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10 Mistakes Smart Doctors Make

Discussion in 'Hospital' started by The Good Doctor, Apr 10, 2022.

  1. The Good Doctor

    The Good Doctor Golden Member

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    When most people think of physicians, they think of the class nerds or the smart kids who got all As and took honors classes and were on the debate and math teams, did the science Olympiad or won the spelling bee. They think of us as brighter and more intelligent than most of society.

    But we are also just human beings who have the same flawed brains and make the same mistakes as everyone else. In fact, I would argue that we often make more basic mistakes than the average person. I believe this is solely because we spent so much of our young adult lives following a predetermined career path. That path required a tremendous investment of time and energy, which left little room for outside learning and failing and exploring and refining many basic life skills that would serve us well to revisit today.

    Here is my list of the ten dumb mistakes that smart doctors make that we can correct should we desire to do so.

    1. Creating your entire identity around your career. When someone asks you what you do for a living, how do you respond? Most physicians (myself included) say: “I’m a doctor” or “I’m a (insert specialty).” Try this instead: “I practice medicine” or “I practice (insert specialty).” It’s a subtle shift, but it makes a huge difference in how you see yourself. When what you do becomes who you are, there is little room left for all the other parts of you. Making this shift doesn’t mean that you are any less of a doctor. It just means you recognize that you are much more than a doctor. Being a doctor is a very important part of your identity, but it is only one aspect. The sooner you make this shift, the earlier you will start to embrace all of who you are and all the beauty and joy that comes with that.

    2. Forgetting to put your own oxygen mask on first. The culture of medical training teaches us to always put our patients’ needs above our own. We endure sleep deprivation, long nights and weekends, work after hours and on days off, and lack protected time to take care of our health needs while telling our patients to avoid these same things.

    That can work for a while, even years or sometimes decades. But at some point, we run out of air and can’t help anyone else. Many of us women who are also the main caregivers for others in our family choose to reduce hours and thus significant compensation to compensate for these realities of our profession. Sometimes it works, but not always. We hear terms like burnout or moral injury, and we may not know the exact definition, but we know how it feels. We work for a health care system that forgot to take care of the physician. The flight attendant is not going to put on that oxygen mask for us. That’s our job. We have to prioritize our own physical and mental health, or we are no good to anyone else.

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    3. Not becoming financially literate. When we are in training, we often work for what amounts to less than minimum wage for hours put in. Then we get out and start making real money, often three or four times what we made in training. At the same time, we are saddled with often multiple six-figure debts.

    We have been watching our non-medical friends make good money for years and start buying homes and building families there, and we are tired of all the delayed gratification. Because we often don’t know any better, as no one really taught us how to manage this major change in our financial lives, we overspend and get ourselves into trouble straight out of the gate.

    It’s a sad and often told tale that can be completely avoided with a little education. I wish I had one good class that was required as part of medical school that covered financial literacy for physicians or a “dummy guide to physician finances.” Nowadays, we are fortunate to have so many amazing resources such as financial blogs and podcasts and online courses and coaching and much more available, but it would still be nice if it were built into the curriculum.

    4. Not protecting our time. I was asked to write a chapter and article in a journal related to my specialty for years. For years I did it — totally uncompensated. But it wasn’t free for me. It cost me lots of time. I didn’t mind it at first. It seemed like a nice thing to clarify my own thoughts and bring information to others. I also thought it wouldn’t hurt to have those chapters and articles on my CV.

    But after years of this, I realized that I had better use of my time. I had other interests and other projects where I would rather volunteer my time. So I stopped. I learned to say no to some things so I could say yes to others. It is a skill I wish I had learned much earlier in my career.

    Saying no is hard for many young and not-so-young physicians. Our time is pulled in so many directions, and there are often no clear boundaries set up to protect it. I can’t tell you how many times in my career I’ve been told, not asked, to attend this meeting or join this group or committee or give this talk or that lecture. I am convinced that if physicians were left to make these decisions for themselves, they would choose to do the things that matter most to them, and their talks and papers and meetings would be so much more interesting when they were done of their own volition.

    5. Not knowing our worth. We often forget that medicine can’t run without the doctor. Yes, there are midlevels and some very excellent ones who are extremely capable and competent and, as a group, maybe taking over medicine to some extent.

    But find me a midlevel with a serious personal health issue or an ill loved one who doesn’t want a doctor involved in their care. We abdicate control to too many other players and forget our own value. We ask for extra time or resources to best serve our patients or to do x, y, and z and then get upset when the answer is no. We ask rather than tell. We forget that the system needs us more than we need them. We think we are dispensable, replaceable, just a cog in a wheel because that’s how we are often treated. That doesn’t make it true. We sometimes are afraid to ask for what we actually need because we don’t want to be a burden or disappoint anyone.

