Mike Woo-Ming, MD

We all know the impact of burnout, and the toll it takes. Loss of control is a significant factor, often reinforced by beliefs that get cemented early in our career. These beliefs have an overriding influence on how we think and feel as a doctor.

For example, didn't we all think that once we got past residency it would be smooth sailing? Or why we agonized over deciding on our first job out of residency, believing we would work there for the next 40 or 50 years? Or the prevailing belief that if you had the best scores in class, you would get the highest paid jobs? It sure burst my bubble when I learned one of the most successful, highest profile physicians I know, dropped out of residency in his first year because of poor performance.

Looking back, many of us could see how naÃ¯ve we were. Perhaps if we realized the true impact insurance companies or even our employer had on medical decisions, we could have anticipated the changes on how we practice, or even in the type of job we chose. Here are common physician myths that often obscure true fulfillment in our career.

Myth 1: Your Self-Worth and Income is Dependent on Work Ethic 

You may be thinking, "What's wrong with being a hard worker? No one wants to be thought of as a 'slacker'." It reminds me of an old medical school joke, about the incoming surgery resident who was interviewing for different intern positions. The surgical attending would ask him, "Here at our hospital, we make it mandatory that new interns work call every other night…how do you feel about that?" A true hard-working intern would reply, "To be honest sir, I would be very disappointed because I will miss half the cases."  

I have known residents who would live at the hospital in hopes of improving the respect of their attending's. Doctors often bring that same mentality in their career, while sacrificing their own time and dooming personal relationships. More important than working hard, is working smart.

As a business owner and practicing physician, I've been accused of being a workaholic. But over the years, I have learned when I feel I have too much on my plate, I ask myself, "Is this a task I have to do myself, or can it be done by others more effectively?" For instance, is it imperative that I need to be staying late at the clinic inputting this information in an EHR, or can I have a medical scribe do this instead? As doctors are more willing to delegate, the more they will be rewarded.

Myth 2: Choose Your Specialty Wisely, Because There's no Changing

It is certainly true that it's much more difficult to change specialties if you spend all this time to be a cardiothoracic surgeon and now want to move into psychiatry. But it is not impossible. And if you are an employed physician, you may have more flexibility than you think. You may have heard of the concept of job crafting, where the idea is you can pursue tasks and duties that can put more emphasis on your own strengths and values, in hopes of re-energizing your life and feeling more fulfilled. I was a people pleaser, and hated saying 'No' to my CEO. This resulted in me being stuck on administrative committees, unmotivated and not feeling anything got accomplished.

These days, you have more opportunities to practice in different environments. Tired of hospital life?  Consider going outpatient only. A change of scenery may be needed if you prefer a rural or city environment. Perhaps you don't want to commit to a full-time job. There is nothing wrong with having two part-time jobs, or even doing locum tenens.

Myth 3: Physicians Should Only Focus on Practicing Medicine

This is one myth that I see commonly, especially with new practice owners and it often gets them into trouble. They worry that they only have to focus on what they were trained to do – see patients. But when it comes to running a business, they hand over the controls to someone else, and then are clueless as to the reasons why their practice is failing. You may be the best doctor, but if you are constantly late to appointments, it may be time to study time management.

The days of doctors only seeing patients are over. Doctors need to have a well-rounded education to understand anything that could influence their life and career.

Myth 4: Pick the Job with the Highest Wages 

How many of us get that headhunter offering the "Perfect Job" with the best 401k packages, and the potential to make double what an average physician would earn? When you find a job offering twice what other doctors would make, it is usually because either no one else wants to do the job, or nobody wants to live in the location.

As for pension and 401ks, it's surprising that many doctors are not aware they can set up their own financial vehicles, or get premium health insurance that won't break the bank without being an employee. If you decide to take an independent contractor job or do locums tenens, there are many websites that can point you to different insurance and investment options.

Myth 5: Medicine is No Longer a Calling, It's a Job  

Many of us still aspire to the noble aspirations that we were called on to become a doctor, performing a greater good. A recent study showed that once a physician feels that he or she is no longer serving a higher purpose, their performance suffers, as well as the quality of care they give to patients. The study concludes these doctors are at extremely high risk for burnout.

When you do decide on a physician job, realize that you have more options then you had in the past. Make an effort to pursue tasks and experiences in your job that line up with your own values and goals, keeping your energized and fulfilled. If you are surrounded by negativity, whether it be bosses, co-workers, or even patients, do your best to change that situation or if all else fails, get out. Remember, our time on this planet is finite. As the saying goes, we can always make more money but we can't make up more time. 

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Perception does not have to be reality. Here are five myths about unhappiness among physicians.

5 Physician Myths that Can Derail Your Happiness

It's no secret that physicians are busier than ever, and not necessarily busier seeing patients. Earlier this year, the Physicians Foundation, a non-profit advocacy group, found that the average doctor spends at least 20 percent of their time on uncompensated tasks. These days, many doctors get paid based on patient productivity, but rarely do we delve into topics such as office and electronic medical record (EHR) efficiency that take up so much of our time.

