It’s time for physicians to practice an evidence-based life


Evidence-based medicine is at the heart of what we physicians do. It is the basis for professional decision-making, and a focus of most journal articles we read. Using solid evidence to practice good medicine has been a foundation of clinical practice for decades.

There are consequences for failing to follow evidence-based guidelines. If patient harm results from straying from a more loosely defined “standard of care,” which tends to be evidence-based, we may find ourselves facing a dreaded malpractice lawsuit. If certain evidence-based quality metrics are not met, our paychecks may suffer. That is the case with my employer, even though my practice as an anesthesiologist isn’t measured by any of the core metrics my salary depends upon.

While there is still a place for the art of medicine, the science of medicine largely dictates how we act out our professional lives.

Do we make evidence-based decisions in our personal lives?

In some ways, we do. Few physicians smoke cigarettes. The average BMI of physicians is below that of the population; at least, it was when the Physicians’ Health Study II was completed ten years ago. This tells me we do a better job of exercising and eating healthier than the average patient, which may simply be a reflection of our relative affluence.

In other ways, we fail to make evidence-based choices when it comes to our personal lives. We allow our mental health to suffer, and are reticent to ask for help when we need it.  We suffer from burnout, undiagnosed depression, and easily diagnosed suicide in frustratingly high numbers.

We work long hours under many stressors, and struggle to find the work-life balance that will keep us and our families happy.

We ignore the evidence in regards to our finances. While surveys have shown that a level of spending above $50,000 to $75,000 a year fails to increase our happiness, many physician families spend double or triple that, chasing fulfillment that money can’t buy. We splurge on fancy homes, cars, and luxury items that we feel we deserve, not realizing that we’re actually selling our future time by failing to save now.

A recent Fidelity survey of physicians showed that nearly half were saving less than 10 percent of their salary, and failing to contribute the maximum to their 401(k) retirement plan. With a high debt load and late start to our careers, failing to save a significant portion of our income is a path to working indefinitely, with no way out when the workload overwhelms us.

Why not practice a more evidence-based life?

Try putting at least 10 percent of the effort you put into evidence-based patient care into evidence-based living. For every 10 hours you spend improving your patients’ health, spend an hour improving your own. Exercise. Learn to cook healthy meals. For every 10 hours you spend reading journal articles or attending lectures, spend an hour reading a self-help book, or learning about personal finance.

Don’t spend yourself into a corner.  Think about the things that really make you happy and you’ll realize that the Rolex isn’t even in the top ten.  Set financial goals, and keep them in your sight. Pay down your debts. Build up your nest egg. Obtaining financial independence, the ability to afford your lifestyle without paid employment, can give you a new lease on your professional life.

I was able to call myself financially independent last year, a few months before my fortieth birthday. I have no intention of retiring or slowing down in the near future, but knowing that I could grants me serious leverage and freedom to continue practicing in a way that makes me happy. The fact that I’ve made no changes affirms the fact that I am content in my current practice, and that I’m making good evidence-based choices in the way I live my life.

No, I don’t smoke. Yes, I have a normal BMI. I value experiences over things. I drink good beer in moderation, and do my best to exercise a few times a week. If I could just find a way to enjoy five servings of fruits and veggies a day, I’d be in great evidence-based shape.

“Physician on FIRE” is an anesthesiologist.  This article originally appeared in Physician On FIRE.

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