Showing posts with label work-life balance. Show all posts
Showing posts with label work-life balance. Show all posts

Monday, November 11, 2024

Regaining happiness in our medical careers

In the previous blog, I discussed why physicians are unhappy. It is a multifactorial problem, but there are solutions to our unhappiness. In this article, I will provide a few suggestions that will allow us to return to those halcyon days when we enjoyed the practice of medicine. We can regain that same passion for medicine when we start our careers, and it allows us to take our eyes off the computer EMR and once again focus on the patient.

I think the road to happiness includes paths to financial security, prioritizing our own health, and achieving a favorable work-life balance.


Our finances


One of the most popular and conflicting statements is, "Money can't buy happiness." However, money is a factor that determines happiness worldwide, including for physicians.

Contrary to popular belief, doctors are not filthy rich. In fact, finances are a huge stressor for many physicians. Between decreasing reimbursements, rising overhead costs, and paying down student debt, it's easy to see why becoming a doctor isn't as financially favorable as it once was.


Being smart about your finances from the beginning of your medical career is essential.

With the average graduating medical student having a debt of $250K, it's common sense to want to pay it down as soon as possible. When a young physician begins their practice and makes more substantial payments on their loans, that debt is closer to $400,000.

Physicians, especially recently graduated or practicing physicians, often make the common mistake of thinking that they'll worry about finances and their debt later. That $250K debt starts accruing interest the moment they receive their diploma, and the interest on the loan starts accruing immediately after graduation.

For these reasons, it is necessary to understand financial basics. Unfortunately, our medical education systems do not prioritize business basics during our training. As a result, many doctors make mistakes that cost them a small fortune.


Importance of compounding


Compounding is a powerful investing concept that involves earning returns on both the original investment and the interest received on that investment. For compounding to work, you need to reinvest the principal plus the interest accrued.

Assume you are a physician in practice for a few years, and you begin by saving $1000 a month at 7% interest for twenty years.

To calculate the impact of compound interest, use the following formula:

A = P X (1 + r/n)t

Where:

A = the future value of the investment/account balance

P = the principal amount (the initial investment)

r = the annual interest rate (in decimal)

n = the number of times interest is compounded per period (usually a year)

t = the number of months

Assuming you're investing $1,000 monthly at an annual interest rate of 7% over 20 years (240 months), it would accumulate to $609,794. This result reflects the initial contributions and the additional wealth generated through compound interest over the investment period. A free calculator is available at investor.gov.

For physicians juggling demanding schedules, complex financial obligations, and long-term goals, regularly tracking finances can be difficult and daunting. However, advancements in technology have introduced budgeting apps as powerful tools to help physicians better manage their money.

Budgeting apps streamline tracking income, expenses, and investments, saving doctors valuable time. By automatically categorizing transactions and providing real-time updates, these apps make it easy to monitor spending and savings.

Using a budgeting app can help doctors manage their money, achieve long-term goals, and build a solid foundation for financial security.

I recommend beginning using a budgeting app to track your expenses. A complete list of free budgeting apps is available from capterra.com.

Your personal health


Our health and well-being should be the highest priority. We advise our patients to practice good health habits but don't take the same advice we give our patients. We need to prioritize our health because if we aren't healthy, nothing else matters, and we will never regain the happiness that we once had. This is like the advice regarding using the oxygen mask on an airplane. The adult passenger must use the oxygen mask first before putting the mask on a child.

I surveyed a group of male physicians and an aged-matched group of male attorneys. I asked each group about regular screening for cholesterol levels, colonoscopy, and PSA testing. It was of interest that lawyers participated in preventive health with greater frequency than physicians. How can we expect our patients to practice good health habits when their doctors don't set an example?


Suggestions for improving our physical health:


Start with small, achievable goals that fit your schedule, such as exercising for 15-20 minutes daily. We can incorporate more physical activity into our daily routine by taking the stairs instead of using the elevator.

Consider using a fitness app or wearables to track your progress and help you stay motivated. I recommend TechRadar, which lists top fitness apps with ratings, detailed features, compatibility, and pricing information.

PCMag provides a curated list of fitness apps along with their ratings, pros and cons, pricing, and detailed reviews. A website for home gym equipment is also available from pcmag.com.

My take-home message: Exercise is one of the first things we compromise on as we become busier. We must avoid sacrificing exercise to be busy. You can't take good care of patients unless you care for yourself. When you take care of yourself, you perform better and are better equipped to take care of patients.


