Category Archives: Physician Burnout

Doctors with More Empathy Win Patients and Improve Hospital Scores

doctor empathy wins patients

We’ve known for awhile that doctors who show more empathy have better patient-physician relationships and can actually have fewer medical errors.

And there’s a direct correlation between job performance and empathy. Forbes writer George Anders calls empathy The Number One Job Skill in 2020, naming this the common trait in a wide range of occupations—from teaching to healthcare to customer service.

The truth is that the position we’re in as doctors and leaders requires a higher than average level of empathy. So, if we know that empathy wins friends and influences people, why don’t we just use it?

One thing that stops us is the roadblocks along the way, according to David Swink’s Psychology Today article. Roadblocks like lack of attention, not knowing how to communicate with empathy, and just not “feeling it” all make it tough to show empathy for our patients and others.

So what can we do?

Should we fake it till we feel it?

A new study suggests that there’s a way we can gain empathy as we feel it.

Niki Gianakaris reported that when people experienced mild discomfort by rubbing their hands on sandpaper, they became more empathetic.

According to the findings in the Journal of Consumer Psychology, when participants touched the rough surface of sandpaper, they felt more empathetic and were even more inclined to give charitable donations.

Okay, where are we going here? Does this mean we need to keep a stash of sandpaper or an emery board in our lab coat and give it a rough go before we interact with a patient, especially the grumpy patients? That might actually work, but that’s a research project for another day. 🙂

So how CAN we use this in our medical practice?

What if we were to find a way to connect with every patient?


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Connection with your patients can lead to empathy.


Here are three easy ways to foster connection and improve empathy that I’ve learned through coaching clients over the years:

  • Find something in common: a sports team you both love; a hobby; pets.
  • Decide that something about them reminds you of a loved one or an old college friend. Do they wear the same perfume as your grandmother? Have a Southern accent like your Uncle Fred? Or have that funny way of grunting at everything you say?
  • Invite them to join with you, and make them part of the process. Let your patient know that the two of you are a team when it comes to their surgical outcome or their health goals. You’ll find this will get your patient on board with the plan, and make them feel less guarded or defensive.

 

What’s one way you’ve found to add empathy in your practice? Please share!

 

 

 

How Ordinary People Inspire and Teach Us

Inspire and Teach Us

The author and Buddhist nun Pema Chodron said, “Nothing ever goes away until it teaches us what we need to know.”

When we find ourselves in tough situations, there’s usually something to learn. This also goes for people in our lives, even the ones that feel ordinary.

I have a practice of having my O.R. team name 3 things they’re grateful for every day, as those of you who’ve seen my TEDx talk know.

This has served me well and gets me, the patients and the staff in the right mindset.

But last week I decided to change it up. I asked them to each describe someone who had helped them in their career. I was blown away.

And it made me realize this…


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Each of us has an impact on others beyond our imagination.


Here’s what I learned:

  • My scrub technician had started his training in the military. He was assigned to a war zone and was right in the thick of it. One day, it got to him. He was in the supply closet, crying and scared. Who could blame him?

His commanding officer came in and talked to him. After a long talk and some tears, the commander said, “Remember that you are an AmeriCAN, not an AmeriCAN’T.” That stuck with him and gave him the strength to hang on.

  • My circulating nurse worked as a floor nurse in the hospital years ago, and she had several bad weeks in a row. She questioned if nursing was really her calling.

A good friend of hers who was also a nurse said, “You do all you can do with the situation you have, and that’s all you can do. Then you go home and sleep, knowing you did the best you could.”

  • My anesthetist trained with an anesthesiologist who not only taught her everything he knew about medicine, but about the importance of taking time for oneself, having a family life, and enjoying the journey.

In fact, he offered her a job when she graduated but recommended that she not take it, as she was a young single woman and he didn’t think she’d find a life partner in their little town. (He tracked her down several years later after she married and had a baby and said, “Now you can come to our town!”)

  • For me, my story starts with one of my professors in residency who encouraged me well beyond the “usual and customary” at a time when I was doubting my ability to stay in ophthalmology.

The weird twist of fate is this: When my professor was five years old, his neighbor (who was six) saved him from drowning. Now, had this neighbor not been there, would I still be where I am today? Only God knows.

 

Each of us has an impact on others beyond our imagination. And how we approach others matters.

Who has shaped who you are today? I’d love for you to share in the comments below.

 

 

 

The High Achiever’s Guide to Being Enough in 3 Steps

Being Enough

How do you feel when you need to refer a patient elsewhere because their problem is outside your expertise?

