A successful career in medicine means learning how to forge ahead with feedback and not allow it to stop you in your tracks.  For some doctors, this is a challenge.  Feedback feels bad. It’s perceived as negative, not being good enough.  We’re exposed to it and its negative impact quite early on the journey as medical students. Medical school rankings are feedback that begs the question, “Am I doing as ...

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Happiness doesn’t always come easily. Some people seem naturally happy, like they inherited the right gene or were born into the right circumstances. Many other people struggle to find happiness. Perhaps even more people hope to become happier than they already are. But what kind of plan should people follow if they are hoping to become happier? Or will any kind of plan merely make it harder to thrive?

It ...

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You’re at the top of your game. And you are perhaps thinking that this is not how you envisioned life at this stage in your career. Many successful physicians are frustrated that they can’t find the time or energy to be present with their family and friends. They haven’t even thought about activities just for fun and creativity. Taking a vacation seems impossible without the practice coming to a screeching halt. You ...

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Trust has always been the foundation of any relationship between a patient and those of us in health care. Clinicians enter patient encounters with the presumption they will be trusted, based on their knowledge and good intentions. But medicine is changing, and today patient-doctor relationships are buffeted by a complex labyrinth of a rapidly evolving health care landscape and an exploding information environment. As physicians, we must adapt to this changing ...

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Protecting your lifestyle starts with protecting your income. Disability insurance provides a solid foundation for your financial future by providing you income when you’re unable to work due to an illness or injury. When most people hear the word “disability,” they immediately think of accidents. But the reality is that 90 percent of disabilities are actually caused by illnesses. Disability insurance is more complex than other types of insurance. We recommend ...

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We sat in the driveway, my business partner and I, each peering out our opposite windows, each wrapped in the disappointing sense that we had failed one another while the uncaring car simply idled in the background.  “We agreed on this,” my partner said, without turning her face toward me.  “No, you told me how we were going to do this, and I said nothing” was my response as I ...

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Physicians are excellent at floccinaucinihilipilification, which is seeing something as unimportant or worthless.  We engage in floccinaucinihilipilification every time we see a patient. We listen to their story and symptoms, and quickly filter, accept, or discard information until we arrive at our presumed diagnosis. The 18-second rule In 1984, Beckman and Frankel wrote in the Annals of Internal Medicine that the average time it takes a physician to interrupt ...

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On my final day of work before beginning my self-imposed  burnout sabbatical, a colleague asked, "Why don't you just get on medication?" I remember thinking, "What am I medicating?  I feel nothing." I was in the vice grip of burnout, overwhelmed, and physically and emotionally exhausted.  But mostly, I was numb. But in reality, I have always self-medicated - with work.  As a professional ballet dancer turned doctor, my life has ...

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The center of a physician's job is the doctor-patient relationship.  Without a healthy one, the physician is unable to help the patient make meaningful changes in their life to maintain a state of wellness.  Too often, in the process of medical training, a physician's personal relationships suffer the consequences of long hours, financial strain, and the ever-present danger of Burnout.  If embracing the concept of personal wellness is ...

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Medical school prepares doctors for patient care: perform a history and physical, and based on the findings, consider the next diagnostic tests to order, review all data, and develop a treatment plan. By graduation from medical school, you are skilled to perform those duties with a certain level of competency and confidence. Success in the next phase of this journey and the rest of your life depends on honing those skills ...

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Many doctors make the decision to pursue a career in medicine in their youth.  They have an experience that points them in this direction.  And once the decision is followed by a firm commitment, we seldom change the course.  Medicine here I come! At that age and with such limited life experience, it's impossible to truly grasp the depth of the commitment to this career. Becoming a doctor is not a career decision, ...

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It was mid-January, and I found myself catching some rays on a rooftop in Cancun with 15 other physicians — all women of varying ages and medical specialties. Besides enjoying the sand in my toes and a martini glass in my hand, I was there to attend the TransforMD retreat, looking for clarity on my life choices, values, and goals. Daily Vedic meditation was to be integral to the agenda. That ...

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A major goal of MIPS is to increase the sharing of information between providers and eliminate so-called data silos. Central to this goal is the implementation of fast health care interoperability resources (FHIR). FHIR allows one EHR to directly query and pull information from another EHR, and is based on the belief that medical charts can be reliably abstracted into resources. All ...

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Health care professionals, medical students, and students of public health are increasingly aware of the "social determinants of health." Everyone has begun to realize that poverty is the most important cause of illness. Too often, however, the analysis stops there, instead of asking what the root cause of poverty is, the question is: what causes those "social determinants"? Why do resources remain unequally distributed, why cannot everyone access the same quality of ...

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When I finished my training, I wish that I had known all of the options I could practice medicine.  Most of us categorized our options as either “academic” practice or “private practice,” but in reality, these two options only cover the tip of the iceberg.  Was my limited understanding a shortcoming of my medical training?  Perhaps.  I doubt that many medical schools back then actually had seminars on practicing medicine. ...

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They say you learn a lot from your clients. Not in anesthesia, where I frequently feel great empathy for my sick patients and their families. Our connection in the peri-operative environment is too short-lived for this, I believe. But in therapy, where the relationship is both critical and deeper, and where I have more recently turned my attention, I have come to appreciate that observation personally. I specialize in “burnout,” that ...

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Human nature is to hold on tightly to the ideals of perfect. Once we find something that ticks all the boxes, we want it now and with firm conviction. The same holds when seeking that dream job. Competition, scarcity, and desire for coveted positions risk burying your CV in the proverbial pile. Having a few strategies to deal with this phenomenon can help you retain sanity and win at the end ...

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I previously published a post discussing the most recent Medscape burnout survey results for physicians.  An interesting point of discussion was that many physicians felt that if they made more money, they would likely be happier.  Today, we will discuss the implications of this thought process and if there is evidence to support the claim.  Will more money make me happier? Let’s find out. Defining the problem In the aforementioned survey ...

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I have no idea who my boss is.  Is it the chief of surgery at my hospital who tells me I need to use more of my block time, or it’ll be reassigned?  Or the office manager who tracks my CME money and vacation days?  Or the medical group administrator who signed my contract and hasn’t spoken to me in two years since then? Or the mentor who was assigned ...

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In my recent post, "Why Gratitude Is A Superpower," I told the story about a thank you note that my daughter, Maya, left me one morning for making her coffee. I was literally overcome with warmth and appreciation. My reaction demonstrates the real impact we can have on another person's emotional state when we express gratitude — either verbally or written — for something (gift, assistance, help, ...

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