Work-life balance


Physician burnout and unhappiness have reached epidemic levels. Few physicians disagree that our professional lives are often out of balance. Many of us had not even heard of the term burnout at the start of our careers. Now, more than 50% of physicians complain of one or more symptoms of the condition. Burnout can adversely affect patient care and is even causing doctors to retire earlier than they had originally planned.

Becoming a physician is an arduous journey, often taking more than 12 years after graduation from high school. Further, beyond seeing an increasing number of patients each day, many practices and health systems mandate same-day entry of detailed notes in the electronic medical record. That requirement has added a new term to the medical lexicon: pajama time. This is the time – typically one to two hours a day- that physicians devote to completing their medical records in the evening. This is time away from family, friends, and non-medical activities, such as hobbies, exercise, and relaxation. As physicians, we are seldom off duty. We are tethered to our mobile phones and make ourselves available to our patients 24/7. As a result, we don't take time to recharge our batteries.

In this blog, I cannot provide comprehensive solutions to the challenges of burnout. However, I do have one suggestion that will favorably impact your work-life balance: get unplugged. (This was described in Physician Practice in the December 15, 2023 issue) Disciplining yourself to not respond to emails, Facebook, Instagram, or TikTok videos for one day a week will allow you to move from imbalance to a better work-life balance.

Bottom Line: The amount of pressure and risk you take seeing patients for eight to ten minutes per session, the educational debt, and the fear of getting sued have created a climate of dissatisfaction and unhappiness in our profession. Physicians must cultivate healthy habits around sleep, exercise, nutrition, finances, and relationship building. A physician's career is fraught with challenges, stress, and anxiety. Doctors who do not prioritize healthy habits risk burnout and more dire health consequences, including increased mortality. Investing in relationships and fulfilling hobbies improves career performance and creates a favorable work-life balance. When doctors take care of themselves financially and physically, they perform better. They are also equipped to take care of their patients, and they put joy and satisfaction back into their medical practices. Ultimately, physicians prioritizing finances, health, and balance are healthy and financially secure when it is time to hang up the shingle.

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Tuesday, February 21, 2023

Have a better day: Make your bed

I must confess that I have an addiction! Not the drug-seeking kind of addict but a college graduation speech junkie. I have watched countless graduation speeches by presidents, politicians, college professors, professional athletes, movie stars, comedians, and titans of Wall Street and Silicon Valley. However, one graduation speech stands out—Admiral William McRaven's graduation speech to the University of Texas Class of 2014.


This YouTube video has been viewed over eight million times, making it the most-viewed graduation speech.

(You can view this incredible speech on YouTube)

McRaven was a Navy SEAL and the Commander of the famous SEAL Team Six, which was responsible for organizing and overseeing the execution of Operation Neptune Spear. This special ops raid led to the assassination of Osama bin Laden on May 2, 2011.

So, we are speaking about a tough, disciplined, highly motivated, and dedicated man. You wouldn't want to be on his sh*t list, as he is a professional killer!

His graduation speech discusses basic SEAL training, six months of long torturous runs in the soft sand, midnight swims in the cold water off San Diego, obstacle courses, unending calisthenics, days without sleep, and always being cold, wet, and miserable. It is six months of being constantly harassed by professionally trained warriors who seek to find the weak of mind and body and eliminate them from ever becoming a Navy SEAL.The training also seeks to find students who can lead in an environment of constant stress, chaos, failure, and hardships. McRaven provides ten lessons he learned from basic SEAL training that has stood him in good stead, and I would like to discuss his first lesson—first, make your bed.

(This is the title of a book with the same name as the ten lessons mentioned in the graduation speech. Make Your Bed: Little Things That Can Change Your Life...And Maybe the World by Admiral William McRaven)

The drill instructor would inspect the student's bed every morning in basic SEAL training. If you did it right, the corners would be square, the covers pulled tight, the pillow centered just under the headboard, and the extra blanket folded neatly at the foot of the bed. It seemed ridiculous at the time since they were aspiring to be real warriors and battle-hardened SEALs. It was a simple task, but they had to make their bed to perfection every morning. The wisdom of this simple act has an incredible message that is valuable for physicians.


Suppose you accomplish the day's first task, regardless of its simplicity. In that case, it will give you a small sense of pride. It will encourage you to do another task to perfection, followed by other tasks completed similarly. By the end of the day, that one task will have turned into many completed tasks. A small accomplishment at the beginning of the day will also reinforce the fact that little things matter. You must do the little things right to do the big things right.

