…or Volunteer Closer to Home Dr Kirschenbaum emphasizes that medical talents should also be volunteered at home. "You can travel to Africa, South America, or Asia, but you don't need to look further than down the block. Consistently spending time ensuring that the most socially deprived people within the United States, and within your own community, have access to you is something every doctor should do in his or her lifetime." Teach Your Patients a New Vision and Model of Health It's easy to focus only on treating disease. But it's equally important to focus on building good health in your patients. "I want to help my patients achieve their fullest potential in body, mind, heart, and spirit," says Dr Bialek. Allan Magaziner, DO, founder and director of the Magaziner Center for Wellness, Cherry Hill, New Jersey, coordinates public seminars to "teach people how to live with health and vitality instead of spending their final decades in steady decline, dependent on prescription medications to control their multiple symptoms." He hopes to "develop a community-wide program to show that chronic degenerative diseases can be diminished by a change in consciousness, nutrition, lifestyle, exercise, eating wholesome foods, and reducing exposure to toxic chemicals." His bucket list goal is to expand this model to other communities throughout the United States. Expand Your Intellectual Horizons No matter how old you are or how proficient in your career or specialty, there's no end to how much knowledge you can acquire. In fact, says Dr Kempen, doctors are natural lifetime learners. And passion for learning goes beyond CME courses and journal articles. Tony Francis, MD, JD, director of Legal Medicine Research and author of advisory reports for US federal judges, told Medscape that he wants to "become a more intellectual person" and study classical Latin. He also wants to study Greek philosophy, mainly Aristotle and Plato. Dr Smith advises learning new computer programming. "It can do wonders for helping understand how computers think, and gaining an appreciation for what they are good and bad at. You'll never look at those little check boxes in your electronic health record (EHR) the same way again after you've written some if-then statements in LISP or another BASIC programming language. Relax. Hang Out. Repeat. Sometimes, you should make time to kick back, put your feet up, and do whatever you enjoy, even if it's just counting air molecules. Dr Weiss wants to "see as much live music, especially as much live jazz, in as many cool venues as possible; read, read, read; bike, bike, bike; see every great movie ever; and find a great place to stare at the ocean, and then stare at it for a long time." Dr Gloria Bachmann, MD, associate dean for women's health, Robert Wood Johnson Medical School, New Brunswick, New Jersey, also has a list of activities that she'd like to engage in. "Who wouldn't prefer spending more time with family and friends, and having more time to keep up on all of the latest clinical and research advances in medicine? More awake hours would also include staying up into the wee hours of the morning watching favorite movies, reading best-seller books, and debating politics with friends—to name just a few activities that there's never enough time for." You don't have to wait for retirement, vacation, or sleep-banking to begin relaxing. With creative time management, you can integrate some relaxing activities into your ordinary week, while keeping longer stretches of relaxation time on your bucket list Break New Ground in Areas of Medical Research Being on the cutting edge of advancing science and medicine is extremely gratifying. Several physicians described their passion for research and innovation. George Lundberg, MD, is one of them. Still working full time at age 82 years, he is an editor-at-large for Medscape, the editor-in-chief and chief medical officer for CollabRx, and president/chair of the Board of Directors of the Lundberg Institute. Dr Lundberg has always been at the forefront of innovation—for example, using the Delphi process to inform administrative decisions or introducing the brain-to-brain loop concept of medical testing. He says, "Transformative movements and branding have always been my thing." Jacques Barth, MD, PhD, a Dutch endocrinologist and cardiologist and professor of family health at the Keck School of Medicine, University of Southern California, Los Angeles, has been an innovator in use of ultrasonography in atherosclerotic disease. Now back in The Netherlands, he is the principal investigator on the Trauma and Resilience Initiative—an international research project studying intergenerational transmission of trauma and resilience patterns in descendants of Holocaust survivors. But his interest extends beyond Holocaust survivors. "I would like to get humanitarian research funded to help promote peace, satisfaction, and resilience in all people." Solve Problems That Stymie Other Doctors Today's physicians face an unprecedented number of clinical and administrative tasks, and many doctors would become professional heroes by solving some of these problems. The EHR is a huge and frustrating problem for many, if not most, physicians. Dr Weiss wants to "build a new and improved EHR from the ground up, eliminating all the stupid things that have tortured me in all the EHRs I have been forced to use and replacing them with a truly doctor-friendly, spectacularly elegant EHR." He plans to eventually segue out of clinical practice into a role as an EHR physician-consultant. Dr Raby is interested in implementing an office-based brain mapping technique that is more practical and less expensive than functional MRI. Andrea Fagiolini, MD, professor and chairman of the Department of Mental Health and the University of Siena Medical Center, Siena, Italy, wants "to develop easy algorithms to identify and code disease subtypes, with the goal of individualizing treatment by immediately identifying which therapy is most appropriate for the