Making our own well-being​ a priority – today and every day. A physician coach offers steps to improve patient care, extend our careers, and bring joy to our lives

9.5 million entries on Google for “physician wellness”  speak to what a big topic it’s become.  Hospitals, medical groups, and medical associations are including an increasing number of programs on physician wellness.

So why do 300-400 physicians continue to take their own lives each year?

Because, for many of us, our own wellness is at the bottom of our list.

Human Pyramid and Thumbs Up
We need to recognize that our well being is the foundation of good medical care.  When physicians are stressed or suffer from depression or anxiety, the quality of our care is negatively impacted.  Our productivity diminishes. We leave our profession, or we leave our lives.  Wellness is like the people on the bottom of a human pyramid.  Although we tend to focus on the person at the pinnacle of the pyramid – look at their grace, balance and poise! – without a firm foundation, they would topple.  The same is true of our own personal wellness.

In her excellent article, Danielle Ofri cites the ongoing culture of perfectionism.  Clearly, one needs to be fairly perfectionistic to obtain the grades and scores to get into medical school,  to acquire exponentially increasing amounts of scientific knowledge and understanding, and to conform to high standards of practice.  Knowing the stakes are high compels us to drive ourselves and keeps our anxiety levels high.  As perfectionists, we focus on our small mistakes, our less-than-perfect outcomes, when a more balanced appraisal of our performance would be more accurate – and healthier.  We can improve our well being on a personal level by keeping a journal of our successes and asking ourselves, “What did I do WELL today?” as each day comes to a close.  This will provide a broader view of how we’re doing and allow us to balance our inevitable shortcomings with the many excellent actions and outcomes we provide.

As a group, we can address systemic problems – the inefficiencies of the EHR, a focus on productivity over quality of care, insensitivity to individual physicians’ needs.  Arranging exam rooms so physicians can see both the computer screen and the patient should be imperative.  Physicians’ requests to adjust their schedules so more complicated patients are given longer appointments or to allow for family or personal needs should be easily accommodated.  Support staff such as scribes should be immediately incorporated into the routine and culture of healthcare, just as the EHR has been incorporated.  This will help to alleviate some of the stress and will allow physicians to feel as if they are being supported by their organizations.

There are excellent, evidence-based interventions that build resilience and restore physician wellness.  Shanafelt et al showed statistically significant improvement in all measures of burnout when groups of physicians met biweekly for an hour for mindfulness, reflection, shared experience and small group learning.  The groups continued for 9 months and improvements were sustained at 12 months.  The benefits of mindfulness practices and exercise are well known.  We all know that nurturing outside relationships and passions improves our state of mind and lowers our stress.  What’s missing is our own prioritization of these things in our lives.

When we give ourselves even a small amount of time to focus on us – personal reflection, activities that nurture our soul or reconnect with ourselves such as meditation or walks in nature, time with those we love, eating healthy foods  – we tell ourselves that we are important.  Good decisions like this lead to other good decisions during the day.

What will it take to make your own well being a priority?  What small step can you take today to support yourself?  Give yourself 30 minutes a day for your own wellness, and watch your life immediately improve.

(Hint: For some ideas, click here)



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An Invitation to Become an Emotionally Intelligent Leader – free webinar 8/30/17


Our tweet chat last night was filled with great ideas and the sharing of many issues that confront physicians who wish to lead from their passions but are worried they will get tripped up if their emotions come out at inopportune times.  While both genders struggle with gender-based stereotypes regarding emotions, we would like to offer a program especially geared toward the challenges that women physicians face.

Deborah Munhoz, MS, PCC, and I invite you to join our webinar, hosted by the American Association for Physician Leadership (AAPL) ( on Wednesday, August 30th from noon-1PM Eastern.  We will bust some myths about emotions, discuss the importance of Emotional Intelligence in patient care as well as leadership, and you will leave with a simple, 3-step process for using your emotions powerfully to gain greater influence in your life.  AAPL has graciously allowed us to invite non-members to the webinar.  We hope you’ll join us! To register, click here.

Warm regards,



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The Secret to Becoming an Emotionally Intelligent Leader – please join me for a tweet chat Tuesday, August 22nd!

The value and power of Emotional Intelligence are well accepted. In fact, how we manage our own and others’ emotions can determine our own effectiveness as a physician and a leader.   It’s my pleasure to invite you to join the international discussion of how to best use our emotions in the healthcare setting on Tuesday, August 22nd at 8:30 PM Eastern.  Hosted by the American Association for Physician Leadership and HCLDR, we will explore this important and timely topic and focus on 4 questions:

  • How have emotions helped or hindered you in your career?
  • When does expressing emotions seem like an act of strength, rather than a weakness?
  • How can expressing your emotions help to form your reputation as an effective leader?
  • What are some tactics for expressing emotions in a constructive way, that have worked successfully for you?

