Does your physician work meet the "7 C" standard?

Election Day -- at last! It's both a huge relief and a source of trepidation for me.

I hope you are exercising your precious right to vote.

Now -- what will I have to look forward to in the next few months as we all settle into knowing who our new president-elect is? Life will be ever so boring -- no more wardrobes and terrorist associations and "my friends" to plague our days and nights. I'm not sure if that's a good or a bad thing! 

Here's one way to address the "gap" that's likely to open up in the next few weeks, especially as we begin to glimpse a looming 2009.

How about examining just how meaningful your work is?

And how does one judge that?

This month's The Entrepreneurial MD Newsletter article, "The 7 C's of Meaningful Work" takes a look at the special attributes of work that give you the sense of doing what you were meant to be doing.

One of the determinants of our happiness is feeling that we have a purpose in life and then being able and willing to act according to that purpose.

The simplest question to ask is "Do you leap out of bed each day and race eagerly to work?"

Okay - too corny!

Maybe there are more subtle clues.

In my mind, there are seven "sacred C's" that signal purposeful work:

1. Creativity
2. Commitment
3. Connection
4. Competence
5. Clarity
6. Caring
7. Contribution

Check them out here in the article.

How do you rate your 7 C's of meaningful work?

And if something is missing, what can you do to boost your 7 C quotient?

Should physicians be considering career change at this time?

With the Dow Jones rising and plunging like a breaching whale, and with the ripple effect of its mini tsunamis reaching the corners of the globe, is it a smart idea for physicians to be considering a career change at this time? 

To inject a dose of reality into your fantasizing, here are 5 reasons you might have to continue clutching your security blanket for a while longer:

1. We are wired to panic. Whether we like it or not, our brains are geared for "fright or flight" and the smallest leak of adrenaline into our blood streams produces a big fear response. If you were afraid of change before "the crisis", your anxiety levels will likely have increased. Not good for clear-headed thinking!
   
2. You haven't got much of a rainy day cushion. Most financial planners encourage you to set aside a cashable stash (6 months of expenses) you could easily lay your hands on in the event of real need. Like a lay off, or a family emergency, or a career transition that is going to take many months. If you haven't created your back-up fund, it would probably be wiser to work squirrelling some acorns and nuts away before pursuing a new career or business.
   
3. You don't have portable bennies. With healthcare and health insurance moving onstage as presidential campaign topics, it's tempting to imagine that this issue wouldn't be a deal-breaker for a career move for much longer. Surely something is going to be done to fix this -- right? Well, I suggest you don't hold your breath. The solutions to this complicated problem haven't been found by some of the best minds in the biz, and we are likely to be stuck with the status quo for a while.
   
4. You're too exhausted to make the effort. Here's a Catch-22. A 2006 ACPE Physician Morale Study showed that 77% of physicians in the survey were experiencing deep fatigue (66% had experienced burnout!). How can you take any of the steps or do any of the work needed to transition out of clinical practice into a new career or business, when you can barely stay awake in front of a ball game at night? And yet how much longer can you continue to feel so fried by the job?
   
5. You fantasize about escaping, but haven't been able to come up with a plan. Changing careers or starting a new business successfully requires three things:
   
   
   • A Vision of what who you want to become and what life you intend to create and lead
   • A Plan to get you there
   • A Team to help you on your way.

Until you're able to take the time, find the energy, and have the will to put these together, you might be better off sitting tight.

Am I wrong?

Tomorrow, I will debate myself and share my thoughts with 5 reasons that this IS a good time to make a change.

What happens to your Physician Identity when you change careers

The Entrepreneurial MD's October newsletter article "The Delicate Art of Handling Your Physician Identity" originated in the reflection I was engaged in as I prepared my presentation for SEAK on the weekend.

I was blown away at the conference by the chord this seemed to strike in the audience and how many physicians commented to me on their struggles with this shift in self-perception!

One physician told me "I have known for a long time now that I haven't wanted to be a doctor any more, but I can't handle the disapproval of my family and friends whenever I talk about leaving".

Please share your thoughts after reading the article.

How does this challenge affect you or the colleagues you have spoken to?

The Physicians' Manifesto

On the plane from Boston to Los Angeles after presenting at the SEAK conference on Non-Clinical Careers for Physicians, I reflected on the many difficult conversations I had engaged in throughout the weekend.

When I asked the audience of about 250 physicians who would actively encourage their children to go into medicine at this time, no more than 10 raised their hands. This does NOT bode well for our futures as patients!

What would our esteemed physician forebears think of our situation?

I was so deeply distressed by the palpable pain and frazzled frustration expressed by the physician attendees that I thought it time we find a way to speak up.