I used to feel inadequate and think my patients would be upset with me. But time and again, they just seemed grateful that I was getting them to the right person for their problem. The only judgment in the room was my own – which probably comes from being a high achiever.

It got me thinking about why burnout is more of a problem these days for high achievers. How much is our own negative self talk adding fuel to the fire? Is it that we really aren’t enough, that we aren’t trying hard enough, making breakthroughs enough, accomplishing enough? Or do we just think we’re not enough?

We’re not robots. Medicine is not as exact a science as we want it to be. People don’t always respond as we think they should to our surgery or our medical treatment.


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Stop beating yourself up for imperfections only you perceive!


And that’s a problem.

When the negative nellies overwhelm us, the conversations we have in our heads are either going to support or sabotage us.

We’ve got to start believing that we are enough.

Cut yourself some slack, already.

Just like my patients who are perfectly okay with me not being able to perform a procedure outside of my realm of training, you need to be okay with not being able to perform miracles in the O.R., in the board room or at home.

It all begins by putting yourself first.

Here are 3 ways to remind yourself that you are enough:

1. Make a list of your strengths. Those strengths are your super powers!

2. On the same page make a list of your weaknesses. You can’t be great at everything. Love your super powers, accept your weaknesses and move on.

On the same page, make a list of ways you can spend less time and effort on the “weakness” category. Can’t bake a cake? That’s why God invented bakeries!

3. Acknowledge your “enoughness” every day. Positive affirmations (“You did great today.” “You are a loving parent.” “Your speech was amazing!”) can make the difference between feeling just okay and feeling awesome.

 

If you were coaching yourself, what would you say? What positive feedback would you give yourself?

True confessions time. Which of these is the toughest for you to do?  Share your comments with me below.

 

 

 

How To Magically Turn Stress Into a Burnout Buster

Turn Stress Into

Imagine you’re about to give a speech to several colleagues and VIPs. While you’re backstage, do you:

a) Perform breathing exercises to create a sense of calm, or

b) Get excited?

If you chose (a), read on . . .

This research comes straight from Harvard Business School professor Alison Wood Brooks. She asked hundreds of people if they should calm down or be excited when they were about to give a presentation to a huge group. Almost everyone (91%) said they should try to be calm.

Then she had a group of students who were actually getting ready to give a big speech repeat to themselves, “I am calm.” And had others repeat, “I am excited.”

Can you guess what happened?

The group who had been excited felt less stress than the ones who were aiming to stay calm. And the observers found those “excited” speakers to perform with more  confidence and competence.

The theory is that they transformed their anxiety into excitement.


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Can embracing stress help burnout?


Studies show that when students view stress as helpful rather than harmful, their scores are better.

This also has translated into well-being at work for doctors. Those who perceived anxiety as helpful were less likely to experience burnout or frustration.

So how can we use this information to help us beat burnout?

You may not have any control over the things that cause stress and anxiety each day, but by changing your mindset and shifting how you think about stress, you can use it to your benefit.

The key is to learn how to make it work for you. Here’s how:

When you’re stressed in the O.R. or office and you’re kicked into high gear, try telling yourself that your wheels are turning faster and thus you’re headed for a better outcome.

The same way you can conquer a fast-moving river by flowing with the current instead of against it, there may be some truth to this theory.

I did this myself when I gave my TEDx talk to over 2,000 people. I chose to channel the excitement of the day, rather than to remain calm. (Seriously, who can remain calm on a day like that, anyway?)

Here’s what I think – stress, per se, does not help us function better. But having the mindset that stress can be a good thing just may make our stressful experiences less exhausting.

When you take a stressful situation, and acknowledge “this is stressing me out,” it allows you to get out of “reaction” mode. And lets you move into a mindset of control.

Try it this week, and let me know if it makes a difference!

 

 

 

Set Boundaries, Take Back Your Time, and Stop Explaining Yourself

Stop Explaining Yourself

You have a healthy lifestyle, exercising, eating right… you’ve even committed to a new meditation practice. You’re doing all the right things to avoid burnout. But there’s one thing still wearing you down… the demand on your time and your lack of boundaries.

Here’s how your week looks:

  •  you’re booked solid next Thursday, but you need to be off by 3 p.m. to be at your kid’s soccer game
  •  your partner is asking you to switch coverage with her next month, but that would really not work with your schedule
  •  your Aunt Sally’s birthday party is at a very inconvenient time
  •  you’re being asked to do surgery now on a patient who isn’t scheduled yet

So all you have to do is try to get out of some “commitments.” Easy, right?