Here’s a blog post to pique your interest and provide additional resources on the topic.

To join the chat, log on to your Twitter account and search #hcldr – I hope to see you there!



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Let’s ASCEND to a more effective flow of communication with our patients. A physician coach shares a useful mnemonic

Communication, as they say, is a two-way street.  For several years, we have taught Male doctor discussing reports with patient in medical officemedical students the art of communication.  They learn to develop rapport with patients through eye contact, body language that conveys interest in what the patient is saying, and by demonstrating an interest in the patient as a person .  They learn to signpost their
way through the encounter to let the patient know what to expect next, reducing the patient’s anxiety.  They learn to deliver “bad news” with the SPIKES protocol.  Strategies to help patients remember what we tell them are taught and practiced.  Although doctors are often criticized for their communication style, our profession is working to improve our skill set.  That’s one side of the communication street.

But what are we doing to enhance our patients’ ability to communicate with us?

Many times, patients leave our offices more confused than when they came, their real questions unanswered, even though we offered our best care.  In order to change this, it’s time for us to assist our partners in communication – our patients.  Karen Knops MD, an experienced palliative care specialist in Washington, along with the Gold Foundation, dedicated to Keeping Healthcare Human, provide us with an excellent tool for this purpose.  ASCEND is a simple mnemonic that provides six principles and practices to assist patients in becoming strong and effective partners in their care.

Dr. Knops suggests that patients develop the habit of Anticipating their doctors’ appointments by thinking about the purpose of the visit and considering what questions they want to be answered and who should accompany them.  After her experience as a teenager with scoliosis, she shares that, “I’ve never lost my awareness that commonsense can easily go on hiatus when we are gowned and vulnerable.  Taking notes should have occurred to me as a straight-A student, but never once did I try that.  I would log hours practicing for a youth symphony audition, but preparing for a doctor visit never crossed my mind.”  Once in the room, patients can ask their physician for a Summary of the big picture before details are discussed.  They can share their Concerns, Explore the risks and benefits of planned tests or treatments and ask for Explanations, including what the Next steps will be.  And they should be sure to Document the important information and instructions.

We provide patients with all sorts of assistance – why not suggest a simple mnemonic that will help to ensure the smooth flow of communication in both directions?

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The Art and Power of Saying “NO” -Physician coaching clears the path for fulfillment and impact

It’s a common experience- someone asks us to do something and, while our heart and gut are screaming, “NO!” we hear the word “yes” come out of our mouth.

Woman Scientist: Stop SymbolWhy and how does that happen? And, more importantly, how can we change that behavior so our response reflects our true desire?

When we find ourselves saying yes, it may be for a variety of reasons. Unfortunately, we rarely take time in the moment to examine our priorities so we can come up with the most appropriate response. Instead, old patterns, such as wanting to please others, not believing we have the right to say no, a fear of missing out, or a variety of other worries hijack our response system.

One protective approach is to invoke an automatic response. “That sounds like an interesting idea – let me think about it and get back to you,” buys some time so we can consider the pros and cons in a safe environment, without the pressure to please.

Then, we can sort through our values and decide whether the opportunity aligns with them or not. This alone may help us decide to say yes or no.

Another important step is to imagine how much time the new project will take. By consulting our calendar, we can see if we have time for this. If not, our answer may be simple. And if we still want to say yes, what might we have to say no to in order to fit this new commitment in?   Conversely, if we say no, what might be possible instead? Often, when we hold one option up next to the other, we see clearly which is the wiser use of our time. If we truly don’t have time to do a good job, it’s always better to decline. Otherwise, we’ll end up disappointing others with poor quality or late work. Our reputation is built on the integrity we show and the product we produce, rather than on our willingness to say yes if we end up turning in poor quality or late work.

Many of us feel guilty if we refuse various offers, as we don’t want to appear selfish or not a team player. Yet, if we decline an offer, it may create an opportunity for someone else to step up. Who might be good at this besides us? Who might appreciate the chance to learn or receive some recognition?

In the end, if we decide we don’t have the interest or time to accept the offer, there are a number of ways to say no that still maintain our connection to the person who asked. We can offer to do part of the project, to work on it after a certain date if time is the issue, or to work on another project if we just don’t have an interest in the current offer. And, if none of these responses fit, we can offer our encouragement and acknowledge the importance of their efforts – these are important sources of assistance as well.

By becoming more skillful at discerning where our time is best spent and learning to say no, we’ll have more time for the things that are truly a yes for us.  Only in this way can we are live our most fulfilling lives and have the most impact in the world.