So here is my Physicians' Manifesto. Let's see what you feel.

****************************************************

We, the physicians of the United States of America, declare that:

• We chose to practice medicine to express our dedication to being of service to our communities, our fascination with science and the human body, and our desire to promote health, healing and dignity in dying.
• We understand that there is a relationship between the practice of medicine and business, and that there are not infinite resources for healthcare within our society.
• We value and appreciate the trust the public has, in the past, placed in our profession.
• We respect and observe our Hippocratic Oath, especially of "Do No Harm" and "Protect the Privacy of Our Patients".
• We honor the values of integrity, ethical behavior, and professionalism in our every day work.
  
  However:
• We are entitled to be compensated appropriately for our skills, hard work, dedication, willingness to go the extra mile to save a life, and our many personal sacrifices that the practice of medicine demands of us and our families.
• We are profoundly disappointed in the deterioration of our professional lives, caused mainly by bureaucracy, declining reimbursement and loss of clinical decision-making autonomy.
• We are tired of feeling like a cog in the wheel of one or more large organization's plans for profit.
• We are angry at the toll our professional practice is taking on our personal lives - the depression, emotional burnout and incessant fatigue we feel.
• We regret the undermining of the trust that has heretofore characterized the physician-patient relationship.
• We abhor the direction our professional lives seem to be taking as we battle to cope, day in and day out.
  
  In addition:
• We are committed to playing a major role in the reshaping of our broken healthcare system through wise physician representation and bold leadership.
• We will invest the time, if permitted the opportunity we so long for, in helping prevent disease and maintain well-being.
• We are willing to try and grasp the economic challenges of healthcare and co-operate in finding solutions that respect us as professionals while meeting the healthcare needs of the public.
• We will champion any reasonable proposals and efforts to restore physician-patient trust, protect the integrity of the bedside or doctor's office relationship, preserve and use our limited resources carefully and thoughtfully and include us at the table when key decisions are being made.
• We will take the time to learn to be more effective as business owners or professional partners in our organizations.
• And finally, we are eager to do our part, however small, in helping build a robust US healthcare system that provides necessary, decent and appropriate care to all who seek or need it.

****************************************************

If this is a Manifesto that you can believe in, please make your comments below, and help spread the word by forwarding this post as an email to your physician colleagues.

And if you don't agree, I'd love to hear from you!

You can also sign the Doctors Unite Open Letter to the American Public on Sermo. 

It is our responsibility to speak up as one voice and be heard!

Do entrepreneurial physicians need to be hands on clinically?

This question comes up often enough that I thought it worth exploring with you.

The argument goes this way: If I don't maintain my clinical skills as a physician executive or an entrepreneur in a health-related business, I will lose all credibility with my peers, and even my "customers" -- right?

And my response (as a non-expert on this topic) is "Well, it depends!"

It depends on:

• Your passion for clinical practice. I spoke with a client this morning who has a unique set of clinical skills, and while she no longer wants to exercise them full-time, she cannot imagine abandoning them completely. Her desired compromise is to create a situation in which she can practice one day a week and devote the remainder of the week to her new career or business.
• What your work entails. If your business or new position requires a level of clinical knowledge that merely keeping up with the literature won't be enough, then it is likely valuable to the position for you to maintain some level of clinical activity.
  This is particularly true if you plan to develop a business as an expert witness. You are required to demonstrate that you are in clinical practice at least some of the time.
• Your credibility with your patients or customers. As a medical weight loss expert or someone with a medical education business, it may well be necessary for you to maintain a practice to keep your skills up, to reassure your patients that you can truly deliver the goods.
• Your financial situation. If the new business is going to take a while to get going, and you have pressing ongoing money needs, you may have little option but to keep working at your "day job" as a clinician. 

What it no longer seems to depend on is the opinion of hiring organizations. Most forward-thinking companies that have created roles for physician executives have come to appreciate the special skill set that such a doctor brings to the job at hand. As this article titled "Adopting the CEO model--why physician executives should not be required to practice medicine" states:

"It is certainly acceptable if a physician executive chooses to see patients and has the time, but it is entirely different if a physician executive chooses not to practice because of the competing demands of practicing and managing. The growing complexity and diversity of the delivery system have created the need for more physicians to become involved full-time in directing the medical-industrial complex."

If you are thinking of starting your own business, it will become your thoughtful decision as to whether and how much you still practice medicine.

On the other hand, if you are considering a physician executive role in a company, it will be between you and the company bosses as to what value your ongoing practice adds or detracts from your ability to get the job done.

Any thoughts to share?