- Love Being a Doctor vs Like Being a Doctor
- Physician Burnout – in the Mirror
- Can Happiness Change?
- 1. Set a Later Clinic Start Time
- 2. Stopped Doing Disability Exams
- 3. Stopped Doing IMEs
- 4. Blocked Out Last 2 Friday Slots
- 5. Scheduled Lunch Breaks
- 6. Scheduled Travel Time
- 7. Expanded Our Clinical Workforce
- 8. Dropped Committees Where I’m Not 100% Essential
- 9. Skip or Dial Into Every Other Meeting
- 10. Stopped Agreeing to Every Commitment Offered
- 11. Plan 2-3 Time-Blocks on Each Weekend
- 12. Meditate 10 Min Every Weekday Morning
- 13. Exercise 30-45 Min 6 days per Week
- 14. Be More Present When With the Kids
- 15. Take Breaks
- 16. Avoid Web-Surfing During the Day
- 17. Prepare For Tomorrow
- 18. Schedule Regular Date Nights
- 19. Take Time Off Work
- 20. Arrange for Coverage When on Vacation
- 21. Obtained Volunteer Clinical Teaching Positions
- 22. Scheduled “Admin” Time
- 23. Reduced Productivity Pressures
- 24. Stopped Allowing Sponsored Meals
- 25. Joined Medical Informatics
- 26. Refer Out Less Desirable Procedures
- 27. Scheduled More Time per Patient
- 28. Express Enthusiasm and Empathy
- 29. Clarified My Financial Situation
- 30. Delegate Office Work
- 31. Set Challenging Professional Goals
- 32. Later Clinic Start Time
- 33. Fewer Patients in One Morning
- 34. Improved Speech Recognition
- 35. I Learned How to Use the “Sticky Note” in My EMR
- Now I Love Being a Doctor
- You Have Leverage at Work
Do you love being a doctor? Is your job satisfaction level a 9 or 10 on a 10-point scale? If not, continue reading.
Love Being a Doctor vs Like Being a Doctor
A lot of doctors answer 6 or 7. As seen in responses here: WhiteCoatInvestor.com.
Younger folks had higher scores. It got me thinking. I was a 9 or 10 on the career satisfaction score when I started.
It may have dipped to an 8 or so for a decade. A few years ago, mine went to a 6 or 7 as I neared the end of my second decade of practice.
That pattern may be common, but I didn’t like it.
Physician Burnout – in the Mirror
Where would it end? Am I required to endure this downward spiral?
Should I change to a different practice setting? I even considered early retirement in my 40’s.
For me the changes were gradual. I almost didn’t notice the lowering quality of life over time.
I started reading about physician burnout. My colleagues needed help. The more I learned the more I could guide them.
It dawned on me though that I too was heading down that road and was much farther than I realized.
I took a step back. My reading about burnout had a new purpose – to apply the ideas to my life.
Can Happiness Change?
Fortunately, about 50% of a person’s well-being is genetic and mine is positive.
I needed to work on the other 40% (attitudes, ideas, habits, etc.) and 10% (externals like money, schedule, etc.).
I made helpful changes. Some may apply to you. I share them only as examples of what is possible and what I found helpful.
I took online surveys like Myers-Briggs, DISC, and Strength Finder. They helped me learn more about myself.
I then applied what I learned. I learned that I’m an “objective thinker”, “an introvert”, and a “lover of learning.”
1. Set a Later Clinic Start Time
I have learned that I need a lot of sleep. To achieve, I have learned to grind through on minimal sleep.
But it takes a toll on my mood and work. I also need some time for the other things in my life like exercise and helping with the kids.
2. Stopped Doing Disability Exams
I usually end up saying the person can work and they disagree. It is subjective and frustrating.
And dangerous. The examinees sometimes see me as the one who stopped their gravy train of money for nothing.
3. Stopped Doing IMEs
An Independent Medical Exam (IME) is a one-time history and physical. Only an independent physician can perform them.
These are often contested legal or insurance issues. The physician is providing a critical specialty opinion. Charging as an expert can be profitable.
They sometimes end up in personal character assassination, depositions, or court appearances. Some of the examinees are living life on the edge as it is and this made for a lot of unnecessary stress for me.
4. Blocked Out Last 2 Friday Slots
I used to get stuck late Friday night when finishing the work week. My family got tired of waiting.
The fatigue and frustration wore me down.
5. Scheduled Lunch Breaks
Yes, I do need a break and yes, I need food. Why not put that on the schedule and treat it as important as a patient visit?
6. Scheduled Travel Time
I block out time to get from one meeting, clinic, or surgery center to another.
I also scheduled a “travel day” before or after travel for CME. A weekend conference used to mean getting home late Sunday night. I was tired and felt I missed a weekend somehow.
