Managing a “crisis”

Nov 18, 2021

Previously I wrote about my own crisis that really wasn’t one because I properly triaged the situation.

Urgencies - when we worry and inflate them into a mini-crisis - can be a major source of burnout.

Here are some great starting points on how to manage the next problem that lands at your feet:

  • It almost certainly isn’t a real crisis. True emergencies are rare. Unless the situation involves serious personal or financial harm, it is probably an urgency. Pause and take a deep breath.
  • Acknowledge that the event is in the past and immoveable. The only thing you can control is your own future actions and words.
  • Now that panicking and time-travelling are off the table, stop to consider your options. Don’t be reactive by acting on the first thought in your head.

Thinking about your own life:

  • How often in your week is a “crisis” brought to you?
  • How do these events affect you emotionally and physically?

The worry in a non-emergency is often more...

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Leading with civility – part 3 of 4

Nov 11, 2021

(Over Oct. and Nov., I am sharing a series of posts on the topic of civility.)

A recent MIT study shows that commercial air travel safety has improved tremendously over the last few decades: now one death per 7.9 million passenger boardings compared to one per 1.3 million from 1988-1997.

And so, it’s safer to fly than to drive. 

Their secret?

Complete naked honesty without any repercussions whatsoever—any kind of mistakes, miscalculations, mishaps, negligence, or faux pas are fully disclosed without reprimand.

The lessons learnt are freely shared amongst all departments and companies. After all, concealment is the biggest risk of all!

Wow, how diametrically opposite that philosophy is compared to our medical culture.

In a world of litigation, college complaints, 360 degree peer reviews, and top-down bureaucracy, many clinicians sadly resort to just checking boxes of standard operating protocols to “CYA” (Cover Your Anatomy)!

If we could reshape our work...

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Is it really a crisis?

Nov 04, 2021

Dear {{first_name}},

Earlier this year, Dr. Yatin Chadha interviewed me for his podcast Beyond MD.

The topic was real estate but one of my best stories was “lumbar puncture night”.

I shared how I worked an incredibly busy night shift in the ER with a flight booked the next morning. But shortly after finishing work (and on the way to the airport), I got a call from one of my tenants saying the suite above hers was leaking water through the ceiling.


This was obviously a big problem.

But was it really a crisis?

I got through that mess by falling back on a familiar technique we all use in medicine: triage.

While I immediately began to worry about the disruption to my elderly tenant and potential costs of clean-up, I paused and reminded myself that this wasn’t a true emergency.

No one was injured or dying. I had good insurance and great team in place to handle repairs.

I reviewed the damage but then hopped on that flight without a second thought.

The next time...

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Leading with civility: Part 2 of 4

Oct 28, 2021

(Over the next two months, I’ll be sharing a series of posts on the topic of civility.)

In the last post, we established the importance of workplace civility, especially in the clinical setting.

I recall in my clinical clerkship days (some three decades ago) we student interns were nicknamed EBUs—Ego-Building Units. It seemed everyone from the staff physician to the residents, nurses, and even janitors could somehow stomp on our fragile, ignorant selves to help themselves feel better.

Self-pity aside, it‘s high time that we as medical leaders reshaped our work culture that might otherwise be marked as top-down, cold, unforgiving, or even toxic.

Without rewriting policies and protocols, a simple step to foster civility is to practice valuing and appreciating your team members, regardless of their rankings:

Value their:

  • Work—respect the wisdom of those who are closest to the specific portion of the work
  • Roles—appreciate the importance of...
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Debt can be good

Oct 21, 2021

In previous discussions, we talked bad debt.

Today, we’re covering good debt.

And no, I won’t be trotting out the old adage that educational debt and mortgages are always a good thing. 

It isn’t true and it isn’t relevant. These debts are only a small part of a doctor’s relationship with borrowing. Let’s dive into something deeper. 

Using a simple example of two physicians, let me show you how debt cuts both ways over the course of a decade.

Case 1:
Frank takes out a $100,000 personal line of credit which he promptly maxes out on consumer purchases and never pays off.

Assuming a $3000 annual cost, the LOC has cost Frank $30,000 over the decade.

Worse still, he had to pay additional personal income tax to cover the annual interest by withdrawing these funds from his corporation.

