How I Became a More Successful Physician

Note from Graham: This week, I invited a friend of Offcall and my former residency attending Dr. Resa E Lewiss to contribute a guest newsletter post. Big thanks, Resa! If you have something to share with fellow physicians and are interested in a spotlight for a future newsletter, get in touch (graham@offcall.com)!

Last year, I published a book called MicroSkills: Small Actions, Big Impact with Dr. Adaira Landry. It’s a business book to help professionals improve their performance at work and overall in life, and the premise is simple: MicroSkills are small actions or behaviors that anyone can learn, implement, and apply in a compounding manner to achieve large goals. For example, when I decided that I wanted to become a more competent and confident writer, I broke the goal down into MicroSkills and practiced three steps:

1. Reading books on how to write, such as William Zinsser’s On Writing Well and Anne Lamott’s Bird by Bird.

2. Collaborating with experienced authors by asking: "Do you have a writing project that I can join and help take over the finish line?"

3. Signing up as a peer reviewer for emergency medicine journals to see how others write and understand what makes writing “publishable.”

It can be surprisingly difficult to practice MicroSkills for self-care in medicine because our profession so rarely teaches, models, or celebrates taking care of ourselves. This is true of healthcare as well as many other workplaces. Despite this challenge, one concrete MicroSkill that’s helped me is building and maintaining a personal board of directors. A personal board of directors is a group of carefully chosen people who provide guidance, support, and expertise across different areas of your life. There are always open seats at the table. Here are types of people who sit on my personal board:

- A few financial experts who help me make informed decisions about saving, investing, and day-to-day expenses.

- Trusted friends and mentors I call when I need any of the 3 H's: to be heard, helped, or hugged.

- Negotiation strategists from a few industries for higher-stake situations such as job offers, contracts, and other professional opportunities.

By cultivating this go-to network, I’ve been able to make better decisions, feel supported, and be confident in my professional journey as a physician. The relationships are mutually respectful and kind. They are not one sided or merely transactional: I care deeply for my board members and offer intentional gratitude. MicroSkills the book shares instructions on how to identify the right people for your board, and thereby establish meaningful, reciprocal relationships. For sure, taking this small step will create an incredible foundation for your self-care and long term success.

So who would be on your personal board of directors? Shout them out in the comments. Also, reply directly or add a comment with any other MicroSkills you’ve personally used to practice self-care in medicine.

Resa E Lewiss, MD
Professor of Emergency Medicine and host of The Visible Voices Podcast

P.S. If you’re interested in buying the book, you can find it here. You can also listen to Resa’s excellent podcast interview with Graham via Offcall here and Graham’s excellent episode with Resa via The Visible Voices Podcast here.

P.P.S. Know someone who would benefit from joining us? Help us grow our tent by forwarding this newsletter to your physician colleagues and subscribing here.

How Burned Out Doctors Can Find Creativity Again

This week on How I Doctor, Graham talked to Dr. Emily Silverman, a San Francisco-based internal medicine physician who’s also host of the award-winning medical storytelling podcast The Nocturnists, which is devoted to humanizing medicine by telling the stories of doctors and other healthcare workers. During residency, Emily worked back-to-back 20-hour shifts and drove herself to exhaustion and illness — the experience drove her to examine medical culture and structural health policy questions, and also build a narrative storytelling community to help fellow healthcare professionals cope with burnout and find our creativity again. (If you haven’t yet heard The Nocturnists' series on shame in medicine, you need to!). The episode has sparked some great comments!

Listen to the episode →

Most Talked About On Offcall

AI Agents Should Be Trained Like Medical Students →

Physician op-ed from Rishi Khakhkhar, founding medical director of Counsel Health: “To truly revolutionize our ability to provide all patients with high-quality, affordable care, AI needs to play a role in the delivery of clinical care — but first we need to train and test it correctly.”

Here’s a Better Solution to the MD vs. NPP Debate →

Yet another physician op-ed from emergency medicine physician Chad Swanson: In response to Graham’s piece about NPs and PAs, I believe the current debate over NPPs in healthcare is missing a broader and more fundamental issue: competence, and our antiquated system of training doctors.

I Rejected This Common Piece of Burnout Advice — And Became a Happier Doctor →

Another great physician op-ed from family physician Santina Wheat: After I got burned out, everyone told me to “just go part time,” but here’s what actually helped me personally and some work-life tweaks other physicians should consider.

