The ideal physician job - does it exist?

"Heck, no!" I hear many of you yelling. "I'm sick of being a physician." "I still like medicine, however my job sucks ..."

In an article today from HealthLeaders Media, "For Stressed Docs, Where to Turn?", the author writes:

A recent survey and report by Physician Wellness Services, a Minneapolis, MN-based company that counsels physicians and hospitals on wellness and related issues, and Cejka Search, a St. Louis, MO-based physician executive search firm, shows more physicians are getting stressed and it's getting worse.

...How bad is the problem? The survey shows that 87% of 2,000 physicians reported they were moderately to severely stressed, and 63% said the stress has increased "moderately to dramatically" over the past three years.

...For physicians, the work-related stress factors are:

• Administrative demands
• Long work hours
• On-call schedules
• Concerns about medical malpractice lawsuits

All those factors are essentially built into today's job of being a physician, at least for the docs who stick with it.

..."The result of this cumulative stress is declining job satisfaction, motivating physicians to change jobs or leave the practice of medicine altogether," the report states.

Okay, so it's getting really rough, leaving you fantasizing about a finding much better job, or quitting.

For most physicians, quitting isn't a realistic option, so maybe it's time to work on redefining your ideal job. Once you know what you want, you can go out and find it, right?

I'm going to play Reality Checker here. Let's begin with the radical idea that your ideal physician job doesn't yet exist (unless of course you have actually found it). 

An even more radical thought -- You are going to have to create it yourself ... assemble it in bits and pieces.

So how do you do this?

I invite you to play along with me (this is the final exercise from the CPM Program I participated in) as we engage in this thought experiment. But first, a word of caution. What I am about to help you do here is begin to ask questions of yourself  -- the kind you may have been avoiding.

So, grab a piece of paper, and writing in the present tense, get started with "I work as a ... in a ... ".

Think of this in multi-layers: 

1. What is your ideal job's workplace environment? Be specific. Describe the furniture, the building, the view from your window.
2. Who are you interacting with ? In what capacity? In what numbers? For how long? Think bosses, peers. employees, customers etc.
3. What is the organizational culture like? How is it expressed? What is your impact in the organization? Are you solo, or working with others?
4. What skills and talents are you using in this role? What others have you had to acquire to do this job well? How did you acquire them?
5. Are you still a clinician? A physician entrepreneur? A physician executive? Someone with no further connection to medicine? How have you coped with that shift in your identity?
6. What are you contributing? What is your impact, and upon what or whom? How are you benefiting? 
7. What core values are you expressing in your job? Does what you are doing contribute to the larger good in the world, or at least in your community? Are you sufficiently satisfied with what you are doing in this role?
8. If there are conflicts occurring in this vision, how do you resolve them?
9. Do you have a family? How does the family fit into all of this? What are the trade-offs and how are you handling them? 

There are a few rules with this exercise: 

1. Take your time with it. It may take months or years to craft this job.
2. Explicitly recognize contradictions. This doesn't mean they can't occur. Just be aware of them, as potential obstacles to navigate around if necessary.
3. Avoid the naysayer trap.
4. Recognize that these are difficult questions to answer. But you will never find the answers if you don't at least start asking the questions.
5. Recognize that you have more personal power than you realize.
6. And recognize that, as you do this exercise, you may come to redefine success.

 For my sceptical readers, there is neuroscience to back up how this "manifesting your desire" works - you can read more here and here (and no, I am NOT a fan of "The Secret" or "the Power" -- too woowoo for me!)

A final note -- It may be that you are already in your ideal job - perhaps it just needs your intentional focus, good boundary-setting and some tweaking! Good luck.

Healthcare reform and the physician business owner

What do you really know about healthcare reform? 

And do you even care?

The past few years have thrust healthcare into the limelight, with the passage of the Patient Protection and Affordable Healthcare Act (PPACA) in March 2010. And confusion has reigned ever since.

Once in a while, I come across good explanations that attempt to demystify the PPACA. As much as I'd like to be an ostrich with my head in the sand, mainly to escape the rancor and fury of those decrying the Act and the cries of those begging for meaningful change, I can't escape its impact on my clientele and readers.

For those of you who are interested and trying to make sense of the news, outrage and potential impact on your practice or executive role in a healthcare organization, here are a few of the more helpful resources:

1. From the American College of Physician Executives comes this video:

Healthcare Reform: A Spectator's Guide, by Sarah Freymann Fontenot BSN, JD. SHe concludes with a plea for "physician leadership, direction and well-educated voices" to help guide the debate and to produce the outcomes that really matter - quality, patient satisfaction, accuracy in billing, education and community.
This 47 minute informative video illuminates what's happening at the intersection of healthcare, the law and politics without taking any particular stand.  

2. From the American College of Physicians, An Internist's Practical Guide to Understanding Health Reform is a document written without legalese, accompanied by useful tables, plenty of useful links and even a patient summary. It's 109 pages long, so I don't encourage you to print it!