Monday morning was hard and things were only worse later in the week. Taking that Monday off or even a later start can make a world of difference.
7. Expanded Our Clinical Workforce
Our new clinical staff (NP, PA, MD, DO) decreased wait-times while improving patient and physician frustrations. It also allowed me to cut back on work and hours.
8. Dropped Committees Where I’m Not 100% Essential
People liked me on these committees. Because I showed up.
I learned a lot in those meetings, but was my presence essential? When the answer was no, out it went.
9. Skip or Dial Into Every Other Meeting
Sometimes I can be walking on my treadmill at home during the meeting rather than sitting in a chair for 2 hours.
At one meeting I looked around. The physician leaders looked stressed, tired, and over-weight.
That is not what I want for me. I took action.
I decided to make my health a priority. In my case, that meant more sleep and more exercise.
10. Stopped Agreeing to Every Commitment Offered
There seems to be a committee for everything and more every week.
“I appreciate your giving me this opportunity. Let me think about it.” Became my default response whenever invited to join a committee.
Then two days later, “I would have loved to be involved in this important work. Currently, I have too much on my plate.”
Those two responses saved me hundreds of hours away from my family and my other work priorities.
It counteracted my natural tendencies to be flattered and say yes to any free work offered. Such offers boosted my feeling of importance. But joining a committee ends up meaning more time and self-sacrifice that isn’t worth it.
“I need to find out a little more about this.” That was my new response to any committee I was considering.
Send follow up inquiries:
- Could you send me a copy of the charter?
- What does the structure look like?
- Who else has confirmed or been invited?
- Who are the organizers?
- Is there a budget or funding source?
- How often will we meet? What time? Location?
- How will we track outcomes and measure success?
- Is there already an existing team working on this issue?
- This is not a permanent committee, right?
- When will be our final meeting?
- Who is requesting this or supporting this effort?
- Who is opposing this?
If they answer most of those questions, I may join.
11. Plan 2-3 Time-Blocks on Each Weekend
Recreation is important. We don’t need to have every minute scheduled but everything seems to go better if we have some structure.
To balance those approaches we started planning one or two activities per weekend day.
These include family fun, fitness, spiritual work, and hobbies. We do more and have more fun.
12. Meditate 10 Min Every Weekday Morning
I use the Headspace app. It is awesome.
13. Exercise 30-45 Min 6 days per Week
Three strength training and three cardio.
I do this at home to save time. Most life-long exercisers and people who lose weight and keep it off work out at home.
Getting to a gym is great but I can’t manage to do that daily with my work and family obligations. Still, fitness needs to be a high priority.
14. Be More Present When With the Kids
No work at home. I was complaining that the kids are on “electronics” too much.
Then I realized that I was on my laptop or iPhone way too much. Cutting back on that has helped me and my family.
15. Take Breaks
For me, that means a 10 am and 2 pm for a snack, email check, EPIC in-basket check.
Avoid these activities for the rest of the day. Checking email or in-baskets during the day is a time waster.
Switching tasks eat up time. Changing screens, logging in and out, sorting messages all take time. With less frequent checking many of the “crises” in an e-mail or your EMR may be solved or delegated by the time you check.
16. Avoid Web-Surfing During the Day
Did you ever go to one of those cafés where you pay by the minute for internet use? That is where I realized checking email and some news takes me 15 minutes. It is so easy to click and click and get distracted for 20 minutes or more.
17. Prepare For Tomorrow
Schedule time in the afternoon to prepare charts for the next day. I love coming in knowing that some of my charting is already done.
18. Schedule Regular Date Nights
My wife and I find a babysitter and make time for our relationship.
It is critical. Unless it is a priority and on the schedule, it doesn’t happen.
19. Take Time Off Work
Whether it is PTO (Paid Time Off) or unpaid, it is restorative.
I now schedule spring break, winter break, and summer vacations,
I used to let my PTO go to waste. Very macho Super Doc I was. And very stupid too! My family and I suffered from that attitude.
20. Arrange for Coverage When on Vacation
Whenever I had WiFi access on a break, I used to cover my own in-basket and check in with the office. I know my patients best and it didn’t take long. Then I wouldn’t owe a favor to another doctor.
In reality, the other doctors didn’t mind the extra work. It added stress and work for me. I never could completely unwind. One needs to completely unplug and disconnect.
21. Obtained Volunteer Clinical Teaching Positions
The time and work are minimal.
Teaching students and residents can be fun. It challenges me and keeps me learning.
The young minds ask great questions and teach me new technologies.
22. Scheduled “Admin” Time
For me, that meant Tuesday afternoons.
It allows me to catch my breath in the early part of the week so that things don’t build up. Otherwise, it all crashes on me on Friday.
