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!
What if I told you the key to breaking through the repetition and monotony of clicks, typing, and charting in medicine was actually to DO MORE? But I thought we just spent two episodes talking about the importance of margin, principles, doing less?
Check out this episode to hear how I believe advancing your wellness as a physician is best achieved through this pursuit of more. More things, more clarity, more focus.
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Variety and time diversification, a recipe for wellness
I feel like I’m doing the same thing over and over and over again. I need to mix it up a little. I feel like I’m in a rut. The hamster wheel metaphor really hits home for me right now. Click, type, sign, repeat. Sounds monotonous. Repetitive. Like a day in the life of a typical physician these days.
What if I told you the key to breaking through the boredom and monotony was actually to DO MORE? But I thought we just spent two episodes talking about the importance of margin, principles, doing less? Stick around to hear how I believe advancing your wellness is best achieved through this pursuit of more.
So you may be wondering, why did I contradict myself? “Doing more!!” That sounds like a TERRIBLE idea. Why?!? There is already so much to do, I feel overwhelmed. I hear you, I have been there, no margin in my time, working harder, running on that hamster wheel of achievement. I have felt the dopamine with checking the boxes, watching the metrics, signing the visits. And yet, MORE was an answer for me. Before you tune out, let’s get to the bottom of what I am saying and what I’m not because it may not be what you think.
I heard this saying growing up, “All work and no play makes Jack a dull boy.” I certainly worked hard, but I had outside interests as well. I played soccer, piano, saxophone, volunteered, and spent time with my family. I also briefly tried skateboarding around 5th or 6th grade since my best friend at the time was doing it. His dad was a contractor and built a small ramp in the driveway. It was cool for a bit. However, after attempting to “drop in” from a real ramp at the skate park my friend took me to, I’m not sure if my joints or my ego were more bruised from my falls. I quickly saw my future was not in skateboarding and promptly gave it up.
I was a good student all through school, working hard and blessed to have good teachers, starting with my mom. I learned lots going to museums around town and going to the library, reading lots of books.
Even in high school, my piano teacher was gracious when I didn’t always practice before my lessons. He said, many kids that are doing music are also doing other things well also. It helped keep me playing which I greatly appreciate looking back. As a result I can now play chord charts in a band setting because of the training.
Journey to Focus
These other activities in pursuit of made me a more well-rounded person. Gradually though, you go to college and pick a major. Even so, I was a part of the mens choir at my college and obtained a liberal arts education. But then came medical school, more focused, more intense. Residency and now an attending. All specialized and focused, ready to do what I trained for, 24 years of school and training combined…
And yet, “the next thing” becomes an achievement treadmill if your mindset and priorities are not in the right place. The next paper, the next grant, the next project, the next promotion, achieving partner, achieving tenure. Where is this all going? These things are not wrong in and of themselves, but they need to be seen in the context of you as a well-rounded person.
It comes back to priorities. What is important to you? Do you have other interests outside of medicine? Family, friends, kids, sports, music. The list could go on, but a well-rounded person is able to pursue their balance and wellness in a way that connects them to something outside of themselves, outside of their main gig in medicine. This means you taking time to meet up with friends not only is healthy for your mental health, these friends also provide a good outside perspective, knowing you and being able to say, “Dude, you are pushing so hard, maybe you actually need to take that vacation you keep talking about rather than just complaining about how many shifts you are on this month AGAIN!”
So those things you did before medical school, hobbies you dabbled in during training, go ahead and pick it up again. As of this recoding, I have played more piano in the last year or so than the prior five. It has been fun, and I have had opportunities to share that music with others and make new friends. And this isn’t just for the attendings here, even in med school or residency, making that margin with your time can allow you to do some of those things.
Maybe you want to try a new hobby. Go for it. Maybe it is a creative outlet or something else you enjoy doing outside of medicine. This will make you a better physician by helping use your brain in a different way, take off some stress, and help you relate to other people. It could be you enjoy triathlons, painting, music, volunteering, or something else. It may take planning, saving up time and money. For those of you following along, this is part of the WHY behind margin in time and money. Whatever it is, plan for it and go do it. Time with family and friends, some of these outside activities, these are all part of my wellness plan.
And if doing more with hobbies and things outside of medicine wasn’t enough for you overachievers out there. Yes, I’m talking to myself as much as you. I’m going to ask you to do even more than that, to DO MORE in your professional life as well.
