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The DO | Your Practice | Practice Wise

5 New Year’s resolutions for DOs and students

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Jennifer Kendall, DO, has two New Year’s resolutions that she hopes will make her a better DO. First, she’d like to concentrate on keeping up with medical literature.

“When you’re an attending, you need to look at the literature almost every day,” says Dr. Kendall, the interim medical director of Healtheast Spine Center in Maplewood, Minn.

Dr. Kendall also resolves to stay on top of billing, coding and documentation.

“A lot of things are going to change in 2013, so you want to be on the front end of knowing what those changes are,” she says, noting that those who aren’t will have to hustle to catch up.

To help inspire other physicians, The DO has assembled five New Year’s resolutions for DOs and osteopathic medical students and provided tips for each from experts and leaders in the osteopathic medical community.

What’s your New Year’s resolution? Tell us in the comments below.

1. Be more active in the profession

DOs should first consider what their specific strengths and passions are, says D. Gabriel Polk, DO, the president of the Tennessee Osteopathic Medical Association.

“It really starts with what people’s interests are,” he says. “Because when they are more interested or engaged in a particular area of service, they tend to do it more vigorously and with more success.”

Pineless

“Physicians have to do some things that they weren’t planning on doing when they went to medical school. They have to advocate for what they believe in.”
Dr. Pineless

There are myriad ways DOs can become more active in the profession, Dr. Polk says. For instance, DOs with leadership skills can pursue positions in local and state medical societies or national organizations. Those who prefer community service can pursue sports team physician positions or work with local organizations. Education-minded DOs serve as clinical preceptors for medical student rotations, while those with humanitarian interests can contribute to DOCARE International, participate in overseas medical mission trips or volunteer during domestic crises. And these days, legislative opportunities for DOs abound, Dr. Polk notes.

More physicians need to be involved in advocacy so they can help shape developing health care laws coming from the Affordable Care Act, says Hal S. Pineless, DO, the president of the Florida Osteopathic Medical Association (FOMA). Some easy first steps: Write letters to your congressional representative, and watch for the AOA’s email alerts that ask physicians to write their representatives, Dr. Pineless says. Although physicians may not have gone into the profession to become lobbyists, this work is vital, he says.

“Physicians have to do some things that they weren’t planning on doing when they went to medical school,” Dr. Pineless says. “They have to advocate for what they believe in.”

Physicians who are interested in advocacy but don’t see themselves writing daily letters to lawmakers may want to schedule one day out of the year to head to the capital and meet with their state representative or state senator, Dr. Pineless says. He notes that even if a meeting with a lawmaker is out of the question, a meeting with a legislative aide can usually be arranged.

“If physicians can just find the time to do that once a year, it can make a huge difference,” he says.

When advocating, physicians should resolve to remember their commitment to patient care, says Gregory M. Christiansen, DO, the president of the American College of Osteopathic Emergency Physicians.

“I hope physicians will remain engaged and stick to their principles and stay patient-focused,” he says. “That’s the reason they went into the profession, and that’s where the reward is.”

2. Stay on top of best practices and changes in the profession

Billing. Coding. Policy. Reimbursement. Physicians work in an ever-changing world, which makes keeping abreast of best practices particularly challenging. Dr. Polk recommends being vigilant with continuing medical education—physicians can use the AOA’s calendar filter to find CME courses—and maintaining certification.

Staying ahead of the curve should be a priority for every physician, Dr. Polk says. Strapped for time? Physicians can arm themselves with technology to weave reading industry news and the updated clinical information into their daily routines, Dr. Polk says. Electronic medical resources, such as UpToDate and Epocrates, can help physicians stay current without sucking too much time out of the day. Dr. Polk notes that physicians who want to track trends in the profession need to be comfortable with the latest technology.

“Because data change so quickly, having a degree of comfort with the technology allows you to access that information more rapidly and more efficiently,” he says.

Dr. Pineless subscribes to emails from local, state, and national organizations, so he can stay connected without leaving his inbox.

“It’s really not that difficult for doctors nowadays to keep up on the latest just by checking their email,” he says. The organizations Dr. Pineless keeps up with via email include the AOA, the FOMA and the AOA’s Grassroots Osteopathic Advocacy Link (GOAL) Program.

Dr. Pineless also likes to read medical journals, specifically those that cover his specialty, neurology, and news online, and he notes that the Internet offers options for different learning styles.

“There are various ways people can learn,” he says. “They can read; they can listen to audio programs.”

3. Improve your work-life balance

Whether the aim is to spend more time at the pool or on the playground, many physicians struggle to find a happy equilibrium between their work lives and the rest of their lives. While it’s rarely easy to make big changes to your daily schedule, work-life experts offer some guidelines that may help make your 2013 a year of increasing professional and personal balance.

Consider where the gaps are between the life you have and the life you want, and give yourself a timeline to close the gaps, Matthew Kelly, the author of Off Balance: Getting Beyond the Work-Life Balance Myth to Personal and Professional Satisfaction, wrote in an email. The timeline could be 12 months.

