Category: Physician Mindset

Doctors in Retirement

Check this out.  What you will see are the musings of a retired physician. But the paragraphs here are less important than the thought process that they can start. A mental path I have not previously traversed. More specifically, “What happens when a doctor retires?”  

Imagine for a moment the psychological impact of a physician’s retirement. Years of training and study put on the shelf, never to be consulted again. Social interactions with patients and colleagues gone for good. Time to recuperate from years of increasing burnout.

On Hilton Head Island, SC, a caring physician, now deceased, figured out a way to channel the possibilities here. Way back in 1994, Dr.  Jack McConnell realized that there were two very different groups on HHI. One was a rather large cadre of physicians, dentists, nurses and pharmacists who were retired on the Island, and bored out of their minds. The second was a rather large group, amazingly one out of every three people on the Island, who were too poor to have access to medical care.

Light bulb. He founded Volunteers in Medicine. VIM. An opportunity for retired practitioners to serve this population, part time, amazingly in an environment where licensure and malpractice insurance are defined out of the equation. It is now a national organization. Find out about it here.

Bottom Line. Retirement for anyone is a profound rite of passage. For a physician, even more so. America’s doctors have been our customers throughout their, and our, entire careers. Is there a way we can help them to deal with hanging up their stethoscopes?  

Medicine Through The Eyes Of A Resident: “Less Room For Error”

Check this out. When you read the strange title above, you probably thought that in 2019, there is less room for resident physicians to make medical errors than there used to be, what with being employees, having government computers watching them, malpractice suits looming, etc.

Nope. That is not the point of this post. Rather, this young physician is keenly aware that the economics of being a doctor have changed rather substantially in recent years, and not in a positive direction. Medical school costs and loans have increased substantially, residency programs take longer and  eventual compensation is lower. Interestingly, the blogger poses the question as to whether it is still worth it to go to medical school. His answer is still yes, but . . . 

Bottom Line. . . . there is less room for error in a physician’s planning of the finances of his life. Used to be doctors could blow a lot of money, and still be fine. Now physicians who want to remain financially solvent have to be much more attentive to their investments, expenses, etc. And there are often no do overs.  

One more source of physician stress and burnout?

Yup!

Addicted Medical Professionals

Numbers are one thing. Like, 10-15% of medical professionals will, at some point in their lives, become involved in substance abuse. But as usual, numbers don’t quite tell the whole story. Check this out. In this rather lengthy post (No need to read all of it. Just skim!) what you will see is stories. Verbatim recounts of their problems from medical professionals who have gotten into trouble with alcohol and drugs. Focus on the words. You can feel the pain.  

As a pathetic aside, you will also learn some of the tricks that these professionals use to enable their addiction. Like the doctor who filled the windshield washer reservoir in his car with bourbon so that he could imbibe undetected as he drove from hospital to hospital. Or the doctor who agreed to make a house-call so that he could steal back the narcotics he had prescribed.

Bottom Line. In his seminal book, How Doctors Think,  Jerome Groopman makes a major contribution to our understanding of our physician customers. He helps us to understand that rather than going through a careful check list of diagnostic and treatment considerations, doctors actually use pattern recognition, often very quickly, to reach their diagnoses, and typically make prescribing decisions based primarily on habit. As my ThinkGen colleague Dr. Neale Martin puts it so succinctly, “Expertise is what happens when knowledge enters the Habitual Mind.”

BUT. This post helps us to understand that there are other forms of habits, addictions, that can play an unfortunately disruptive and important role in “How Doctors Think.”  We need to understand all of this if we are going to lay claim to being truly customer centric.  

Becoming A Healer

As most of you know by now, I love words. I am fascinated by words. One of my favorite learnings in undergraduate school was the Whorfian Hypothesis. The notion that the language we use can affect our view of the world. The famous example often offered is the fact that Eskimos have several different words for “snow,” reflecting subtleties in the way they see different versions of solid precipitation. In English, we just say “snow.” The Whorfian Hypothesis argues that because Eskimos have more words for snow, they perceive their snowy world in greater detail than we would.

Against that fascinating (?) introduction, check this out. It’s a blog posted by a young physician, pictured above, who also happens to be an author. She likes words too. And suggests that each physician focus in on becoming a “healer.” That got me to stop and think. When was the last time I had encountered that word? And what does it mean, anyway? Dr. Fraser couldn’t help me with the answer to the first question. And I am not so good at answering that one either. Best I can figure, I haven’t heard the term “healer” in a long, long time. I am wondering why. 

But she does a great job of answering the second question. In brief, she posits, a healer is someone who exhibits compassion while administering treatment. BUT. Showing compassion, she explains, requires time. In an era where fee-for-service, insurance payments, etc. demand rapid patient throughput, what practitioner has time for compassion? Pity!  

Bottom LineSarah believes that if a physician becomes a “healer,” the extra effort that she gives to caring for the patient gives new meaning to the phrase, “Time heals all wounds.” I think she is right!

I’m An ER Doc and I Have No Friends

We have talked about ER docs before. The strains of encountering an endless stream of unknown patients. Dealing with drug seekers. Fuming as they sew up gunshot wounds and stabbings from a night of violence. Having to decide whether or not to send a homeless man back to the freezing streets when he has no condition that would make it legitimate for him to be admitted for an overnight stay.