Previously, I shared my journey into burnout. Going, going, going. Notes, notes, notes. Click, type, click, type. You know the feeling. And yet, part of my road to recovery was through taking two steps back and then another step forward. That step forward just happened to be in a slightly different direction. Getting the extra training with my medical record system, I was able to use different skills, the creative, technical side of my brain. It was invigorating, energizing.
Yes, it was doing more, but the diversification of roles at work lends a certain amount of variety that increases my job satisfaction and how I see myself as a physician. This additional role fits into my priorities, my why of helping others and getting to use my gifts and abilities. And because I had the financial margin, I could cut my clinical time from 9 to 7 sessions to accommodate the additional role.
More For My Colleagues
Having diversification is not only good for your finances, (and just a reminder, this is not investing or financial advice but for your education and entertainment only) but it is good for you as a physician. Not only good for you but also your colleagues, patients and community. I have colleagues in my system doing work with school collaborations, case conferencing, a special clinical program for an at risk and underserved population, statehouse advocacy, working alongside specialists to see some of their lower acuity consults, advancing identification of needs in social determinants of health. The list goes on. And you know people doing amazing things too. You are probably one of them.
Take That! Imposter Syndrome
Hey there, stick with me, and don’t let that imposter syndrome sneak in and make you compare yourself to others. You are a unique, valuable individual. You are capable, intelligent, with your own gifts and talents, perspective and viewpoint, passions and experience. Your journey doesn’t need to look like mine or that amazing physician next to you.
Rather, figure out what passions drive you and then go for it. You will fail and learn from it, make mistakes and take that next step forward.
Continuing to Move Forward
For me, I couldn’t just stay there, content to use my tech side with medical record optimization. I also enjoy that my patients come from all over the world. I get to speak Spanish on a daily basis, and I have learned at least a few greetings in four other languages. The different cultures, getting to ask about their families, the diversity of backgrounds and experiences. These have been really valuable for my growth as a physician in residency and now as an attending. Thinking about my priorities, one of them is service. One of the ways I wanted to be able to give back and care for my families was by becoming a United States Citizenship and Immigration Services Civil Surgeon. No, I didn’t go back to residency or want to shift into the operating room. This designation allows me, as a pediatrician, to sign the medical form for children who are going for their green card. It was a process and an investment, but for me, I decided it was worth it.
Objections, Where Is The Time?
Now I know what you are probably saying. So where is that extra time coming from? Extra value for your patients, sure. Extra paperwork, ummm, yeah. Because my system supports case conferencing a half day a month, if I find that I am able to build a steady stream of patients needing this service, I will use that time for taking care of the paperwork and additional history taking or consultation with followup specialists those patients may need to see.
Find The Time
Let’s pause for a moment. As we can see, doing more often involves adding these professional satisfiers. And then at the same time, it involves figuring out what efficiency gains can be made elsewhere or where financial margin may allow you to cut back some clinical time to give you the personal margin to feel like you have some level of balance and wellness.
Saying yes to one more thing professionally that is not required, especially when it is not compensated, needs to be a huge satisfier for you. It must add value to you as a physician, and ideally, it should be something where you could eventually come back to your group, your employer, and say, look at this amazing stuff I am doing, let’s renegotiate my contract, my schedule, my administrative support. It’s called leverage, and it comes from you adding value, making yourself and your services valuable. It is strategically allocating your time towards your big priorities, your big goals.
So I want you to take a moment today and really look at what else you need to add to your plate.
- First, personally. Is it a hobby? Some activity you really enjoy to stay active but haven’t made the time for lately? Developing a friendship or cultivating rituals or traditions in your family?
- Then, professionally, what do you add? Is it volunteering somewhere medically or just in the community with an organization that aligns with your priorities? Is it seeking a leadership position? Giving a talk to your local med students or residency program? Starting a side gig?
- Finally, to make the time for these things, where is that time coming from? Is it time I otherwise spend watching television or just not being focused with my time? Is it decreasing my shifts and planning around that in my budget? Is it more carefully monitoring my wellness while running a little harder while getting a side gig off the ground with the intent of using that to cover some reductions in clinical time later.
So what are you going to add personally and professionally to advance your wellness? And then, where are the time and money margins coming into play in actually making this happen?
Make a plan and then make it happen!