So how does making your bed relate to our profession and the practice of medicine? In the past, and for most of my medical career, I was always rushing—make rounds quickly before surgery, arrive at the operating room on time, finish surgery and rush to the office to see patients, which was frequently 30-45 minutes behind schedule, skip lunch to see patients who were delayed during the morning clinic, hurry back to the hospital at the end of the day for evening rounds, return phone calls, then make every effort to be home for dinner with my family. You may know that routine, and it's no wonder that fifty percent of doctors experience burnout.

The beginning of every day positively or negatively impacts the rest of your day. If you have an initial positive experience, even as small as making your bed, the rest of the day may go smoothly. On the other hand, if you have obstacles or problems at the beginning of the day, this will likely impact the rest of your day.

The easiest task to start your day off in a positive direction is to be on time for your first patients in your clinic or office. This simple task can render the rest of the day moving smoothly from one activity or patient to the next. It is impossible to accomplish this task of being on time every morning. If you are thirty to forty-five minutes late for the clinic, you will play catch-up all day, and you and your staff will be exhausted at the end of the day. Let's be honest; we can do a much better job than we may have done in the past.

Let's not overlook that the number one complaint patients have about their healthcare experience is the difficulty obtaining an appointment and then waiting for the doctor once they have arrived in the office. Both situations can be resolved.

Bottom Line: As Admiral McRaven said, "If you want to change the world, start by making your bed. If you are a Navy SEAL, make your bed; if you are a doctor, see your patients on time! The same applies to our medical practices; we must start with the little things, like being on time for our patients. Then, all the bigger things will be much easier if we start every day with small success. If you can't do the little things right, you will never do the big things right."


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Friday, April 1, 2022

Physicians want work-life balance

I really enjoy my job. I appreciate the people I get to work with and feel like the work we do really matters. That’s why I’m willing to put in extra hours and effort to ensure the job is done well. I believe physicians do the same thing. They work hard, they’re dedicated to their patients and their jobs and most love what they do. That makes putting in the extra work easy.

However, even at my busiest I don’t think I could or would average working 80+ hour weeks. I’m also not responsible for making literal life and death decisions on a daily basis. The expectations we as a society put on physicians is that they will always be there when we need them, regardless of when or where. Physicians embrace that responsibility and they are there when we need them most. This often comes at the cost of their personal lives and was a regular part of medicine for an extremely long time.

Dr. Andrew Wilner, who graduated from medical school in 1981, had this to say:

“When I entered the world of medicine, there was no such thing as physician burnout or work/life balance. It was a privilege to become a physician. The chosen few admitted to the hallowed halls of medicine expected to devote 100% of their lives to this sacred calling… as a product of that generation, the drive to excel as a physician significantly postponed my family plans, almost permanently.”

Later in his career Dr. Wilner found it was possible to have a life separate from medicine while still maintaining a successful and positive career as a neurologist while still spending time with his family.



Young physicians today have a different outlook and a recent survey by CompHealth’s parent company, CHG Healthcare, found the number one factor new physicians are looking for in a job is work-life balance. This was followed closely by work schedule and location. What makes this more interesting is that CompHealth asked a similar question in a survey CompHealth back in 2018. Work-life balance was number one on the list as well. However, in 2018, 63% of physicians listed it as their number one factor, this year that number jumped up to 85%.

Achieving work-life balance isn’t just good for physicians it is also good for their patients and the facilities they work. Even before the pandemic provider burnout was seen as an issue that caused adverse patient reactions. Add in COVID-19 with physician burnout at an all-time high and negative patient impact is even higher.

“For as many as 50% of physicians, burnout symptoms of cynicism, exhaustion, and reduced effectiveness overshadow their personal and professional lives,” says Dr. Wilner. “Like the coronavirus, burnout has reached global epidemic levels. Responses by academic institutions, government, and private industry to systemically address the burnout epidemic are woefully inadequate.”

Burnout is often a direct result of a life out of balance. Having that time outside of work to rejuvenate and focus on family or other interests keeps physicians fresh for when they return to work. In our role of placing locum tenens physicians in temporary jobs around the country I have seen physicians that were ready to quit medicine find new life in their careers. They found that taking more control of their schedules and freeing up some time for themselves made a huge difference in their personal and professional lives. The physicians that work with us still work long, demanding hours but the difference is they are choosing when and where to work and if they need a break, they can control their schedule.

Physicians are integral parts of our community and it’s important we recognize they deserve a healthy work-life balance as much as anyone else. New physicians are making job decisions based on this need and if we want the profession to grow, we need to do whatever we can to fight burnout and promote balance in physicians’ lives.


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