One way to work on closing gaps? Schedule white space on your calendar, Kelly wrote.

“Everyone needs white space on their calendar to thrive,” he wrote. “The busier you are, the harder it is to find that white space organically. You need to schedule white space. Time that is specifically scheduled for whatever you feel like doing.”

Kelly is a big proponent of planning, and recommends physicians spend 20 minutes each Sunday afternoon planning the week ahead, while making sure to schedule in personal and family time.

“We schedule the things we think are important,” he wrote. “But very often, the most important stuff never makes it to our schedules.”

Setting limits can give physicians more breathing room, says John-Henry Pfifferling, the director of the Center for Professional Well-Being in Durham, N.C., which provides stress management resources for health professionals.

“People expect physicians to always be on and available,” he says. “And from their perspective, there are no limits on what they ask and why and how often and how quickly. Therefore you have to set limits—on when you can be interrupted, when you can’t be interrupted.”

This can mean taking a lunch hour every day during which phone calls go to voicemail, or it can mean leaving the office at a certain time each day.

Work on setting limits internally as well, suggests Bryan Dodge, the author of The Good Life Rules: 8 Keys to Being Your Best as Work and at Play, who recommends that physicians focus on separating their personal and professional lives as much as possible.

“Too many people are sitting on the beach thinking about work,” he says. “When they get to work, they think about the beach. They are constantly crossing over. They are missing the most important entity when it comes to balance: When you are where you are, be there.”

Trouble with setting limits goes hand in hand with the inability to say no. But like setting limits, knowing how to say no is a vital skill to possess for work-life balance, Pfifferling says.

“Saying no does not mean the whole world is going to be angry with you and think you’re not really a caring person,” he says. “That’s a big myth. Lots of physicians want to please so much that they get into the habit of saying yes to so much that they disregard their own self-care.”

4. Be a better osteopathic medical student

Medical students spend their days awash in classes, research, volunteer work, labs and exam prep. Some may feel that just getting everything done will suffice. But there are two very simple things osteopathic medical students can do that will make a big difference in their performance, says Don N. Peska, DO, the dean of the University of North Texas Health Science Center Texas College of Osteopathic Medicine in Fort Worth.

Students should focus on preparation and presentation, Dr. Peska says. He notes that students who prepare for classes by going over problems and readings ahead of time will eventually become better physicians.

Peska

“Students need to feel and present themselves as doctors from the minute they get to our campus.”
Dr. Peska

“All of our schools provide such rich learning opportunities for the students, but they have to be prepared to get the most out of it,” he says. “All of our curricula are fashioned so that students must bring a certain preparation to the classroom to be able to affect their own learning of the material. Most of us don’t lecture anymore. We give case examples, we give problems to solve.”

For students seeking to solve the problem of what to wear to class, Dr. Peska has an answer. He notes that even if a school doesn’t have a dress code, medical students should be dressing the part at school, particularly because they never know when an unexpected guest, such as a member of Congress or a philanthropist, will be sitting in on the class. For instance, one day in a class at his school, a standardized patient was in class to the students’ surprise, and many of them were in flip-flops, cutoffs and T-shirts while the patient was impeccably dressed, Dr. Peska says.

“You never know what’s going to happen and who’s looking and what it’s going to mean to them to see you as professionals,” he says. “Students need to feel and present themselves as doctors from the minute they get to our campus.”

5. Be the best resident you can be

When grappling with 80-hour weeks and an onslaught of new knowledge, some residents let physical fitness and proper rest fall to the wayside. Residents should resolve to exercise at least three times a week, says Dr. Kendall. She notes that residents who stay fit will have lower stress levels and be able to better serve as an example to their patients.

“If the doctor can say, ‘I’m really busy too, and I still find time to work out three times a week,’ it’s easier for patients to follow his or her example,” she says.

Beyond hitting the gym, residents should work on cultivating a more personal relationship with their attending physician, Dr. Kendall says.

“It’s so important for networking and for future jobs,” she says. “You never know when your attending is going to hear about a job that would be perfect for you. If they know you on a more personal level, they may bring this job to your attention or even recommend you for the job.”

Residents who get to know their attending can also more easily ask for feedback, which Dr. Kendall says is another important resolution to make.

“Attendings aren’t always good about offering up feedback, but if a resident opens the door, attendings are very willing to sit down and talk,” she says. “And some of that feedback you get, if you open that door, will be invaluable to making you a better physician and adding to your skills.”

In addition to asking for feedback, residents shouldn’t shy away from asking questions of all stripes, says Dr. Christiansen, the simulation director for the emergency medicine department at Virginia Commonwealth University in Richmond.

“Residents need to ask questions,” he says. “And if they can’t find the answer then they have to discover that answer for themselves. Never give up on learning.”

Dr. Kendall agrees. Being a resident is one of the few times during a physician’s medical career when he or she will be expected to ask a lot of questions, so take advantage of it, she says.

“Never be afraid at all to ask questions,” she says. “Ask why a doctor is doing it a certain way, ask what benefit it is to the patient.”

rraymond@osteopathic.org

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