Below are the episode show notes and transcript. Some episode transcripts have been edited more than others, but they are up in the meantime to help those who would rather read and for searchability on the web. Extensive editing has not been prioritized as I seek to both produce regular content and maintain my own wellness. Enjoy!

Show Notes

Ever feel like medicine is out of control? That if you stayed on the same course, you would end up in burnout?

Come hear how three simple things can help you shift your mindset as a physician or medical student. But just because they are simple, doesn’t mean they are easy…

Your wellness is worth it, listen now!

Today’s sponsor: If you KNOW you NEED disability insurance but either haven’t taken care of it yet or want to check your current policy against what you might qualify for, check out today’s sponsor, Pattern, at


Medicine is out of control. Yes, you heard me right. Out of control. All the notes, paperwork, restrictions, non-competes, compensation plans, overhead, staffing. We could go on and on, regardless of whether you are employed part of a group or self-employed, there are so many things that make it challenging to be in medicine these days. If you feel the tension to keep listening, to hear about three responses that can help you thrive in the midst of these challenges. Welcome to the MedEdWell podcast, where physicians get empowered to take the next step in their wellness, personally, professionally and financially. I’m your host, Dr. Ryan Stegink, a practicing general pediatrician and online entrepreneur. Again, welcome to the med ed. Well podcast. Thank you for joining me here on this. The 14th episode here’s support and listening really means a lot to me. I really want this to be valuable to you and your wellness as a physician. So please reach out with ideas. You can find me on Instagram or the contact form on my website. I have learned so much by doing this podcast about myself and how I work best. I’ve also gained a lot in my own personal and professional wellness as a result.

So today we’re talking about how medicine often feels out of control and threatens our wellness. And then we’ll talk about how we as physicians should respond to this chaos in which we find ourselves. But before we dive in further on this episode, let’s hear from today’s sponsor disability insurance is complicated. Doctors. Shouldn’t have to take time to sort through a bunch of insurance quotes to find the best policy don’t stress over insurance shopping. Let pattern find the best coverage for you at the most affordable price by visiting pattern, forward slash med ed. Well that’s pattern, forward slash med ed. Well, the link will also be in the show notes. All right now, back to today’s show. So let’s say it’s a Monday afternoon and my schedule is pretty typical, but I have a family with four kids on the schedule. I have siblings come in often, sometimes three before, not too often having a huddle with my nurse or medical assistant beforehand helps discussing what they need for the day.

But these rooms with four kids in them are busy with at least six people in there, myself, a parent, and the four kids each has dedicated time on the schedule, but some of that can be lost in registering and rooming them, particularly if they come right on time for the first appointment slot. No worries. I know a lot of my schedule is flexible. Some coming in early, some coming late, we try to accommodate for this as much as we can. The bus system and prearranged transportation options are challenging at times and that’s on a good day. So, okay. My family is in a room. The kids are all due for well visits and I get some done others. I defer some because I’ll need to see them back later for various things. And I spent at least one of the time slots having an open conversation about the routine childhood vaccinations, we recommend using some of those motivational interviewing principles.

I discussed back in episode 10. Great. The family feels heard. They choose to restart vaccines. I got some other things that I think they need and they go home. So I may not be able to do everything. Every single visit that maybe someone in billing or administration might want, but in those types of situations, I bill appropriately for what I did and I use my clinical judgment to provide good patient care. Regardless of the situation, there will be times when you feel like you either should be doing more, or you’re being told that these requirements are coming from another person or external entity, you will feel out of control. So when you feel like things are outside your control, there are three main responses I want to guide you through as we consider your mindset and its effect on your wellness. But before we go through them, I have a caution.

This is not fatalism. This is not giving up that I can’t change anything. It is staying engaged and working toward progress. So the first response, when things feel out of control is to actually relinquish that control as humans. This is hard because we like control. And at least for me as a physician, and I’m sure others of you too, it’s especially hard. Think about all the things that had to go right for you to get where you are now. You worked hard in high school and college taking the MCAT medical licensing tests, boards, acknowledging that we can’t control everything is the first step towards coexisting with the chaos that we often face. We can certainly make inroads on bringing order to a particular process. Let’s say getting my patients, their sports physicals, done the paperwork, the vision screening, the physical exam, their signed documentation with an extra copy in case school loses it. But that’s a process and it typically involves multiple other people. I can’t control it all. And I can’t do it alone. Similarly, quality improvement projects done well required teams. My clinic’s note template redesign that I talked about earlier again, a team, I had my templates. They worked well enough, ideal. No, but they were mine. And I had the control. I knew where everything was. It was familiar. And yet by relinquishing some control and having a collaborative approach, we are building something better together.

