Change Yourself, Change The SystemDec 06, 2022
“Be the change you wish to see in the world.”
I stumbled upon the Financial Independence Retirement Early (FIRE) movement when I was extremely frustrated with medicine. Retirement seemed like the best solution for my physician burnout. I’m not sure I completely understood the extent of my burnout; I just knew I couldn’t continue on the same career trajectory.
The truth is that I despise the word burnout. The word burnout is something hospital administrators love to throw around before presenting you with a pizza party or cookie to thank you for all your efforts. I didn’t care about my burnout. I only cared about my escape plan.
The interesting thing about FIRE is that it had me working harder and more urgently than ever before. Rather than creating a solution for my burnout, my escape plan actually perpetuated it. I found myself checking my investments multiple times per day and exploring the latest metrics regarding how much money I would need to live a comfortable post-medicine existence.
Physician coaching was not on my radar as I hatched my escape plan. In fact, when I met with my first physician coach to explore the systemic healthcare issues driving my frustration, I couldn’t fathom spending even a single dollar on myself because the investment was likely to prolong my agony in medicine. It wasn’t long before my faulty thinking was uncovered.
The reality is that I enjoy being a doctor. I remain a full-time practicing physician with a wife and two kids. From the outside, my life appears the same as it did before finding physician coaching. The perceptible difference resides in how I manage my clinical practice. And that can be summed up in one word: Boundaries.
I have a very busy clinical practice, and my next available appointments are several months away. I have always maintained a waitlist to accommodate more urgent patient needs. Whenever there is a cancellation, I ensure that appointments are provided to the patients with the most urgent needs. I carefully examine and manage the waitlist at least once per week to ensure that my patients are accommodated and receive the care they require and deserve.
I was recently informed that a computer program would begin offering available clinic appointments to waitlist patients at random. After hours, an email would be sent to these patients without discretion and without preference given to acuity, urgency, or medical need. The implementation would be system-wide, and there would be no exceptions. I felt my frustration begin to build, and my thoughts about escaping medical practice once again bubbled to the surface. And then, I remembered my newfound ability to create boundaries.
Rather than spiral into a pit of despair about the state of healthcare and the inability of physicians to control even the most straightforward aspects of their schedule, I created a boundary. It was a simple response: “OK. I will allow the computer system to manage my waitlist. In so doing, I will relinquish my responsibility for overseeing the waitlist. This change will save me 20-30 minutes per week which I will now allot for other clinical duties. I will also hand over the responsibility for finding appointment slots for more urgent patient needs to the managers and directors.”
This response does not come from anger. It comes from honoring my responsibility and love for myself and my patients. Of course, I believe patients with the most urgent medical needs should be seen first, but I also acknowledge that I do not have the decision-making power in my current role. Rather than focus on the things I cannot control, I choose to focus on what I can control. I will continue to maintain my previously agreed-upon clinic hours, but I will not accommodate clinical work beyond those hours. As issues arise with this new system, it will be up to those who created and enacted it to develop solutions.
With physician coaching, I have learned the importance of creating reasonable and consistent boundaries within the healthcare setting. What does this mean? It means not adding clinical work into time that was not previously assigned to clinical tasks. It means allowing clinical staff to work to their highest level rather than doing the work for them. It means responding to messages in a reasonable amount of time rather than immediately. And it means being clear about what I am willing to do and what is non-negotiable.
It turns out that when we accept the status quo, that is precisely what we get. Alternatively, when we are clear about what we are (and are not) willing to accept, we can live more of the life we were meant to live. This does not mean that everything will always go our way. On the contrary, many things will not be within our control. Focusing on our locus of control puts us back in the driver’s seat and removes the urgency in our escape plan. When we can create and honor our boundaries, we stop arguing with the reality of the current healthcare management structure and step into the power we possess. And in these minor forms of resistance, we help to reshape the healthcare landscape for ourselves and future generations.
Maybe physician coaching doesn’t solve every healthcare issue in real-time, but the lessons and takeaways help us to create the life we want today rather than putting off our happiness until we can escape medicine. While I still save aggressively with the goal of financial independence, I have decided that retirement is not in my near future. I would rather enjoy the ride than anticipate how much longer remains until it ends. I still keep a close eye on my investments, but knowing that I can be happy practicing medicine on my terms has allowed me to stop checking them multiple times a day. If that isn’t freedom, I don’t know what is.
Are you interested in creating more balance in your life? I want to invite you to check out my FREE TRAINING. Click here to get: How Busy Physicians Can Stop Trying To Escape Medicine And Start Living Their Best Life Today.
This training will teach you the five essential techniques physicians need to stop feeling stuck, burned out, and trapped in medicine. You will also learn how to stop racing toward retirement and start using tools that empower you to practice medicine your way.
PS. I get a lot of inspiration from music lyrics. Many people use inspiring quotes (and I do, too), but music really speaks to me. I hope you find inspiration in the songs too.
John Mayer - Waiting On The World To Change
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