23. Reduced Productivity Pressures
I encouraged our administration to shift away from a wRVU-productivity compensation model.
We are now paid a salary plus incentive. This removes a lot of the “pressure to perform.” My focus is now on quality medical care and listening to my patients.
I don’t miss the stress of scampering to the next wRVU-producing procedure.
24. Stopped Allowing Sponsored Meals
Those drug-rep lunches and dinners provided too much of the wrong foods.
It took time from my charting and made my afternoon rushed or longer.
The exposures skewed my thinking in an industry direction on minimal science. I don’t miss them.
25. Joined Medical Informatics
Being proficient with computers is part of modern medicine. Love it or hate it, computers are here to stay.
Rather than just avoid them or complain about them, I decided to embrace electronic medical records.
My hospital network was eager to have physician involvement.
It serves many purposes. Including income and breaks from clinical work.
By teaching others, I learn how to chart better and faster. I have better access to IT help when I have a problem.
My employer pays for my trips to Madison, WI. (I enjoyed the one in August, but not so much the one in February!).
26. Refer Out Less Desirable Procedures
Because I can do them, it doesn’t mean I must do them.
If I don’t enjoy them, or am not that great at them, or they are not worth my time. Out they go.
27. Scheduled More Time per Patient
I enjoy the encounters more when I have more time. I am able to listen better. Who knew?
28. Express Enthusiasm and Empathy
I have always felt both during office visits. But I didn’t always show them.
I started this to improve my “patient experience” scores (NRC-Picker). I started for the wrong, cynical reason.
The effect of that change surprised me. The patients and I seem to connect better. We both enjoy those encounters more.
29. Clarified My Financial Situation
Confirmed that I am FI (Financially Independent). Being FI reduces billing and production pressures.
30. Delegate Office Work
Most were operational tasks. An assistant with minimal training and supervision performs them.
31. Set Challenging Professional Goals
That could be a new sub-specialty certification.
It would be easy at this stage of my career to drop some of my credentials.
I would rather challenge myself to grow. I don’t want to wind down or stagnate.
Learning new techniques and knowledge can energize you. Sharing tips with and learning from colleagues and fellows is rejuvenating.
32. Later Clinic Start Time
I made Wednesday my late-start day. That gives me valuable weekday morning time.
It has allowed me to attend grand rounds, put my kids on the bus, workout, or meet a friend for coffee.
33. Fewer Patients in One Morning
I chose Wednesday mornings for this slower pace. That gives me time to talk to and teach the residents who are usually with me then.
34. Improved Speech Recognition
Upgrading my software and microphone made a huge difference. I learned how to optimize settings and functions. Making even a few verbal commands make charting quicker and easier.
35. I Learned How to Use the “Sticky Note” in My EMR
This “private” area in the EMR is seen by only me. I note personal things about the patient.
Those may be upcoming vacation plans or a tidbit about their granddaughter. Patients feel cared for and appreciated when a doctor pays attention to them as a person.
They are more likely to cut that doctor some slack when they forget a detail or mess something up.
The follow-up visit will be more fun for me and them.
What is the result of these changes? Well, a lot of good and nothing bad.
Now I Love Being a Doctor
I have a closer relationship with my family members. I’m teaching and learning more.
I have less stress and shorter hours. And I am making more money.
I don’t want to quit any time soon. Retiring isn’t on my radar.
Now I love being a doctor again. My satisfaction is 9 to 9.5
You may never reach that level. Every person and situation is different. If making changes is difficult or impossible in your job then stack cash and then quit.
I share this since the changes I made improved the quality of my life both on and off the job.
You Have Leverage at Work
A few of my colleagues have tried some of these changes and had good experiences. I hope this list will inspire you to make a change for the better.
Many doctors feel powerless, but after learning some basics of negotiation skills they become empowered.
Have you made changes that improved the quality of your life? Do you hate being a doctor, like it, or love it?
My suggestion is to pick one change on this list and work to make it happen over the next quarter. The improvement may surprise you.
Society will benefit when you love being a doctor. You will enjoy it and continue to practice and serve patients who need you.
So, what do you think of being a doctor? Will you love it or leave it?
Good common sense advice — very applicable
Happiness in general seems to be a “smile” where you are happy when young, then happiness drops in your 40’s and 50’s only to increase again over time. I wonder if that increase is due to choices we are able to make that improve our life. OR maybe senility helps too!
I try to practice the pareto principle, where you stop doing the 20% of things that bring you 80% of headaches. It helps to be financially independent so you can give up for instance call without fear of making less money!
I am going to pick #9 and 14.
I bet you are working on #31!
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I agree with the U shaped pattern of SWB (subjective well-being) as we age. I’m looking forward to the upward curve from here. Whether that comes from senility or just getting the kids out of the house, I’m not sure which.