I have always been somewhat of a productivity nut. I remember reading time management books during medical school, so I could better consume the voluminous hours of information we would learn each day. Understanding that every practice is different, here are some overlooked strategies that have worked in my practice and will hopefully help you become more productive in yours.

•Avoid getting sucked into the black hole of the Internet.

 We live in a connected world, and many of us spend late nights tapping away at our EHRs. We all know we are just a few clicks away from the latest funny cat video on YouTube, or the latest political debate on Facebook. With the average attention span for adults being 20 minutes, having a timer by my side keeps me on track. If you are really having trouble getting rid of internet distractions, there are apps such as RescueTime that will disable you from browsing to the most common social media sites.

•Get to work earlier to better plan your day.

 Early in my career, I helped incorporate what we called the "five-minute huddle" in our clinic. Basically, I would get together with my medical assistant and nurse and quickly peruse the list of patients that we had for the day.  The purpose of the huddle was to anticipate any issues that might arise.

For example, if we knew that Mrs. Anderson who is always perennially late is scheduled for a 2 o'clock appointment, it might be helpful to send a quick phone call reminder to her early in the morning. Knowing that there's a procedure in Room 1 at 10am that requires significant preparation time, we may not want to put patients at 9:30am in the same room in case that appointment runs late. If you work alone, taking just a few minutes to plan before starting your day could better streamline the rest of it.

Small changes now can lead to big transformations later.

 You may be familiar with the word "Kaizen" which is the Japanese word for "continual improvement" and often used in business. It is the idea that small incremental changes to enhance efficiency can ultimately have great long-term effects. Are there any things in your practice that you can improve?

 For example, I was always forgetting common ICD-10 codes and was having to look them up online. Typing up a simple sheet of the most common codes and pasting it on my desk, shaved not only a few minutes each day, but prevented me from another internet distraction. Are you familiar with all the templates and shortcuts you could be using on your EHR? Taking the time now to make sure you know all possible shortcuts could save you a ton of time in your practice.

•Learn to delegate and avoid being a doormat to others.

 Admit it, we doctors tend to be control freaks. I have a friend who's an OBGYN and a group of us were planning to go out for the evening. After several minutes of waiting for her to come down from her clinic, I went up and found her watering the plants in her office. After asking her why she was doing this herself instead of having a staff member do it, she replied that they often forget and it was easier for her to do it herself. If you are always taking on more tasks just to "get it done," you are doing both you and your staff a disservice.

If you are an employed physician, being known as the "team player," can often lead to becoming "Dr. Pushover" if boundaries are overstepped. I remember in my first year of practice, the nurses would come to me first if my colleague conveniently forgot to call in a prescription or fill out a patient form. Things did not change, until I spoke up and learned to say "no" and took charge of my own responsibilities.

. There will always be people in your professional and personal life who will suck up your time. How many times has that pharm rep just wanted to take a few minutes to talk about great new information she learned at a conference? My staff has my entire schedule, and when something is blocked out and the office door is closed, short of a medical or family emergency, they know my work time must be respected and not interrupted. 

I challenge you to gain better control of your day and your professional practice. If you have time productive tips you would like to share, feel free to add them to the comments. 

In order to maximize productivity at your practice, you need to take control of all aspects of its operation. Here's how to start. 

5 Tips to Help Physicians Be More Productive

How many of us doctors have time to read? Between the clinic and the hospital, it is often very difficult to take a break. However, there is one place where we get a built in break, our cars. The late motivational speaker, Zig Ziglar, once said that if we are looking to improve our business and our life, look no further than the drive to work. By listing to educational audiotapes and CDs, you can have "an entire university in your automobile."

Most of us reserve our time in the car for listening to music, or catching up on current events. So why not be more productive and use that time to educate yourself? I remember a few physician mentors from medical school as well as my father (a pediatrician), would often listen to audiotapes to claim CME credit. Today, with the advent of podcasts and sites like Audible.com, we are privy to podcasts on thousands of niche topics designed for specific demographics, including physicians.  

As a business owner, I often spend a few days each month visiting different clinics. During my rides, I’ve discovered a number of different podcasts that have helped me improve my medical practice.

In terms of podcast recommendations, as someone who has been a podcaster myself, I know it can be very difficult to record consistently. For this list, I specifically chose podcasts that are current, and have consistently released new content over the last year. I excluded podcasts that were focused on CME or catered to one specialty, preferring general information that could help a majority of docs. Here are my top choices:

 Pretty auspicious title, right? Hosted by financial consultant Dave Denniston, the goal of the podcast is to "help doctors slash their debt, slash their taxes, and live a liberated lifestyle." Denniston has produced over 100 informative episodes tailored to educating doctors with financial and business advice. The podcast covers everything from student loan refinancing, to reducing malpractice premiums. Denniston uses his podcast as a way to cover topics many doctors never learned in medical school.

