From risk avoidance to risk mitigation

Jul 01, 2021

According to, risk can be defined as “peril, danger, [or] the chance of loss or injury”.

The traditional scholastic education system discourages risk-taking by rewarding certain predetermined responses to stimuli while punishing any other deviant or “wrong” responses.

In medicine, the punitive measures against miscalculated or risky moves could be catastrophic—for both patient and physician alike. Thus, we’ve been conditioned to be conforming and risk-avoidant.

But in the real world, anyone in history who has ever achieved great things, changed dynasties, birthed new inventions, or shifted paradigms had to take huge risks to become disruptive.

A person who risks nothing, does nothing, has nothing, is nothing and becomes nothing.” - Leo Buscaglia

The following are the three greatest risks in life:

  1. Inaction—a.k.a. “analysis paralysis”
  2. Ignorance—disguised as arrogance, denial, anger, or blame
  3. ...
Continue Reading...

There’s an element of choice in debt

Jun 24, 2021

This post is the first in a series wherein I explore the effect of debt on our lives.

Debts can either be good or bad – depending on a few features that I will explore over the course of several PHE newsletters.

Let me start by listing the bad debts:

  • Credit cards
  • Student loans
  • Car payments
  • Bank loans
  • Personal loans
  • Tax arrears
  • Mortgages

Some debts - such as student loans - are unavoidable on your path to practice. But most debts are, in fact, a choice. You don’t need to have a particular home or car. We exercise our free will in all of these purchases.

And there is nuance here as well. Not only is it our choice to pull the trigger, but there is also the degree to which we do it.

Medical schools are full of students who exceed basic tuition and living expenses by running up lines of credit on travel and restaurants. You can finance the Honda Pilot or the Acura MDX (hint: they all run on the minivan chassis…).

You can save and buy cash.

You can, heaven-forbid,...

Continue Reading...

From default to design

Jun 17, 2021

“Life either happens by design or default. You choose.” - Bob Proctor

Over the last few decades, I’ve come to embrace and believe this concept to be true in life, especially when it comes to medical practice.

Think about your work hours per week. Your call schedule. Your remuneration. The various taxes you have to pay. The scope of your practice. The physical layout of your clinic. The extent of staff support, the utility of your EMR—etc., etc., etc.

Some of these you have control of; others you don’t. But guaranteed, these crucial factors have been pre-designed by someone—either by you or someone else. And there is certainly no shortage of “Big Brothers” who are more than ready to helicopter in, pin you down, and “help” you manage your professional (and indirectly, your personal) life.

If someone led a rebellion or revolution against all my practice restraints, what would I wish for them to accomplish and change? What...

Continue Reading...

Time is your most precious asset

Jun 11, 2021

I often reflect on how my life is racing by. I blink and it feels as though another year has passed.

Our children grow older and more independent. The “new” hospital that I started working at when it first opened is now over seven years old.

In medicine, our lives are filled with long work hours of administration, clinic, call, and OR time.

We are always running somewhere.

I am proud that we feel this strong obligation to serve our communities and families: but where do our souls fit into all of this?

None of us is ever getting back the hours and years that have passed in our lives. And in caring for our patients, most of us are tragically and regularly reminded about how fragile life can be.

But these realities can be an empowering force in our lives – reminding us to cherish our time and make it as meaningful as possible.

Here is my challenge for you this week:

Simply stop and ask yourself whether you are living the life you actually want - one where you feel...

Continue Reading...

You are either growing or dying

May 27, 2021

Every living organism, organ, or cell is either in the process of growing or dying, nothing in between. Even homeostasis is a balance of anabolism and catabolism.


The same holds true for us personally: we’re either growing or dying every day -- either Personal Growth or Personal Death.


What are the signs of growth? 


Freshness, fragrance, life vigour, enthusiasm, addition, multiplication, creativity, innovation, encouragement, passion...


What are the signs of Death/Dying/Rotting? 

Dullness, stagnancy, wilting, withering, stench, reminiscence (“the good old days”), crankiness, whining, complaining, blaming, scapegoating, vengeance, spitefulness, jealousy, cynicism, “excusitis”...


Organizations are also either growing or dying, as there is no such thing as status quo. Your practice, department, or board is also either growing or dying.