But check this out.What you will see is the revelation of an ER doctor concerning her relationships, or lack thereof, with her fellow physicians. Think about it. Every time she calls one of her colleagues, it is to give them, to use her appropriate terminology, “more work.” Often in the middle of the night. Worse yet, often involving patients for whom the specialist can do absolutely nothing. No wonder she has no friends.

Bottom Line. This article got me to thinking. I am thinking that physicians in virtually (?) every specialty that we deal with as pharmaceutical marketers has their own set of “issues.” Things that they need to deal with that result from how that specialty fits into the broader healthcare picture.

It also got me to thinking that it might be both interesting and informative for us to study these issues. Again, it we claim to be customer-centric, then we better well understand our customer. Our whole customer. Not just the guy or lady who prescribes our drugs, but the human being that has to go through every day as an ER doc, Pediatrician, Psychiatrist, whatever. While I am sure that each doc has an individual series of issues to deal with, I am betting that there are significant commonalities within specialty. Maybe even across specialties.  

We should find out what they are!

“Next Level” Physicians

Check this out.  We have talked about this kind of thing before. But here it comes again. Physicians building “side gig” careers by helping other doctors design and build their own careers. This offering is slicker and more multi-faceted than some we have looked at in the past. AND. This one is geared just to female physicians. Watch Dr. Maisha’s video. It takes one minute. It talks about the importance of female physicians having dreams that guide their careers. Attend one of the free seminars listed. Explore the curricula. Why? Because this kind of activity is what growing numbers of our physician customers are pursuing. Learning entrepreneurship, which Maisha correctly points out is NOT taught in medical school.

Bottom Line. Exploring this site left me with two takeaways. First, I am thinking that programs like this, if done correctly and pursued assiduously, can be major antidotes for physicians who might otherwise succumb to burnout. Second, I am thinking that if this is where growing numbers of our customers are going to seek guidance,  we should be watching this trend closely.  

Maybe we should even get involved???

What “Compassion” Should An Emergency Room Provide?

Check this out. What you will see is an ER doc with a real dilemma. What he has in front of him is a homeless alcoholic who does not have a specific medical condition that would legitimate him occupying a bed in the Emergency Room for the night. The problem is, if he is discharged he will literally be out in the cold, sent to sleep on the frozen streets. BUT. The beds in the ER are full, and another patient might well show up needing the bed that “Mr. Green,” a frequent flyer in this ER, is currently occupying. Catch 22.  

What happens? He gets discharged, only to be wheeled back in by another EMS a few hours later to spend the night. 

Bottom Line. What is the point here? Simple. Physicians don’t just have to deal with “medical” problems. All kinds of societal issues make their ways into ER’s and doctors’ offices. Pharmaceutical companies claim that they want to be “customer-centric.” Then add the story above, and similar tales, to the list of things that your customers are thinking about as we go to them to sell our drugs.  

A Picture of Strength

In this article, you will see Dr. Andrea Eisenberg, the Ob/Gyn pictured above, describe the first time she attended a patient’s funeral. Read the story. What you will see is the story of a doctor who did her level best to take care of a pregnant patient’s breast lump. BUT. The story did not have a happy ending.

Picture how she felt as she walked into this crowded viewing, open casket and all. Feel her gut tighten as she tried to mumble a few appropriate words to the patient’s husband. Takes a lot of guts! And, as she points out, this was far from the last dollop of emotional “burden” that she would have to carry during the course of her career.

Bottom Line. We spend a lot of time here talking about the practicalities of being a physician. Burnout, EMR’s, insurance pre-authorizations and miscellaneous bureaucratic nonsense. BUT. We can often forget the emotional costs wreaked by finding oneself responsible for a patient’s life. And potentially her death. 

I can’t imagine! 

Doctors And “Gun Sense”

Check this out. What you will see is a really strange debate that has been going on for some time now. The question? What is the appropriate role of physicians in preventing gun violence?

Lots of different ways of looking at this. This article, for example, argues that physicians have a special perspective on gun violence because it is doctors that get to patch up the results of the carnage. Got that!

Conversely, some lawmakers have historically believed that physicians should have absolutely no role in preventing gun violence, going so far as to pass laws “gagging” doctors to prevent them from discussing gun ownership with their patients. These laws have largely been reversed.

Relatedly, the NRA recently told doctors to “stay in their own lane” and stay the heck out of the gun business. This snotty comment of course brought forth a tremendous backlash. And so it goes. Back and forth.

Bottom Line. SO. What is the role of an individual physician in preventing gun violence? How about this simple answer? Anything she wants it to be. Just like everybody else!

Physicians as Entrepreneurs

Check this out. What you will see is a piece by a physician who, with a colleague, set up a “direct pay” primary care practice. After several years in this practice, it suddenly occurred to her that she is an entrepreneur. A new perspective opened up to her at that point. New literature to read. New ways of thinking about things. Her most important insights? Physicians and entrepreneurs both solve problems. AND. Physicians thinking like entrepreneurs are more likely than virtually anyone else to solve the problems bedeviling U.S. healthcare today.

Bottom Line. In a world where the ranks of “hospital administrators” are growing much faster than the phalanx of physicians, this doctor believes that it is time for doctors to jump outside the box. Think like entrepreneurs. If they are going to be making widgets, she believes, they should be focused on making better widgets.

Makes sense to me!