 The podcast title pretty much sums it up. Two Texas-based physicians share their views on healthcare, the science of medicine, and "everything in between." I especially enjoyed the back and forth camaraderie of the two doctors, and they often give insight on what’s going on in today's news and how it may relate to your patients. I would compare the podcast to eavesdropping at your local hospital's doctor's lounge.  

 Practicing surgeon Dr. Nii Darko spotlights physicians "thriving in non-traditional career paths." Dissatisfied being an employee, Dr. Darko transitioned to locum tenens and along the way ran into doctors leading strong, fulfilled lives. "If I had known some of these stories or met these people during my climb up the ladder, maybe I would have done things a bit differently," he says. From docs running startups, to flipping real estate, this is definitely a podcast to listen to if you have dreams of being a physician entrepreneur.

 Although relatively new to the podcast world, Dr. James Dahle has helped thousands of doctors get a firm hold of their finances with his groundbreaking finance blog. Now through podcasting, you can get your financial advice on the go. This is the site I share with residents and young doctors to curtail their medical school loans.

 I may write for this website, but it would be a disservice to not highlight the wealth of information freely available for both young and old practicing physicians.   The host, Gabriel Perna, does a great job bringing together information that is essential for today's doctors. From practice policy, to the latest news on the Affordable Care Act (ACA), make sure you download a few episodes before your next commute.

A practicing physician recommends 5 of his favorite podcasts to listen to during his daily commute or lunch break.

Listen Up! Podcasts for Physicians

Recently, our medical clinic and spa celebrated its four year anniversary. My staff and I e wanted to use this opportunity to step up our online promotion.  We typically use a variety of strategies to draw in prospective patients but one in particular that had been doing well was online pay-per-click, (PPC) advertising.  We have gotten some great results using Google AdWords in the past, which is probably the most well-known of PPC advertising, so we decided to increase our marketing budget in that area.  

For PPC, you is bid on pertinent keywords that display ads when people search on Google or Bing. For example, you if you wanted your business ad to be listed for the phrase "Houston cosmetic surgeon," you would bid against other organizations for your ad to be displayed alongside organic search results for that keyword phrase. As a paid advertiser, you are only charged if someone clicks on your ad to go to your website, with the ultimate goal of then scheduling an appointment.  (Hence the name, pay-per-click).

We went into my Google AdWords account and increased my budget without changing a thing, as we knew our ads were already converting. Then, I braced for the phones to go crazy, ready for the influx of new appointments. I was surprised that the next day I got an email notice from Google that my ads had been suspended! 

After a few choice words through unhappy emails and phone calls to Google, I was able to find out what happened and was reinstated.  Even though my company had used the same ad copy and made no significant alterations to our website, anytime you make a change such as upping your budget, there is a strong likelihood your ads will be reviewed by someone new.  

I'm not a novice to Pay-Per-Click advertising, as my company also runs a boutique medical marketing agency, where we often run marketing campaigns for other businesses. In this particular case, Google felt there were not enough disclaimers on our website from real patient testimonials.  What was particularly frustrating is that we had made the same changes a few months earlier, but now it was being reviewed by a new set of eyeballs.  

So why all the fuss about testimonials?  It really comes down to the Federal Trade Commission and the fact that health is big money. One in 20 searches on Google are health-related, and the competition for online traffic can be fierce.  This has led to outrageous and over-the-top claims from unscrupulous businesses, with reviews that can be suspect. So the importance of these rules are legitimate, but be aware Google treats everyone the same, whether you are a non-profit hospital, an established practice, or a fly-by-night online operation selling supplements.  

Other areas that clinics should be mindful of is that you cannot create ads that may infringe on trademarks. For example at our med spa, we use Botox for aesthetic purposes, but we cannot run ads with the name Botox. For those who are marketing new and innovative procedures, which are not covered by insurance (i.e. cash based) you may not be able to run ads.  Unfortunately the guidelines may be vague on what and what does not 

I know many of my physician colleagues throw their hands in the air in frustration and hire an online marketing professional or choose other types of online advertising such as Facebook or other social media outlets. I've always had great success using pay-per-click through Google Adwords and Bing, but I'll be the first to tell you it's not easy. Competition continues to grow and often you are bidding against businesses with big budgets such as Walgreens, CVS, or pharmaceutical companies. It takes time and commitment and knowing that the average pay-per-click ad in health is just under three dollars, it can get very expensive. 

The most important thing that I can recommend when it comes to online advertising is to be patient and see what works and what doesn't. The time has come to stop doing the do-it-yourself approach, and leave it to digital marketing experts especially those who specialize in healthcare. 

A physician lends his advice on running successful pay-per-click advertising campaigns, while warning of pitfalls from past experiences.

Author | Mike Woo-Ming, MD

Articles

5 Physician Myths that Can Derail Your Happiness

5 Tips to Help Physicians Be More Productive

Listen Up! Podcasts for Physicians

Online Advertising Challenges for Medical Clinics