patient." Dr Goldman has a similar vision. He's working on an artificial intelligence program that predicts which medications will or won't work in each patient. "For the clinician, this creates an extremely efficient treatment protocol, allowing more time for the deep caring contact that promotes health and quality of life," he explains. Start an Innovative Business or Service Physicians leave medical school with a wealth of clinical information, but a dearth of training about business issues. Arlen Myers, MD, MBA, professor in the departments of otolaryngology, dentistry, and engineering at the University of Colorado, and president and CEO of the Society of Physician Entrepreneurs, wants to change this by introducing an "entrepreneurial mindset" to fellow physicians. "I want my legacy to be a change in the culture of medicine through entrepreneurship," he says. Dr Myers describes many different entrepreneurial models for physicians. One is managing a private practice, which he regards as a "small- to medium-sized professional service business." Another is being a "technopreneur" and trying to get a drug or device to market, or being an "intropreneur"—an employed physician who acts like an entrepreneur within his or her organization. Other possibilities are being a "social entrepreneur"—a physician "who tries to improve the human condition with profit as a secondary motive"; a physician consultant, who helps other physician entrepreneurs; or a "physician investor," who provides money to early-stage companies. Go Against the Grain and Climb Over the Hurdles Ralph Waldo Emerson said, "Do not go where the path may lead; go instead where there is no path and leave a trail." Sometimes, you need to step in and address a gap that no one has tackled before. Dr Cronyn wants to create a comprehensive primary care center for transgendered youth in his area. "Transgendered kids face many hurdles," he says, sharing disturbing stories of discrimination against children as young as 6 years old. He knows he might face formidable barriers. "To really do this, we have to convince the public and private insurance carriers to provide full coverage for the medications, procedures, and interventions that these kids need. But I believe that will come in the next few years." Fortunately, his organization is giving full backing to create a safe space for transgendered youth. "I am so glad," he says Blow Away Metrics That You Consider Meaningless Most doctors cringe when they hear such words as "quality metrics" and "reduced readmissions." Measuring what does and doesn't work in healthcare shouldn't come from "administrative rooms in the bowels of Congress," says Dr Rosenberg. Dr Cronyn says, "I want to find new ways to measure quality in the primary care setting, with true scores that are correlated with better health outcomes and reduced mortality, rather than meaningless metrics invented by 'quality experts' who have never seen a patient or worked in a hospital or health center." Marrick Kukin, MD, director of the Heart Failure Program at Mount Sinai St. Luke's/Roosevelt in New York City, wants to see hospital-level changes. "I would love to get my hands around the success of my hospital system in reducing heart failure readmission rates into the low teens, and use a better metric than the 30-day readmission rate to measure success." Open Up Your Spiritual Dimension Many, if not most, people feel that there's more to us than our physical being. Several respondents said they want to enhance their spiritual growth. Study was the most popular approach. Dr Francis plans to study the Scriptures. Dr Liss sets his sights on completing the entire Talmud. Dr Loh, who has been studying Taoism since his teens, plans to increase his learning. "These days, I'm focusing on the I-Ching, one of the oldest Chinese classics, although it's difficult to understand—even harder than it was to learn Chinese medicine," he adds. Spirituality isn't confined to literature. Dr Fagiolini wants "to spend more time in nature to improve communication with my soul." In addition, "I want to play a role in eliminating religious hatred and intolerance and helping people realize the common core of compassion and tolerance in all religions." Become the Healthiest Person You Can, to Inspire Your Patients "Physician, heal thyself" is an old adage that few doctors take to heart. Beginning with medical school, the message is to attend to the health of your patients while neglecting your own. Some Medscape respondents are recognizing that they serve their patients best by modeling healthy behaviors. For Craig Wax, DO, of Mullica Hill, New Jersey, that passion is creating optimal health. "It is incumbent upon us as individuals to take care of our own health better," he says. "Personally, I want to be an outstanding example of this concept by exercising daily, eating a nutritious diet, drinking water, getting sleep, not poisoning myself with toxins, and trying to lead the healthiest life I can. Because, how can I advocate the proper things for others to do if I don't do them myself?" Celebrate Your Own Accomplishments Even the most accomplished people sometimes get hung up on what they haven't yet achieved, or fail to give themselves enough credit for what they have done. Henry Black, MD, clinical professor of internal medicine and director of hypertension research, New York University School of Medicine, New York City, says he's achieved his dream to be acknowledged internationally as an expert in hypertension and preventive cardiology. He is also fulfilled and happy in his family life. The only thing lacking: "I wish some allergist would develop a way to enable me to have dogs or cats in my apartment." Dr Fryhofer writes, "I have had so many dreams come true, and so many unexpected joys." Among her accomplishments, she has served as president of the American College of Physicians (the second woman to be elected to that position). Like Dr Black, she feels joy in her family life and pride in her children. Source