3 Things to Read This Week

Here’s how much burnout costs employers in economic terms (PubMed)
Employers: Need yet another reason to do something about physician burnout? Consider this: “Employee disengagement can cost employers 0.2-2.9 times the average cost of health insurance and 3.3-17.1 times the cost of training per employee.”

What people think we spend on primary care vs. the reality (Annals of Family Medicine)
Researchers found that on average, people believe 51.8% of U.S. healthcare dollars go toward primary care. The actual figure? Just 4.7%.”

How patients find and engage with doctors (Press Ganey)
New study of 6.5M patient encounters shows: 59% of patients use online search to find a new primary care provider, 80% say online scheduling influences their choice of provider, 24% look for other options if booking an appointment isn’t as easy as making a dinner reservation, and nine out of 10 say accurate listings information is key to establishing trust and credibility.

The “Big Idea” in Emergency Medicine This Week

And now for something new! We want to showcase physician leaders from different specialities sharing a “big idea” about their specialty. This week, Dr. Resa Lewiss kicked us off for emergency medicine. Have a “big idea” of your own? Reach out to Graham to be featured (graham@offcall.com).

Resa presented at Butterfly Network's Innovators summit about FAST 4.0, the Focused Assessment With Sonography in Triage. "It's not if, it's when that ultrasound is going to be in triage," she shares (link here). "Emergency departments are crowded, patients are sick, and waiting room times are long. So why not deliver more patient-centered care by performing a Point-of-care ultrasound in triage?"

Thoughts? Reply with your reaction or share directly in the comments.

Highlights From Our Community

Each week, we celebrate career milestones, launches, & other goings-on in the physician community. Have something to promote? Reply and we’ll feature you.

👀 Saw you at HIMSS!
So many physician sightings, panels, discussions, run-ins, and collaboration all week in Las Vegas, ft: Emeka Anyanwu (here), Minal Shah (here) Lukasz Kowalczyk (here), Joshua Liu (here), Yimdriuska Magan (here), Matt Sakumoto (here), Geeta Nayyar (here).

🎙️New pod alert, Benjamin Schwartz
Dr. Ben Schwartz talked to Dr. Daniel Durand, Chief Medical Officer of Prenuvo, for a new episode of The Surgeon’s Record. Listen here.

🏥 30 days of healthcare, with Dr. G
Will Flanary (aka Dr. Glaucomflecken) re-released his original 30 Days of U.S. Healthcare series into a free and helpful guide, especially for med students and interns. Check it out here.

🚨 Hot podcast drop, Emily Silverman
Emily talked with well-known Canadian physician Dr. Allan Detsky about his lifelong love of Broadway and musical theater. Listen here.

🗣️Thanks for speaking up, Casey Grover
Dr. Casey Grover published a piece in Emergency Medicine News about his experience dealing with PTSD after practicing for 14 years. Read it here.

📝 Great perspective, R. John Sawyer
Ochsner Health’s John Sawyer says we need to stop grading doctors on parking or cafeteria food and focus on the metrics that matter. Read more here.

🎤 Congrats, Rita Ng
Dr. Rita Hg, Physician-In-Chief at The Permanente Medical Group, MC’d the American Heart Association’s #GoRedforWomen Gala. Learn more here.

✅ Strong work, Peter Grinspoon
Mass General primary care doctor Dr. Peter Grinspoon published an op-ed in the Boston Globe about why so many physicians in the Boston area are unionizing. Read it here (paywalled, learn more here)

🗒️ Great presentation, Basil Kahwash
Dr. Basil Kahwash recently presented at the American Academy of Allergy, Asthma and Immunology - AAAAI/World Allergy Organization Joint Congress in San Diego on the topic, "Not Asthma but the Lungs: Evaluation and Diagnosis of Pulmonary Conditions Such as Non-Asthmatic Eosinophilic Bronchitis." Read more here.

💬 Quote of the week, Graham Walker
Best internet comment Graham’s seen all week. Read it here.

Did Someone Share On/Offcall With You?

Thanks for reading! Each week, we’ll give you the latest news, information, financial and career tips, and a dose of inspiration delivered to your inbox. Join our growing physician community by subscribing to our newsletter! And forward this newsletter to your colleagues and friends.

Subscribe