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Speak Out to Heal our Divide and Get What you Want. A physician coach offers a simple, 3-step process

Physicians report increased anxiety among patients, who cite the political climate as a major source of distress. “Our country is divided,” we often hear. Preferring not to couple pointing fingers at each other, blaming each otherconsider others’ opinions, we remain in the echo chambers of shows that feature only our views. While few enjoy the tachycardia, tight muscles, and flushing that accompany confrontation, another reason we avoid potentially antagonistic conversations is that we don’t have the skills. We’re afraid to share our opinions, lest others become angry and say hurtful things or we direct those damaging outbursts toward others. This simple, three step process has the potential to open up productive dialogue and heal the divide we are feeling.

When we feel a confrontation coming, the first step is to recognize our emotion. Is it anger? Frustration? Fear? Sadness? Exposed to difficult feelings throughout training, physicians learn to ignore them as a defense against feeling overwhelmed and being unable to act appropriately. With practice, we can become adept at understanding our emotional state. We feel a strong emotion when an issue we care about is at stake, so the second step is to identify the issue. If we’re cut off during a discussion, are we angry because we feel disrespected, because it’s important to hear all viewpoints, or because the information we’re sharing may prevent something untoward from happening? Once we understand the issue, we can speak calmly and directly about that.

Let’s say you are assigned a different MA from the float pool each day of your assistant’s vacation. You are frustrated explaining your protocols to a new person every morning; any experience she gains that day is lost when she doesn’t return. You have run an hour late each day, lab results have slipped through the cracks, and you are worried that a serious issue might occur. You feel disrespected because another colleague was assigned one person for the entire duration of her assistant’s vacation. You feel your jaw clench and your fists tighten as another new MA walks into your office in the morning. You want to explode.

Instead, you recognize you are angry. The issues are patient safety, the efficiency of your practice, and the unfairness and disrespect you perceive. With that understanding, you call the administrator and say, “I’m unhappy I’ve been assigned a new assistant each day. Things have slipped through the cracks and I’m worried there may be a serious patient safety issue if this continues. In addition, the situation is unfair and disrespectful to me, as my colleague was assigned the same MA for the entire duration of her assistant’s vacation. I request that I be given the same respect and that the MA in my office today remain with me for the duration of the week.”

Using this simple 3-step approach can help us speak plainly and powerfully without risk of damaging relationships, and greater understanding between people can occur. Only then can we heal the divide we are experiencing.

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What are you tolerating?

Most physicians are hard-working, driven people.  We wouldn’t have gotten where we are without that drive, ignoring opportunities that might have been more fun so warningwe could gain knowledge and skills to care for our patients.  People are surprised when they learn that our daughter, a second year medical student, is studying over 12 hours each day in preparation for her licensing exams.  No physician would be surprised at her dedication and strict regimen.  It’s what we accepted we must do to become a doctor. Don’t misunderstand me – I’m not complaining about this investment of time and attention.  I love learning and felt happy to be gaining important information that I imagined I would use to help my patients. But along the way, I became disconnected from many things I loved.   What’s troubling is that I became so used to striving that my almost single-minded devotion to learning began to seem normal.  Several years later, I became burned out.

Similarly, people in failed relationships often look back and recall behavior of their partner that foreshadowed what was to come.  Refusals to help when asked, unwillingness to spend time together, and hurtful, dismissive comments were ignored or overlooked.  “She’s tired, stressed, preoccupied,” were excuses given to explain the behavior.   We often tolerate unpleasant or unhealthy behaviors or situations for fear of imagined repercussions, hoping that the behavior will change.  Unfortunately, this is magical thinking. When we tolerate undesirable behavior, from others or ourselves, what we usually get is more of the same, or worse.

What are YOU tolerating?

Are you tolerating intimidating or unfair treatment by others in your office?  Are you tolerating a poor diet or lack of exercise, believing you don’t have time to do better? Are you tolerating being left out of plans made by your partner or friends, even though you feel ignored and hurt?  Or perhaps rude responses from your kids?

While your current level of distress or disappointment may not have reached its boiling point, imagine that this situation has continued for the next 10 years.  How will you feel then?  What will you have given up?  How much better would your life be if you had corrected this situation now?

Stepping up to a conversation in which you honestly share what you have noticed and the impact it is having affords the other person an opportunity to change.  And if the behavior continues, you can make a conscious choice between continuing to tolerate it or changing the situation. Either way, you take greater control of your life, so that in 10 years, you will have given yourself the opportunity to have the life that you truly want to be living, and not one that you are simply tolerating.  How great would that be?


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