Not so much. Because getting out of each of these situations would require a whole lot of explaining. And that feels worse than sucking it up and doing them.

And then what are you left with? Resentment, anger, frustration, and probably all with a touch of passive aggression. So now the drain on your time also becomes a drain on your energy and happiness.

Do a paradigm shift with me and think about this: What if you set some boundaries, didn’t explain, and just said “no”? And what if you knew that each of these situations are huge contributors to your feeling of burnout?

I know that setting boundaries and  just saying “no” seems nearly impossible to some people, especially when you’re in the business of caring for and serving others.
And it just doesn’t feel like the “nice” thing to do. After all, Aunt Sally did send you that nice birthday gift last year. How could you possibly miss her party?

But getting front and center on boundaries is something I’ve had to learn to do, and it has nothing to do with being “nice.”  Look at it this way–


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There are just some things that we don’t have to explain.


We hold ourselves accountable every day for keeping our patients alive and well, our families healthy and happy, and ourselves in one piece.

That, in itself, is a full-time job. Am I right?

In a world where we are constantly explaining ourselves to patients, staff, insurance companies, it’s nice to know there’s a line that can be drawn. Finally.

We owe it to ourselves to draw that line in permanent marker.

Maybe we can’t be all things to all people. But we don’t have to explain to the world why.

And maybe we can allow each other the benefit of the doubt.

Without explanation.

What do you think?

 

 

 

Your Brain on Downtime: Tips for Top Performance

downtime

With our overflowing calendars and daily to-do lists, the first thing on the cutting block can be our ever-fleeting downtime. But the failure to rest and recharge our brains can lead to anxiety, depression and burnout.

Here’s what happens. We look at our schedule and start thinking:

  •    “Maybe I could just go to the gym once this week.”
  •    “Looks like I’ll be starting that meditation practice tomorrow.”
  •    “I’ve still got these charts to finish. I better blow off dinner with the girls.”

Just so you know, we’re not fooling ourselves. 

Not even a little bit.  Here’s why:

There’s a point in your day where your brain gets overloaded, and it’s screaming at you to stop. Meditation teacher and neuroscience junkie, Michael Taft, calls this the “brain being full” condition – what happens when your brain has taken in enough stimulation and needs downtime.


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Our extra efforts to get more done without a break don’t improve productivity. Instead, it lowers our performance levels and usually leads to overwhelm and burnout.

Ferris Jabr has looked at the research and here’s what he says: “Downtime replenishes the brain’s stores of attention and motivation, encourages productivity and creativity, and is essential to both achieve our highest levels of performance and simply form stable memories in everyday life.”

Ferris Jabr picquote

When you stop to take a walk, go to the gym, meditate for 10 minutes… you are actually being productive. Why should you encourage these activities? Because if your brain isn’t getting what it needs, it won’t function at its peak performance.

Sometimes we all need a good timeout.

What’s stopping us? Using your downtime to achieve rejuvenation requires conscious effort. Watching your favorite TV show for thirty minutes tonight may do it. But spinning your wheels channel surfing for a couple hours? Not so much. Gretchen Rubin cautions us to be mindful, even when we watch TV.

By starting these simple habits now, you begin training your brain to reduce anxiety and decrease the risk of burnout:

  • Make your morning count. The first hour of the day can allow time for a short meditation, a quick stretch, reading a novel. Don’t have an hour? Twenty minutes — even ten — can make or break some days.
  • Be in the moment. Stop to look out the window and really see the leaves on the trees, the sun hitting the branches.
  • Let time work for you. Don’t be a slave to the clock. Set the timer and allow yourself an extra ten minutes before bed to just chill. Sit and think about what you’re grateful for that day. Breathe.

We’re all busy.

And most things — the laundry, the dictation, the email — can wait.

Devote yourself to finding and keeping downtime in your schedule, and not only are you doing your brain and high performing self a favor, but your soul will also come along for the ride.

Please share with us how you find downtime in your day in the space below.

 

 

Can Burned Out Doctors Be “Difference Makers”?

Difference Makers

The idea of being a “Difference Maker” sounds alluring, doesn’t it? It’s not only the extremely successful people we’re talking about – those who achieve cutting-edge results. It’s also those who go above and beyond, and are defined by the difference they make.

The world is full of “Difference Makers.” They can be teachers, volunteers at a soup kitchen, youngsters mowing the yard for an elderly neighbor. Surely, doctors would get a free ticket into the “Difference Makers” Club, right?

