It was a quiet Friday evening on the deck. I was engrossed in Sudoku, anticipating a weekend of mental freedom. Curiously, I had not engrossed myself so completely over any issue all week as I was doing in orienting 81 numbers 1 to 9 in their prescribed pattern. My only escape from the taunts of unresolved clinical practice issues was yet another mental effort.
The reverie of the lake won out with its gleaming and shimmering over the impending sunset. What an opportunity to escape the week of practice, to consider things of value beyond my profession, to find my place with family and the natural world, to look inward, and outward, to find time for peace and reflection! “What are you thinking?” she asked, as she saw I was staring at my knees, new thoughts having crept in. “Work,” I knew was the answer but I could not bear to say it. She knew, however.
Like you perhaps, I spend inordinate time and effort beyond my practice considering patients with unresolved clinical issues, suboptimal surgical results, next week’s OR schedule, the best implant to use, what to think about the new distractor appliance, whether propofol is worth the price, whether my best assistant is going to leave for graduate school, and why our variable costs keep climbing. Such effort might feed success but I believe it robs surgeons of family, friends, health, and happiness. Thus, obsession with surgical practice must be identified, and where necessary, mitigated.
Herein is an unscientific, nonvalidated, self assessment of your practice-related quality of life. If you answer more than a few as “yes,” your practice-related quality of life is poor. Read on for strategies that might help.
1.I make frequent separate trips to the office when it is closed so I can get some work done.
2.I have to engross myself completely in recreational activities (such as golf, puzzles, Internet, or working out) so that thoughts of work do not creep in.
3.Staff and family often say I look preoccupied or do not hear them.
4.Piles of unresolved issues are usually on my office desk.
5.I always feel as though I am not doing enough to keep up with advances in my specialty. Unread journals remain stacked up until they are filed or tossed.
6.Patients sometimes think I am rushed, though I often ask staff to squeeze in more patients.
7.I worry a lot about the finances of my practice, although by every measure I am successful.
8.I have made mistakes due to overwork and fatigue.
9.I fall behind in charting, billing, corresponding, etc.
10.I have identified a stress-related physical ailment.
11.I use food or habit as tools to subsume the nagging issues of practice.
12.I envy other surgeons who appear to have better lives.
13.I wrestle with strategies to deal with my practice issues such as a new attitude, consultants, more staff, a new management style, etc, but years have passed without substantive change.
We all struggle with at least some of these issues. While the needs of our practice seem to pull us ever harder, we must employ strategies to pull back.
What can be done to improve your practice-related quality of life may be beyond the scope of this missive, so I simply give you some bullets to ponder and customize to your own needs.
•Identify the elements of the problem and promote behaviors to change them.
•Talk it over with your staff, family, and colleagues. Ask them for strategies that might help. Try them and let them know how they worked. They care about you as well as the practice.
•Share responsibility for your practice with others.
•Share practice-related quality of life issues with your surgical colleagues.
•Scale back (case load, scope, complexity).
•Finish with one patient or project before starting another. Multitasking is over-rated.
•Take time to read, including nonprofessional reading.
•Try incorporating a contemplative, noncompetitive activity such as walking.
•Take a really long vacation where you cannot be reached. Set up your practice to accommodate this and use that strategy for both short and long activities.
•Tell yourself you are not going to dwell on practice issues unless you are at work, and don’t.
•Seek out role models in other surgeons who have achieved a better practice-related quality of life.
•Give back to others by doing volunteer work remote from your practice.
•Take the time to teach part-time.
•Become an expert at something other than surgery.
•Don’t just count the things that really matter in life, live them.
Take the time to self-assess these and other issues.
As for me, today is Sunday and my family is visiting. I am headed home to fire up the barbecue.
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