Case 2:
Yasmine came across great opportunities in real estate limited partnerships (RELPs).

To avoid missing out, she decides to use her LOC to cover household...

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Leading with civility: Part 1 of 4

Oct 14, 2021

(Over the next two months, I’ll be sharing a series of posts on the topic of civility.)

I just attended the Global Leadership Summit 2021 and a particular quote struck me:

“We’re defined by how we treat each other.”
Shola Richards - Founder & CEO, Go Together Global; Workplace Civility Expert)

Why bother with civility at work? 

A recent survey showed that when workers were ill-treated by their co-workers or superiors:

  • 25% took out their frustrations on customers
  • 48% intentionally decreased their work effort
  • 78% dropped their commitment to the organization

In medicine, our work culture is so entrenched in accuracy, efficiency, elitism, and intolerance of the slightest errors that we tend to treat ourselves and each other critically, harshly and without grace. No wonder so many frontline healthcare workers—especially in high traffic, high-stress areas like ER, OR, or inner-city outpatient departments—have the reputation of being rude,...

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How to say “no”

Oct 07, 2021

Previously, I shared the power of saying “no” and why we should all be incorporating it more into our personal and professional lives.

Now I would like to explain the how because it isn’t easy…

As I mentioned before, physicians are inherently conscientious. Our first reaction is often to agree to a request without a second thought. We do this because we know that others’ look to us for help and leadership.

But as we realize the importance of the word “no”, we need to use it properly. And despite our fears of alienating others, this honesty brings us closer with colleagues and enhances the therapeutic relationship.

So here are some useful strategies:

  1. Live and practice with intention. You are saying “no” because you mean it.
  2. Never apologize. You are doing the right thing for you and the situation. You have nothing to apologize for.
  3. Be gracious. If it’s true, reply that you are honored to have been asked. Offer to help in...
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It's about to get ugly

Sep 30, 2021

As I write these words, Alberta is approaching a crisis in the pandemic: We are running out of ICU capacity.

For the first time in my career, I am preparing to triage critically ill patients to decide who receives life support. This was not something I ever expected to encounter.
Yet during these times, I reflect.

Today I was reminded of the wisdom of one of the greatest athletes in history – Kenyan long-distance runner Eliud Kipchoge.

Mr. Kipchoge rarely trains at full capacity. He saves his 100% for when a title is on the line.

Over the next several weeks, I will be working at my 100% to serve my patients.
I will be tired but not burnt out because, for years (not months), I have been at working at a healthy pace. Wellness means caring for yourself first. It means living with intention.
But now it is time to step in and get the work done.

I am confident our great province will come through the pandemic. I am confident in the work of our incredible nurses, physicians,...

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From top gun to team captain

Sep 23, 2021

Finishing your residency training is like finally graduating from the US Naval Strike and Air Warfare Center as the top gun.

You might indeed be the best air-fighting pilot out there, but in the war zone, you and your team have to fly in formation, dodging perilous fires while trying to shoot the enemies down.

Now, in everyday medical practice, there may not be as much of an adrenaline rush—except maybe during codes—but we’re definitely not flying solo (not even in a solo practice!).

Being team captain vs. top pilot is undoubtedly quite a different game altogether—something our traditional medical training under-equips us for.

It’s a long and painstaking process to go from being a “me” thinker to “we” thinker, and as the team leader, mobilizing your entire team to progress through the metamorphosis can be a daunting task!

Here are 5 stages of evolution along the “Me-We” continuum:




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Debt and choice (Part 2!)

Sep 16, 2021

Last month I went through the first three of six quick wins on your path to avoiding consumer debt.

Now I want to share three more of my favorites:

1. Opportunity Cost.

How much would this $50,000 be worth if I bought more real estate/equities with it instead of a new vehicle? (This is why I’m still driving the same truck five years on).

2. The Tax Bill.

As an incorporated professional, you have the choice to withdraw personal income at top marginal rates or keep it within your corporation to invest. Over years and decades, the spread can be astonishing.

3. Life Energy.

My favorite and the last line of defense! How many hours of my life energy will I spend in clinical work to pay for this? Often when I ponder on this one, I’m out. The big purchase never seems to be worth the night shifts.



While each of these facets appear small, they can add up to accumulated wealth of millions over the course of your career.


More importantly, reduced spending...

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