Not so fast…

It’s easy to say that we’re “Difference Makers” just because our jobs include helping and healing. But it takes more than that to enter the circle of the real “Difference Makers.” This isn’t a club you get into by default because of your title.

In the world of medicine, how can you make the grade?

Here are 5 simple ways you can become “Difference Makers” right now:

1) Take time to make sure your patient understands their treatment and options.

2) Say hello to the stranger in the hallway at the hospital. They may be visiting their dying mother or a sick child.

3) Thank your staff or the nurse taking care of your patient. It may be the sweetest thing they hear all day.

4) Compliment your colleague, your spouse, your child on something today. It can be the tiniest thing ever (“You always load the dishwasher so efficiently!”) but it will be well-received.

5) Perform a random act of kindness.

You’re probably skeptical. I know – I was, too. I was also burned out.

If you don’t think these things make a difference, ask your patients, nurses and staff. And try it to see what happens to YOU when you begin to practice this.

Here’s the thing – seeing yourself as a “Difference Maker” can be empowering, not only for those you serve, but also to yourself.

And when burned out doctors feel more powerful, we can help ourselves — and others —regain energy and passion in our lives, at home and at work.

This can mean anything from giving a talk to thousands of people about the importance of connection, forming a social network group to brainstorm ways of improving healthcare, or having a one hour chat with someone who is at the end of a very short rope.

Each and every one of us can make a difference. And everyone wins, including you.


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Hospital janitors who saw themselves as “Difference Makers” were found in the above-mentioned Forbes article to redefine their roles. How did they do this? By simple acts of offering patients fresh water or extra facial tissue. Something outside their job description. Something that made a difference.

William James said, “Act as if what you do makes a difference. It does.”

Act as if what you do makes a difference. It does. -William James

As you plan your week, what can you do to have an impact? It doesn’t take loads of time. Or even a big bank account. Share with me in the comments below.

 

 

 

How to Use Balance to Beat Burnout

Burnout is not just for medical folks. Over sixty percent of the workforce in America reports being frustrated by their jobs. They say their goal every day is just to “show up.” Not in a “I’m here to do my best” sort of way. More in a “swipe the time clock” sort of way.

What’s the answer?

Trust me, some days I think the answer is to go to the beach and drink umbrella drinks.

But I know that after a couple weeks, that would get old. And we would run out of sunscreen. 🙂

So here’s what I think the real answer is:

Balance. Not that work-life balance thing. Is that really a thing?

That’s a story for another day.

No, I mean the balance between the good and the bad.

Ever notice that when you are having the best day ever, the good things just keep adding up?

Picture when you’re in the good karma zone: you catch all the green lights driving to work, find the perfect parking spot and catch the elevator . . . all before even starting your day. Sweet.

The opposite can sure be true, of course.

How to find the balance?

Picture a teeter-totter. It’s a long narrow board with a pivot in the middle. Usually it’s part of playground equipment, and children will sit on either end, alternating going up and down.

(For those of you wondering why I am describing this, we have so many international members, I’m not sure that teeter-totters exist worldwide!)

So, back to the answer of finding balance.

For every negative item on your agenda, you need to balance it out with a positive thing. It doesn’t matter if that negative item is something your secretary does to drive you crazy or a part of your job that you wish you could avoid.

When you write down your pro/con list, you need to remember to keep both columns equal.

There surely must be pros to your secretary, in addition to the cons. And those really awesome days at work that make you smile to yourself on your drive home? Those need to go on the positive side of the bench.


Twitter-Icon_LoveMedicineAgain.comAt the end of the day everything is a balancing act.


No doubt about it.

 

 

 

 

Life Lessons From Being a TEDx Speaker

You may have had being a TED or TEDx speaker on your “bucket list.” It’s been on mine for the past few years. So you can imagine my delight and excitement when I was asked to speak at TEDxFargo on July 23, 2015.

While you may not be scheduled to talk at a TED event or even give a speech to your local school, church, or bridge club, I’m discovering that the lessons learned from this are far-reaching. And I haven’t learned all the lessons yet, as we’re just a few days away from the actual event.

But I think you’ll be as surprised as I was by some of these lessons.

Here are my insider secrets:

1. People don’t know what “TED” is.

In sharing my news, I found many people don’t really know what a TED talk is. Are these random people, these “in-the-dark” folks? Uh, no. People like my husband. My secretary. My parents. (In fairness, my husband’s actual response was, “I don’t know what that is, but I know you’ve been wanting it, so congratulations!”)