Congrats on passing the CFP exam. You are a great resource for other physicians.
I definitely need to work on #14 (Being more present with the kids). I love writing and blogging but it makes me too detached from my “real life.” The kids are growing up too fast and so I’m cutting back on this online work.
Great Tips! Looks like you are in a interventional specialty like me. Curious what your specialty is?
I’m glad you liked the post. I’ll shoot you an e-mail.
Impressive changes you made to make your work life better and douse the burnout.
You and I share a lot of similarities, I have my scheduled snack breaks at 10am and 2pm exactly as well 🙂
I also try and live by the motto, “Last to Work, First to Leave.” LOL
Even despite some other things I do (pay someone to cover me 1 day a week), Radiology has gotten to the point where it almost feels like the post office and you can go postal, especially on some modalities like mammography.
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Glad you liked it.
Yes, all I need to know I learned in kindergarten. Literally. Especially the part about recess and snack time. I got away from that habit too long. But I’m back on schedule.
I hear you about working for the post office. I am an employee of a big network. Despite all the pain of work, I have times where I help people and they thank me. That really helps. I suspect you get even less of that as a radiologist.
I wonder if it would be useful to follow up with any of the doctors who received your reports or the patients who got a diagnosis because of your read. If you feel the positive human impact of your work on their lives, you can bask in that glow of altruism for a bit. At least those things help me enjoy my work. I realize every person & specialty is unique.
This list is both a call to action and a generously shared blueprint. I’m thrilled to be 8-8.5, can’t imagine how much fun you must be having at 9!
Just realizing that you don’t have to be a passive victim in your career is a start to reclaiming the job you once loved.
Yes doing less of my work helps me to enjoy it more. Funny how that works.
The list will likely look a little different for everybody depending on their career stage, specialty, inpatient vs outpatient, etc. But my list should give others some ideas.
Some think, “Hey, that’s great for you WD but I can’t do that.” The immediate reasons “I can’t” come from the objections of lack of control over their workplace or financial constraints that prevent them from cutting back hours. I would dig deeper into those though. Most of us have more negotiating clout with our employer than we realize. I have spent a lot of time on the other side of the table when building practices, clinics, insurance contracts, recruiting, and physician network leadership. It is very expensive to hire and replace a physician. A physician who has even rudimentary negotiation skills can exert more control over their day.
The money argument usually comes from financial illiteracy. Or overspending. “I can’t cut back or start late since my wRVUs will drop.” is another way of saying I live paycheck to paycheck even though I’m in the top 5% of income. Makes no sense to me.
I like the personality assessment. I used the assessment at UnderstandingMyself.com which has a more granular assessment than the 5 Briggs dimensions though quite correlated. The assessment yields data on strength and weakness and too often some frustration happens by using the wrong personality aspect because it happens to be one you are good at. Hard to make positive changes if you don’t have a well defined starting point.
For me running the practices was as rewarding as practicing medicine. It had it’s own associated creativity
Thanks for the comment. I had not heard of that website. It seems to go to “Wisdom Labs” now. I’m not sure that is the same personality inventory.
At any rate, the more we understand ourselves the more we can create a life that is optimal.
Love how you are passionate about your field! Alot of my private money lenders are doctors and its interesting to see how after 8-10 years of study, they want to quickly amass monies and leave the industry. Im guessing the work can be stressful at times if you are not 100% passionate about what you are doing.
Great ideas, however, administration dictates the terms for most primary care docs. Some physicians have been fired for asking for some respect and a few minor changes like those you list. Employed physicians don’t have these options.
I’m so sorry to hear that. I agree that many of these examples are more difficult or even impossible for employed PCPs.
Even other employed specialists feel helpless and trapped.
I think a few of the suggestions may still apply. Physicians have more negotiating power than they think. I too am employed by a hospital network with rules, procedures, and productivity expectations. I was able to make these work though.
You do raise an important issue. I don’t want to make light of the very real risk of condemnation or termination as an employed physician. This is yet another reason to reach FI (Financial Independence) ASAP.
Thanks so much! These are great suggestions. I especially agree with making time for exercise and meditation.
With the rates of burnout and suicide in physicians at shocking levels, it’s important that we continue to talk about the satisfaction and mental health of physicians. If you love your Profession, it will reflects internally and determines your satisfaction and happiness. Doctors have to use their intelligence and technical skills to treat patients. Many doctors enjoy the challenge of having to diagnosing a patient and figuring out the best way to treat them.
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You made an interesting point when you talked about how it isn’t necessary for doctors to have every minute of their lives scheduled in order to avoid burnout. I would imagine that the desire to help people can sometimes override the need to take care of yourself at times. If I was a doctor struggling with burnout, I would probably want to work with a coach of some kind.