Five Ways Physicians Can Decrease Stress, Increase Happiness

Last week's blog stated what should be obvious: A physician's life is complicated. Success and happiness require constructive responses to that complexity.

The challenge is in making those constructive responses. Here are five specific tactics to employ:

1. Accept that you can't do it all.
There will never be enough hours in the day to do all you want or even all you must do. The trick is to be intentional about what does not get done, rather than realizing later that something has slipped through a crack.

The awareness that something is impossible relieves a surprising amount of stress.  Some of the impossible you can simply take off your to-do list, like training for a marathon.  Other impossible tasks will have to be accommodated in some way, most often by delegation while retaining responsibility for monitoring.

2. Be clear about your priorities.
In a medical practice, volume drives income and most compensation models.  High volume, however, means less professional challenge, and less time for research and/or family. It is much better to acknowledge and prioritize the inevitable tradeoffs prospectively than regret them retrospectively.

Urgent and important are not synonyms.  Without consciously established priorities, the most urgent item will demand attention and energy, starving resources for the important.  The typical result is a series of firefights with no real progress.

A conscious decision not to do something is liberating.  It shortens your list of "shoulds."

3. Delegate.
Associating resource requirements with priorities also helps identify those things that you must delegate.  Once you have run out of capacity, what else can you do?  The syllogism is clear:
• The task is essential.
• Your time, skill and attention are more essential for other tasks.
• Therefore, the task must be assigned to someone else.

Delegation can be a real challenge.  While someone else is responsible for actually doing the work, the physician remains responsible for the work getting done.  That means you must build in ways to be assured of successful completion, and with less effort than doing the work yourself would require.  Learning to delegate effectively should be a high priority for all physicians.

4. Utilize and respond to your staff members' special knowledge.
Your staff knows much more about what goes on in your office than you do.  They are the ones who take calls from patients, manage referrals, and cope with all sorts of problems.  You see and suffer from the symptoms of the problems, but the staff can describe the underlying cause and, often, offer suggestions for remediation.

Take advantage of their knowledge.  You will be amazed at how clever they can be and how willing they are to take on additional responsibility for problem solving.  You may also be surprised at an accompanying decrease in turnover, as their jobs get both more pleasant and more stimulating.

The best way to engage your staff is through regularly scheduled staff meetings where issues are raised, project assignments are made, and proposed solutions are evaluated.  It takes nowhere near as much time as you might think.  Regularity and mutual accountabilities are the keys.

5. Keep an eye on the environment: medical, business and regulatory.
The system that is your practice and your life exists in a multi-faceted environment that is continually changing. To survive and thrive, the system must constantly adapt to its environment.  Successful adaptation requires acknowledging and understanding the impacts of environmental change.

Monitoring and accommodating business and regulatory changes is not the best use of a physician's time, skills, and talents.  It is much more effective and efficient to delegate the functions of monitoring, analysis, synthesis, and problem solving to professionals in those disciplines. 

Physicians must be especially diligent in monitoring non-medical recommendations.  The most effective monitoring requires the non-medical professionals to cite primary, as opposed to secondary, sources and provide models that demonstrate the impact of following or failing to follow the recommendations.  Anyone whose primary purpose is to inflame you with the unfairness of it all is not generally reliable.

It is harder than it used to be to be a successful physician with satisfying professional and personal lives, but it is still possible.  The trick is to maximize the utility of resources, accept the limitations of time and space, and remember that change is the only constant.