So first relinquishing control you can’t control everything. Then second choose your response. You can choose your response. Yes. Let me repeat that. You can choose your response. It comes down to the whole internal versus external locus of control. Are your thoughts and feelings going to be determined by your circumstances, or will you choose to have a different thought when those hard things happen? When you feel out of control? Sometimes the days are really long. I get behind and I get done later in clinic than I expected. And yet ending later may be the result of spending extra time counseling, a particular patient explaining their diagnosis, or maybe I was just not as efficient as I am sometimes or had extra paperwork to complete previously. I would get frustrated that I was getting out of work later, taking that as a negative reflection on who I was as a physician, internalizing those negative feelings.

I think it may have contributed to my burnout. As I came out of residency, all idealistic about what I was able to accomplish, how things should work. And yet I was a bit naive about what I could get done on my own, how fast things could change, how many factors affect many different processes. I also didn’t realize how much impact that real continuity over a longer period of time, seeing that patient or family could really have how much extra patients could really make a patient feel heard and valued. So the perspective and mindset that one uses to approach any of these situations really matters. I thought through this one day after a busy day with only two and not three rooms like usual, I realized that I did my best under the circumstances and took pride in that I affirmed my medical assistant good job today.

We did well even with only two exam rooms, even though the outcome was still getting out late, I had a mindset shift acknowledging what I had done well under the circumstances and that I had done what I could with the available resources. And so I could take pride in what my team and I were able to accomplish. And then I encouraged both my team and myself in the midst of what was previously a lot more frustrating of a situation to me. No, I don’t always keep this perspective, but I’m making progress. So first acknowledge that you can’t control everything, relinquish, some of that control, then number two, choose how you’ll respond. And finally, number three, take time to reflect, take time, to reflect and consider what you can and what you can’t change. This may be long-term things, big changes that need to happen. Some of these may take advocacy negotiation working both within and between health systems with other payers, other entities, legislative bodies, he’s maybe things that you can’t change in your system right now. The number of exam rooms, you have your level of staffing or administrative support your electronic medical record, but maybe there are things you can change your workflow for rooming, a patient for discharging them, for getting pre procedure questionnaires back from patients more efficiently, your documentation templates or orders, even just understanding the landscape better, can help your mindset focusing on what you can or can’t do right now to make a difference for you and your team.

And in this time of reflection, be gracious to yourself and to others have right sized expectations, even as you may want things to be different or to change or to grow. You know, some of these things may have a much longer timeline for achieving them. And that allows you to set your priorities of which tackle first or the ones, which you know, will require a lot of consensus building in order to get there. Your task. At some point today is to take a piece of paper and five or 10 minutes have a seat at the top of the paper, right? I can’t control everything, but I can choose my response. Then underneath that make three columns things I can’t change right now, things I may need more time to consider and things that I could change today. So write those headings down, not now consider soon and make a change.

Then over the rest of the time, brainstorm a few things in each column, try to get at least three to five for each pick two things from the, make a change column and do them in the next week and pick one thing from the more time to consider column and make a plan to investigate it more within the next month matching the kind of motivation and encouragement that you’d gained from these wins the effect on your willingness to start on new changes in your clinical workflows, and then in your life, as you apply these principles, how would it affect your wellness personally and professionally your efficiency and productivity, ultimately your finances as well, seeing how you can be a part of making change and yet having the mindset of being able to understand where it may not yet be possible. You may still be conflicted internally confronting systems issues and dealing with moral injury, but you can see how you can choose to respond and be an agent for change.

Thanks for joining me here for another episode of the MedEdWell podcast, please subscribe to the podcast and share this episode on social media and tag me. There are so many physicians and medical students out there who need to hear this message and to get these wins in their own lives for their own wellness. And for that of their patients, if you’re looking for true own occupation, disability insurance, get a quote from pattern at the link in the show notes. Thanks for listening. And please come back and join me on the next episode of the MedEdWell podcast have a great day.