Physician Empowerment Resource Blog

Decades ago, one of my mentors asked me, “Would you like to make 100% of one person, or 1% of one hundred people?”

That question caught me by surprise. I was working around a hundred hours weekly as a solo practitioner, so I knew all about “100% of 1”. But “1% of 100”? I couldn’t even fathom it! What did it mean?

It’s all about leverage.

Archimedes said, “Give me a place to stand and with a lever I will move the whole world”.

In the worlds of manufacturing, finance, real estate, and franchising, there are numerous leveraging success stories.

In healthcare, we’re faced with radical cuts and dwindling resources while clinical and administrative responsibilities rise. Practitioners need to evolve and learn to leverage other teammates' time, effort, knowledge, expertise and technology.

The old adage of “if you want something done right, you gotta do it yourself” is not only obsolete, but detrimental to...

In an earlier posting, I wrote how debts can be a choice. Today I’ll explore the mental toll that bad debts take.

When it comes to issuing debt, banks use formulas based on occupation, income levels, and existing obligations to determine whether a borrower is a safe bet.

And often, doctors are given whatever they request.

But sustainable debt has less to do with numbers and more to do with your mindset.

Because most of us have one, I’ll use the example of a mortgage.

In some markets, it can consume 30% or more of gross billings.

It gets worse: Remember that payments reflect after-tax earnings in top brackets. Your $5000 per month mortgage is now more than $8000 of earned income.

Worse still: you’re paying large personal tax bills just to cover additional thousands in property taxes.

So, is this debt a joy or a burden?

Here are the real questions to be asked about bad debt:

How many clinical hours per month (or years in my life) will I have to work to pay off this...

Fear is an innate instinct to protect us from danger, but it can also be a learnt or conditioned response to less harmful situations (e.g., heights, public speaking, social settings).

Fear of the unknown is a powerful deterrent and roadblock to the path of greatness, personally and professionally.

FEAR equals False Evidence Appearing Real.

With closer examination and confrontation, a lot of such irrational emotions can be chased away like dark shadows in bright light.

How does fear paralyze us? It’s a mental process where our minds fast-forward the worst scenarios, playing them right now.

What about faith? It’s a mental process where our minds fast-forward the best scenarios, playing them right now.

In essence, fear and faith are the same mental process, just one being negative and the other positive. So why is fear so much more prevalent than faith?

It has to do with our natural bend towards negativity versus positivity—like saying “it’s too good to be...

In an earlier posting, I explored how time in the most precious asset in our lives.

None of us is getting our youth or years back. Yet we lose countless hours consumed with fear.

What I have come to realize when I look back on my own years is how much of my life was spent needlessly worrying. In fact, some of the things that used to keep me up at nights - parenting, money, training goals, and others - are now faint memories.

I feel silly for even having dwelt on such things. All the supposedly “stressful” years of my life are, in retrospect, happy ones filled with a growing family and educational milestones.

So, when today’s worries begin to catch up with me, I perform this basic mental exercise:

What joyful moments in life am I missing right now as I worry? Will I even remember this problem a year from now?

The reason I ask myself these questions is that I’ve gotten tired of letting fear consume the most precious resource in my life – my time.

Going...

According to yourdictionary.com, 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. ...

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,...

“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...

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...

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,...

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...