3. Finally, from the Deloitte Center for Health Solutions comes a document titled The Physician Workforce: Opportunities and challenges  post-health care reform. Here, the impact of PPACA is discussed on the physician workforce.

This is one of the most instructive parts of the document (the text is tiny but you can read the document at the above link):

 

The bottom line, whether you believe that the PPACA will hold up as being constitutional or not, is that the typical physician practice, as we have known it, is headed for change. As are the issues that physician executives in healthcare organizations must grapple with.

Are you ready for the ride? 

Physician business owners' secrets to greeting the New Year

For most of us physician business owners, the beginning of a year is a time filled with hope and intention. "It's going to be a(n even) better year. I’m going to be better at X, Y and Z"! we tell ourselves.

I mentioned previously that I don't believe in New Year's resolutions. I have discovered them to be grandiose and difficult to achieve, leading to a sense of failure and self-flagellation when we fall short and find ourselves back to square one a month or so later. 

What, if instead of focusing on these "ideal" outcomes, we paid more attention to the process... the journey? How would it feel at the end of the week, or the end of 2012, to celebrate your efforts even if you haven't achieved the results yet?

Focus on the Process, not the Outcome ... this was one of our core tenets in the Creativity and Personal Mastery Program (CPM) in which I recently participated. 

I'm as guilty as anyone is talking about how the time is flying, how hectic things are. In my conversations with clients and other physicians, I note how often the words "stress" and "stressful" are used. Is this really how we want to live our lives?

A recent New York Times opinion piece touched a chord in me. Titled "The Joy of Quiet", the article tackles the question of how to develop internal stillness, clarity and focus in the face of all that bombards us and chews up our time remorselessly all hours of the day. And in turn, experience peace and happiness. From the article:

“The urgency of slowing down — to find the time and space to think — is nothing new, of course, and wiser souls have always reminded us that the more attention we pay to the moment, the less time and energy we have to place it in some larger context. “Distraction is the only thing that consoles us for our miseries,” the French philosopher Blaise Pascal wrote in the 17th century, “and yet it is itself the greatest of our miseries.” He also famously remarked that all of man’s problems come from his inability to sit quietly in a room alone.”

When last did you really pay attention to your mental chatter ... how your "monkey mind" speaks to you? Another of our CPM exercises was to spend a week listening to and even documenting, where possible, our mental chatter. I will share that it was, for all of us in the group and for much of the time, pretty ugly stuff -- filled with judgmental, harsh, persnickety words. And yet, it is this mental chatter with which we largely construct our lives. It becomes our "reality" ... How Things Are.

Let me encourage you to put aside your Big Resolutions and instead begin to pay attention. 

• Notice how you speak to yourself. Be kinder. Judge less.
• Become aware of your beliefs and challenge their validity. Discover what is factually real and what you have made up.
• Be present to the process ... all those little and big choices you make each day. Choose what matters. 
• Ask yourself "Am I doing the very best I can in this situation right now?" Keep your focus there instead of on the future.

If you stick to these basics, I can guarantee you a 2012 filled with discovery and inner peace...even if time still flies by!

The Entrepreneurial MD wishes you a rewarding New Year

Although you didn't hear from me, I hope you have all had a wonderful festive season as the old year slid away, to be replaced by a shiny new one.

Happy New Year to you all, my readers!

I was bombarded with blog posts, e-cards and emails from businesses wishing me a happy holidays and even suggesting ways to enjoy them.

In the spirit of confession, while I appreciated the sentiments in these messages and had a few twinges of guilt that I hadn't blogged for over two weeks and hadn't crafted my clever or beautiful ode to the season, I wallowed in the sheer enjoyment of doing nothing, knowing that I'd pick right up when the time called for it. I knew it wouldn't make any real difference to the world out there if I didn't write, but that being available to my family and myself would make a difference to us. 

I hope 2012 is the year you would like it to be -- while you can't fully anticipate the content of the year, you can create the attitude that will permit you to cope with whatever comes your way. 

You can:

• create joy
• be grateful
• take things in your stride
• pause
• choose
• reflect
• seek to understand
• have fun
• cherish relationships that matter
• goof off
• make new friends
• dance
• celebrate life's occasions

I wish you a hugely rewarding and well-lived 2012!

In-the-trenches physician creates educated patient consumers

Ask any doctor who has been taking care of patients for 25 years or more what it's like to be working in the trenches, and you're likely to encounter someone with a deep experience of the US healthcare system.

Dr. Angel Garcia is one such a physician - an internist who is not only still in practice but who is also the entrepreneurial physician creator of an electronic medical record, and an author.

His book, Do No Harm: Saving Our Healthcare System, was written with the idea in mind of improving the doctor-patient relationship. He embraces the idea of an educated "patient consumer" and offers some basic ways in which patients can care for themselves at home with minor symptoms before rushing into the doctor's office, urgent care, or worse still, emergency department. 

He is also careful to paint a portrait of life as a doctor working under the constraints of the contemporary US healthcare system, in the hopes that patient expectations can be better managed.

Listen to my 20-minute interview with Angel Garcia MD in which we explore his entrepreneurial side. And then please add your comments here.