The Exceptional The Exceptional PhysicianPhysician

How to Avoid Being a How to Avoid Being a Miserable DoctorMiserable Doctor1,2 1,2

A Presentation for MGH PhysiciansA Presentation for MGH Physicians

Kendall L. Stewart, MD, MBA, DFAPAKendall L. Stewart, MD, MBA, DFAPAMarch 26, 2009March 26, 2009

1My aim is to offer practical insights you can put to use in your personal and professional lives.2Please let me know whether I have succeeded when you complete your evaluation form.

Why is this important?

• You would think doctors would be happy.

• Actually, a good many doctors are miserable.

• But there are also some contented, exceptional physicians out there.

• Years ago, I made up my mind to be one of them.

• I’ve been studying contented and miserable physicians for years.

• I’ve learned some things about how to avoid being a miserable doctor.

• After this presentation, you will be able to:– List three reasons why

some doctors are miserable,

– Describe three unpleasant consequences of choosing to be miserable,

– Identify three practical strategies to avoid beicoming miserable doctor,

– (If you have already become miserable, these strategies may help you recover,)

– Explain why these strategies are called for and how to bring them off.

1When I was asked to give a talk (as an expert!) out of town, I decided to do some basic research.2Annie Queen asked me whether I was going to take the nurses’ comments personally.

Why are some doctors so miserable?

• It’s not because they enjoy being miserable.

• They may have an illness that makes them miserable.

• They may have developed personality traits and coping strategies that make them miserable.

• They may have learned from poor role models.1,2

• They may have developed bad habits.• They may have come to believe that

being miserable is normal.• They almost always believe they are

fully justified in feeling the way they do.

• They always believe it is someone else’s fault.

• They may be evil. (Fortunately, this is fairly rare.)

1You have to feel sorry for these poor, miserable cusses, but they actually inspire me.2A miserable thoracic surgeon nicked his glove.

What are some of the consequences of being miserable?

• It results in chronic emotional arousal with all of its consequences.

• Chronic anger is not just unpleasant, it is deadly.1,2

• Emotional arousal– Compromises your judgment, – Distorts your perceptions, and– Triggers impulsive behavior.

• The joyful people avoid thee.

1Anger begets defensiveness and defensiveness begets regrets. 2A defensive (arrogant) medical student lectured me about Eaton-Lambert syndrome—a lipid storage disease!

What strategies will help you avoid being a miserable doctor?• Embrace discomfort.• Remain passionate

about the pursuit of excellence.

• Resist the seduction of materialism.

• Stifle the urge to flaunt your power.

• Abandon arrogance as a defense.

• Beware feelings of entitlement.

• Clarify expectations.• Quit being so cynical.1,2

• Stop being so sensitive.

• Choke off pointless rumination.

• Become passionate about health and fitness.

• Become a customer service champion.

• Build and nourish a team.

• Learn to solve problems effectively.

• Give back.• Maintain an even-

keeled temperament.• Teach.• Keep on learning.• Communicate

effectively.• Improve key patient-

care processes.1Some cynicism is healthy, but exclusive reliance on this view of life will make you miserable.2A man went to apply for social security and forgot his wallet.

Become passionate about health and fitness.

• Why should you?– The most effective

treatment for many illnesses is lifestyle change.

– Your patients need healthy role models to help them make those changes.

– Physicians who practice what they preach are more credible persuaders.

– A healthy lifestyle is enormously relaxing and satisfying.

• How can you?1,2

– Follow your own advice.

– Make a commitment and hold yourself accountable.

– Share your own struggles to discipline yourself.

– Share the strategies that have enabled you to achieve your goals.

1I recently prepared a lecture on the psychiatric aspects of obesity.2Let me illustrate the power of teaching by example.

What have we learned?

• Given our privileged lives, you would think most physicians would be happy.

• But many of us are not.• If you have any doubt, just visit the closest

physicians’ lounge.• Many of us would not go into medicine again, and

most of us recommend that our children choose another career.

• Ignoring our blessings, we make ourselves miserable by seeing only those things that don’t go our way.

• The destructive perceptions, attitudes and behaviors that make us miserable are emotional traps that are best recognized and avoided.1

• This presentation has suggested some practical strategies that can help you avoid these physician traps.

1My beginning in Portsmouth was not auspicious. But I heard the voice of God in Kmart.

Where can you learn more?1

• Stewart, Kendall L., et. al. A Portable Mentor for Organizational Leaders, SOMCPress, 2003

• Stewart, Kendall L. et. al, “On Being Successful at SOMC: Some Practical Guidelines for New Physicians” A SOMCPress White Paper, SOMCPress, January 2001

• Stewart, Kendall L., “Bigwigs Behaving Badly: Understanding and Coping with Notable Misbehavior” A SOMCPress White Paper, SOMCPress, March 11, 2002

• Stewart, Kendall L., “Relationships: Building and Sustaining the Interpersonal Foundations of Organizational Success” A SOMCPress White Paper, SOMCPress, March 11, 2002

• The Executive Staff, “Rules of Engagement: Some Expectations for SOMC Staff,” SOMCPress, 2002

• Refer your patients (and yourself) to an incredible, free health and fitness site at http://sparkpeople.com/index.asp. (When asked who referred you, please type in kendalllstewart.)

1Please visit www.KendallLStewartMD.com to download related white papers and presentations.

How can you contact me?1

Kendall L. Stewart, M.D.Kendall L. Stewart, M.D.VPMA and Chief Medical OfficerVPMA and Chief Medical OfficerSouthern Ohio Medical CenterSouthern Ohio Medical Center

President & CEOPresident & CEOThe SOMC Medical Care Foundation, Inc.The SOMC Medical Care Foundation, Inc.

1805 27th Street1805 27th StreetWaller BuildingWaller Building

Suite B01Suite B01Portsmouth, Ohio 45662Portsmouth, Ohio 45662

740.356.8153740.356.8153

StewartK@somc.org StewartK@somc.org KendallLStewartMD@yahoo.comKendallLStewartMD@yahoo.com

www.somc.orgwww.somc.orgwww.KendallLStewartMD.comwww.KendallLStewartMD.com

1All speaking and consultation fees benefit the SOMC Endowment Fund.

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