative or cynical attitudes towards patients

• Reduced sense of personal accomplishment, meaning a tendency towards negativity towards your own accomplishment.

It’s important to understand that burnout is not a psychiatric disorder, but rather it is “ a normal response to a chaotic and stressful environment”.

Many of us have experienced these feelings from time to time, and that’s completely normal. But when these feelings are persistent and overwhelming, then it’s likely that you’re dealing with burnout.

In a 2022 survey, Medscape found that 47% of physicians reported burnout, up from 42% in 2021. Not surprisingly, Emergency Medicine and Critical Care reported the greatest burnout (60% and 56% respectively), but Ob-Gyn (53%), Infectious Disease (51%) and Family Medicine (51%) were close behind.

Women reported more burnout (51%), perhaps due to competing responsibilities at home which were aggravated by the pandemic. But more than a third of men were also affected.

The contributors to burnout reported in the survey are not surprising to anyone in healthcare. Topping the list:

• Bureaucratic tasks

• Lack of respect

• Long hours

• Lack of autonomy

These features are nearly identical to the six factors associated with workplace stress that were 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

Beyond making you miserable, stress and burnout affect your quality of life, your self-confidence, your relationships at work and at home, and perhaps even your patient care.

Sometimes it feels as if everyone is talking about stress and burnout, but nothing is being done about it.

Although mindfulness has been shown to be effective in mitigating the symptoms of stress and burnout, it feels disingenuous to tell physicians to get a grip by practicing yoga and meditating.

Clearly, we are not going to yoga our way out of this mess. And hospitals and healthcare systems need to do more than offer lip service. But in the meantime, a little mindfulness may help. Here’s how:

First let’s start with a simple definition of mindfulness. As a certified Mindfulness Meditation Teacher, I’ve been fortunate to learn from Sean Fargo, a former Buddhist monk and gifted teacher. Sean defines mindfulness as “paying attention to the present moment with curiosity and non-judgment”. In other words, simply being present.

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

As it turns out, there have been a number of studies in recent years that were designed to answer just this question. A meta-analysis of six high quality randomized controlled studies of mindfulness interventions for medical students, published in 2020, reported substantially lower stress indices in students who participated in the programs.

These programs incorporated interventions that included

• Body scanning

• Awareness of thoughts and emotions

• Breathing exercise

• Walking meditation

• Sitting meditation

• Coping with stress

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

Not only did stress scores improve in the short term, compared to controls, but studies that reported six-month follow-ups found that the benefits of mindfulness teaching persisted.

Coaching is another effective strategy for physicians at all stages of professional life. Although it is no substitute for system-wide change and mitigation of the issues that lead to burnout in the first place, coaching can help physicians gain traction and make decisions that help them to reclaim their connection to the profession.

That can range from important changes that create a better work-life balance in the current setting to a move to a new position or workplace. In some cases, a coach may work with a physician who decides to leave the profession altogether.

Research supports the role of coaching as a powerful tool for physicians at all stages. A small study from Duke University included primary and specialty care physicians ranging from first year residents to more senior physicians with leadership roles. The program focused on coaching for physician well-being, and reported improvements in coping strategies, resilience and stress.

Regardless of the specific modality or focus, physician coaching as an intervention has clearly been linked to improvement in well-being and resilience. A 2019 randomized controlled trial of primary care physicians in the Mayo Clinic system looked at the effects of 6 telephone coaching sessions on

• Burnout

• Quality of life

• Resilience

• Job satisfaction

• Engagement

• Meaning at work  

After 6 professional coaching sessions by credentialed coaches, the rate of burnout decreased by over 17% in the coached group but increased by nearly 5% in the control group. And absolute rates of emotional exhaustion dropped by nearly 20% in the coached physicians but increased about 10% in controls.

Coaching is a powerful tool. Mindful coaching may help physicians manage and overcome the effects of the sometimes-overwhelming forces that impact them and, indirectly, their patients on a daily basis.

But most importantly, addressing and repairing the underlying sources of burnout and stress is paramount. This is a commitment that needs to come from the highest levels of our healthcare systems.

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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

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