2. There’s confusion about what TED stands for.

You can see various answers on what TED stands for. Everyone agrees that the T is for Technology and the D is for Design. But the E? The official folks say the E is for Entertainment. Others say the E stands for Education.

3. You find out who your friends are.

There is nothing more boring than listening to 50 different renditions of a short (less than 18 minutes) talk over and over and over. Your friends will only tell you this on about the 24th rendition. Your not-so-friendly-friends will say “Uncle!” after the second practice session.

4. Family are our best allies. Hands down.

My husband, my mom, and my sister have been my biggest supporters in this preparation. They have super busy lives and have still taken the time to listen (yet again!) to my talk, make thoughtful suggestions, and not let me go to voicemail when I call with one more silly question.

5. You find out what you’re really made of.

When it’s time to share an idea that comes from your heart, it’s a bit staggering. You think you know what you want the world to know, and that your message is “an idea worth spreading.” But self doubt can rear its ugly head without any warning. Quiet listening to my inner compass has gotten me through the rough waters.

6. You learn that it is really not about you.

You think you know what people want to hear about your subject matter. At first glance, I thought sharing the message from my viral Huffington Post blog on “The Secret Lives of Doctors” would be the obvious choice. But it turns out that, when you give your talk to random people who are kind enough to listen and voice their opinions, some things you thought would have mass appeal are in the “Who cares?” department. If you want your message to be heard, you need to let ego go and find the global language we all speak.

7. You learn that being humble is your best quality.

When you start out on this adventure, you think you have something to offer. And that you are the right person for the job. But then, “experts” begin to show you what you don’t have. You find out you’re “too soft spoken.” You walk “heavy-footed.” You talk “too fast” or “too slow.” It’s a Goldilocks story of finding things “just right.”

8. You learn nobody knows everything. Even the experts.

One of my strengths is that I am a great fact finder. I can research ’til the cows come home. And I’ve been blessed to have a team of experts helping me and fully acknowledge that it takes a village to make this happen. But it turns out, there are lots of things that aren’t known ahead of time. How big is that round red carpet that we are supposed to stand on? How long does it take for the video to be posted online? How many questions can I ask without driving me or them crazy?

9. You learn everybody has an opinion.

When you ask people for their opinions, they are going to (usually) tell you. This can be a good thing. You don’t want to prepare for this opportunity in a vacuum. But when you ask 50 people and get 50 responses… now, you’re in trouble. Think about when you asked your high school friends what your college major should be. Did you really want 50 different answers? Only one opinion matters, at the end of the day. Yours.

10. You learn to have faith.

Faith that you’ve been given this opportunity for a reason. Faith that your message will be heard despite your nervousness, soft voice, and Southern accent. Faith that if one person changes just one tiny thing based on your message, you will know the truth: you are enough.

 

 

 

One Thing Burned Out Doctors Can Learn Now

doctors

In case you haven’t noticed, we’ve passed the July first mark again on the calendar. There’s a whole bunch of urban legends and true stories about what goes on in the first few weeks of internship and residency for our new doctors.

I think we may have it backwards, when it comes to our concern about new doctors and their July starting date.

Here’s what I mean by that:

We need to review what we can learn from the new kids on the block.

Sure, they may not be able to recite the Krebs cycle or start an arterial line in five minutes. But they can teach us things we’ve likely forgotten over the past few years.

How do I know?

Last week, I heard from one of my clients, Mark, who just started his residency in the emergency medicine department of a busy hospital in the southwest. He’s capable, eager, and graduated from one of the top medical schools in the country, at the head of his class.

On his second day, a young pregnant woman came in, a victim of a hit-and-run, with multiple injuries and fetal distress signs in her baby. The woman was the same age as Mark’s older sister, with the same blond hair, caked in blood. It caught him off guard.

As he supported the team that sprung into action, he told me he had a hard time focusing on all the medical issues going on. The woman’s husband was by her side, anxious and afraid.

Mark tried to process all that was going on and lend a capable hand to the team. He noticed some of the attending physicians were also visibly shaken by the woman’s injuries. Others were instructing the young doctors on protocol, procedures and problem solving.

What Mark discovered is this:

It all matters.

Every bit of it.

  • What actions we take as the patient enters the space
  • How we acknowledge the family members and their concerns
  • How we stay present to be the best provider of care at that moment in time

It’s not about us at all. But it is about how we interpret things.


 

Twitter-Icon_LoveMedicineAgain.com What we think, say and do in the first 5 minutes of each patient encounter is critical.


Mark’s story showed me the importance of first impressions.

And the first impressions are not so much about the new doctors and their abilities.

But about our openness to learn from them.