Since an organization is ultimately a reflection of its leadership,...

Continue Reading...

Put your phone (and yourself) on sleep mode

May 20, 2021

Survey after survey shows that physicians are chronically sleep-deprived. I used to measure lost sleep not in weeks but years. 


As I’ve gotten older and less tolerant of night shifts, I have taken conscious measures to regain control over my routine.   


I tried getting an old-fashioned bedside alarm, but it just wasn’t the same peace of mind as my smartphone. As an ER physician, I’m constantly fearful of oversleeping and being late for a shift. So, I set multiple alarms on my phone to be darned sure I’m up.  


But I have learned strategies to limit my cognitive engagement with the phone. News apps and notifications are completely disabled in the evening. 


The blue light filter runs 24-7. It reduces stimulating light and makes my phone far less interesting to read or watch, thus lowering the cognitive engagement further. 


Reflecting on your own life, imagine a more rested version of...

Continue Reading...

Getting the right people on your bus

May 13, 2021

One way to depict leadership is for the leader to take a group of people on a bus ride toward a destination. 


Here are the scenarios:


  1. Right People, Right Bus: Great, you’ve got the ideal situation and the prerequisite for a great team. Bon voyage!
  2. Right People, Wrong Bus: Uh-oh! However, no matter where the bus goes, they will probably have a good time on the journey. And together they can figure out how to get to their destination.
  3. Wrong People, Right Bus: Now the people are having fights, strife, and strain even if the bus is heading straight to the destination. If they ever get there in one piece…
  4. Wrong People, Wrong Bus: An awful coincidence; a recipe for disaster. Life is too short. Get out STAT!


Early in my practice, I thought that I could shape my team like a sculptor. Boy, was I wrong! 


We’re not on a crusade of changing people-- they’re either the right people or NOT! 


Inverson took an obscure...

Continue Reading...

What really is an asset?

May 06, 2021

In an earlier article, I asked you to calculate your net worth by subtracting your liabilities from your assets.


What is an asset? The simplest definition is an object or financial product that can be converted (sold) into money.


But the question is more complicated than that. 


Take your vehicle, for instance. While it may be sold, you won’t ever get what you paid for it. Every year you own and drive it, the value depreciates. 


Your personal residence is another example. Without constant upkeep, repairs, and renovations to keep it current, its value may wither. If you sell it, will you really pocket the profits while you downsize, or will you be tempted to get a different home of equal or greater value?


Cash is king. 


One definition of an asset is anything in your life that generates positive cash flow with minimal or no effort on the owner's part. 

Continue Reading...

True focus is the secret to your success

Apr 29, 2021

Years ago, I attended a seminar on focus, wondering what the big deal was and how someone could be a “focus specialist”. 


The speaker started by asking how many key roles the audience had in their lives. He started at three, then kept counting upwards. I held my hand high up until the count was done, secretly feeling quite proud of how versatile and important I must have been. 




It turned out that the higher the count the less focused and more scattered you are! 


According to the focus specialist, the maximum count should be three!


We’ve all experienced a good sunburn, but a convex lens can focus the same energy into a powerful beam that lights up a match!  (I guess that’s why we use the term “laser-focused”.)


For anyone who was recognized or remembered in history, it was always about one big idea, or one salient thing they did, not a bunch of different things (eg Ray...

Continue Reading...

How to “turn off”

Apr 22, 2021

As I mentioned in a previous communication, many of us feel that we are “always on” and accessible to our personal and practice networks.


I love my smartphone and consider it indispensable to my medical practice and daily life. But sometime in the last several years, I realized it was a growing hindrance to enjoying family time. I was being interrupted with notifications or felt the need to check email outside of work hours.   


That got me searching for ways to enjoy the benefits of the technology while minimizing its downsides.


The most effective strategies I’ve found in my own personal use are the following:


1. Turn off all notifications all the time. Unless I’m expecting an important call, my phone never rings, beeps, or vibrates. 


2. Leave it on the kitchen counter. Whether I’m building one of my companies or building a Lego set with the kids, the phone stays on the counter. I try and practice...

Continue Reading...
1 2 3 4 5 6 7

50% Complete

Sign up for weekly news!