    We don’t want to seem like we can’t handle things. We don’t want to trouble our scheduler or our manager or appear incompetent in any way. So we devalue ourselves.

    We stay silent and seethe, or we switch jobs thinking it will be better there than here. We forget our true value. We are not just providers. We deliver care from a depth of knowledge and training that no one else around us can even come close to touching. We assume a level of responsibility and liability that no one else has or wants. We are the MVP of the medical game. Let’s not forget that. Period.

    6. Not creating a personal mission statement. Most places where physicians work have some sort of a mission statement that outlines the goals or values of an organization.

    As part of that group, it is implied that you are following that mission created by someone else (unless you are the owner and created the mission statement yourself). But how many doctors have a personal mission statement that they live by?

    How many of us have a drafted vision that we can go back to anytime a new role arises or a new opportunity presents itself to which we can refer before making any decision to proceed. I highly suggest every new doctor creates this personal mission statement for their life and check in with it each time they make any career decisions moving forward. Think of how many wrong turns you might avoid if you had this foundation to guide you.

    7. Looking to medicine to heal ourselves. One of my jobs as a teenager was working as a library page, the person who puts the returned books back on the shelf. I remember coming across a memoir written by a psychiatrist with the following opening: “Most people go into medicine to heal themselves. In the process, they sometimes heal others as well.”

    Unfortunately, I don’t recall the author’s name, but those sentences have stuck with me all these years. I chose medicine after trying so, so hard to find a different career path. But medicine drew me in as it does to so many. We have to remain acutely aware that regardless of what brought us to this career, most of us are helpers at heart, and our primary purpose here is to heal others, not ourselves. If you are looking for medicine to make you feel smart or important or worthy or rich, you are in the wrong place.

    8. Not taking care of our own first. As we can see in the war situation playing out right now, so many people around the world want to help those struggling to escape and build a brand new life. But if you had a beloved grandmother or sister or close friend directly impacted by the current events, that’s where your efforts would be directed first.

    Before you help everyone else, you have to help yourself. Yet try being a physician and getting your own appointment with a doctor these days. I sometimes laugh when my patients complain about my answering service or how long it takes to get in. I am a patient, too, I think to myself. I know.

    But imagine if there were some secret society that I like to believe existed back in the good old days when you could whisper “doctor,” and everyone on the other line understood.

    They would get you in because there is no such thing as a VIP other than a “very important physician” who we need to help ASAP so they can get back to work helping others.

    But this secret society doesn’t exist unless you are lucky to have close friends or colleagues who may pull some strings for you, so you don’t have to cancel a full or half-day clinic just to get that long-overdue mammogram. Maybe it’s time we create this VIP fast pass. Maybe it would even reduce the number of doctors going part-time to fit in all their own and family members’ appointments. I spend at least 50 percent of my days off at various appointments most weeks, which was a big factor in my continuing to work part-time all these years.

    9. Forgetting to nurture friendships. One of the most common themes I see among physicians in online forums is their sense of isolation. As a group, we are quite lonely people. Medicine is often a lonely business. You take call by yourself or with a small team if you’re lucky. You make decisions on your own much more often than in groups or teams.

    Responsibility falls to you alone more often than not. If your spouse or life partner is not medical, they may not understand everything you go through. Or maybe you have no partner or one who is physically there but emotionally disconnected and so even home feels like a lonely place. Part of what made medical school — so fun for me was the comradery, the connection I felt with all my classmates who knew what I was going through and with whom I spent so much time together outside the classroom or hospital wards.

    Then we all left and went our separate ways, and everything seemed to change. It took much more effort to stay connected. I lost touch with too many great colleagues. Life got busy and more complicated. It’s never too late, but this is one mistake I truly regret. I would tell my younger self to cherish and nurture those early friendships. Make plans to visit each other and pick up the phone whenever you can.

    10. Forgetting who we were before medicine. Remember your past self? Remember their passion? You had a fire in you. You wanted to change the world. You wanted to go off to different countries and help those in need. You loved to read books, dance, travel, and explore. You sang in the shower. You took long walks. You rode your bike. You liked to cook or bake. You wrote for fun. You wanted to learn a new language and learn to scuba dive. You wanted to have long, deep, meaningful conversations with friends in a coffee shop.

    That person is still there. They are still you. Maybe you still do some of these things. But you stopped some of the other ones. You forgot your passions. You forgot what lights you up. You forgot who you are. That person is still you. They are not gone. Remember them. They are there.

    Do any of these resonate with you? Have you made any of these “mistakes”? What additional ones would you add? Maybe we can save future generations of physicians some significant heartache and lost time and money.

    We can compile a grand list and have it handed out at the white coat ceremony or mail it with the medical school acceptance letter. What a gift that would be.

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