Saturday Morning Rounds October 19, 2019 - Positive Psychology

Posted by BossB, MD on October 19, 2019
BossB, MD

Saturday Morning Rounds
A weekly round-up of everything that captured our attention over the last 7 days

Quick note

We're at a positive psychology conference this weekend so we can stay on top of all the latest research on how to live your best life and avoid burnout, then share it with you! As such, this is a repost. Looking forward to sharing what we learned next weekend!

What we're reading

Higher Levels of Resilience and Flourishing Correlate With Lower Burnout by Dr. Monica Hagan Vetter, MD (@HaganVetter)

Have you ever had the experience of a patient presenting with one problem or set of symptoms, but you ended spending most of your time on something almost completely unrelated? Well, here at BBMD, the same pattern repeats itself like clockwork at least once a week - it usually follows these motions:

  • Someone purchases a one-hour strategy session
  • We hop on the videoconference line together and spend the first 5 minutes going over their situation and getting an idea of where they want help - usually something very specific and externally measured like "how can I get <X> job to increase their offer to <Y> dollars?"
  • 9 times out of 10 in those first few minutes, we notice some discrepancy between what they've told us is important to them and what they've stated they want to work on during the call - ie "You mentioned that you're really passionate about teaching and research, but you've said that you'd like to focus this time on maximizing the salary offer from a private practice"
  • We spend the next 5 minutes homing in on the thing our client actually wants to work on, but either (a) has never stated to themselves or (b) wasn't comfortable stating to us right off the bat (it's a lot easier to say "I'd like to increase this salary offer" than to say "I'm afraid that I'm not a good enough candidate for my top-ranked jobs" or "I have a scarcity mindset about money and so I'm trying to maximize my income before med school loan payments kick in")
  • We spend the next 50 minutes co-creating a strategy to address said problem and/or achieve the client's desired outcome
  • Wash, rinse, repeat

Most people come to us expecting that the best takeaway will be some negotiation tactic, when in reality our most impactful work is usually focused on what we call "lifestyle design" - defining values, setting priorities, and creating a clear (often bolder-than-original) vision of what we're trying to achieve together. That's where resilience, flourishing, and burnout come in. 

The medical education and training system focuses almost entirely upon external measures of success (test scores, rankings, etc) and one-time events (match, boards, etc.). It's no surprise, then, that physicians tend to think of their own careers in terms of external measures of success (compensation, program prestige, etc) and one-time events (first job, first home, pay off educational loans, 2nd/vacation home, retire, etc). Problem is, while all of those triumphant moments are wonderful peak experiences that should absolutely be savored, burnout is often what fills the space between them.

So what should replace this focus on external measures and one-time events? We believe that the answer is to focus on your day-to-day lived experience - to think about the hours that make a day, the days that make a week, and the weeks that make a life, and then reverse-engineer the life you want from that perspective.

There are plenty of positive psychology interventions to increase resilience and flourishing (you can learn some great ones, tailored to help healthcare providers, from this week's "Who we're following"), but if you're living a life that's misaligned with your vision and values, such interventions will likely fall short of protecting against burnout - "polishing a turd," so to speak.

First, focus on creating a life that will provide daily protection against burnout, a job that will reliably energize you almost every time you walk in the doors, and then whatever resiliency skills or positive habits you work to build will have a much easier job of sticking.

Who we're following

Jordyn Feingold (@JordynFeingold) is a medical student at Mount Sinai, where she is leading the charge against burnout with her REVAMP well-being model, a podcast called Road to Resilience, internal trainings/workshops, and much more. In addition, Jordyn has created a Positive Medicine program designed to help physicians live better lives. She's doing some inspiring and important work - give her a follow to stay up-to-date with the cutting edge of combatting physician burnout!

BBMD tip of the week

Spoiler alert - the "R" in Jordyn's REVAMP model mentioned above stands for "Relationships", and if you only have bandwidth to focus on one area of your life, maximizing relationships has been found to be the best "bang for your buck" in terms of improving well-being. What does this mean for your career though, and in what ways can we use this knowledge to negotiate better? A few ideas:

  • "No assholes" policy - Trust your instincts and refuse to work with people who give you a strong "off" feeling, have a bad reputation, or act overtly rude
  • Hire your own people - Make sure that you've got the ability to strongly affect, if not decide entirely, who you're working with on a day-to-day basis
  • Parental leave/personal time - The relationships in your life that will be most likely to play a protective role against burnout are the ones at home, so maximizing the time and flexibility you have to invest in them often carries a much higher value than most people realize, especially those who are primarily focused on sprinting toward some external financial goal(s)
  • Pay attention to turnover - A positive work environment tends to make people want to stick around; while some turnover is inevitable in any institution, a high rate of turnover should be a huge red flag, and even for places that seem to do well we recommend you interview the person who left most recently to get their honest views on the employer
  • Emotional resonance - Human beings are far more socially and emotionally driven than we are by rationally driven, and keeping that top-of-mind during negotiations will immensely improve your outcomes; as a rule we instruct our clients to focus on keeping the emotional resonance (sense of connectedness, goodwill, "being on the same wavelength") ≥ 7/10 - if you do that, the rest will fall in line a whole lot easier

Quote we're contemplating

“Life is what happens to you while you're busy making other plans”
― John Lennon


As always, please let us know your requests and suggestions on Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!