Page 5 - Mecklenburg_Medicine_February-2019

Change
By Elizabeth B. Moran, MD
C hange, as we all know, is inevitable. And over the
past few years, much writing about modifications in
the medical profession has focused on the negatives
— physician burnout, the rising costs of practice,
a reduction in job security, ever-increasing documentation and
regulations, and an uptick in recertification requirements. These
all serve to paint a pessimistic picture of the current state of
affairs in medicine. Through this lens, it is difficult to see the
positives of what we do. It may be even more difficult to recall
Certainty in our why we started down
jobs, within our
homes and throughout the path of becoming
physicians in the first
place. What drove us to
choose this profession?
And, has the landscape
our relationships, changed so drastically
that those choices are
leads to a sense of no longer viable for our
children, for the next
control and security. generation of doctors?
With the constancy
When certainty is
lacking, increased of change in mind, I
stress occurs. recently found myself
reading about “Human
Needs Psychology,” a
theory developed by
well-known leadership
guru Tony Robbins
(link to his TED talks at the end.) Robbins’ theory, entitled “6
Core Human Needs,” surmises there are six fundamental needs
that govern human behavior and happiness. While each of these
may have varying significance across individuals, each and
every person is influenced to some degree by them all. Although
Robbins’ writings on this subject are geared primarily toward
leadership and team development, I see a strong parallel between
medicine as a career and the fulfillment of each human need.
Medicine, as a profession, provides all the necessary ingredients
for human happiness, and I argue this has not changed over time.
The recognition of these core human needs and the ways in which
our work can lead to their attainment is evergreen. Focusing on
the constants, rather than on the relentlessness of change in other
aspects of our profession, can lead to a better understanding of
what we do and a greater satisfaction in doing it.
Robbins espouses the importance of certainty as a fundamental
human need. Certainty in our jobs, within our homes and
throughout our relationships, leads to a sense of control and
security. When certainty is lacking, there’s increased stress.
However, as nothing in medicine — or life for that matter — is
ever 100-percent certain, doctors, as a rule, are uniquely equipped
President’s Letter
to cope with the anxiety inherent in dealing with some degree of
uncertainty in every decision. Just as we are taught in our training
the unique skills to manage this in clinical arena, perhaps this skill
is transferrable to other areas of our work and lives.
One way of improving our sense of certainty is via better
communication and clarity, Robbins suggests. Although we
work hard to have clarity in our diagnostic and treatment plans,
perhaps we need to strive for greater discussion and clarity
regarding job security, work environment and the other non-
clinical parts of our profession. One example might be to join
a committee or take steps toward a leadership role either in our
day-to-day practices or in the local or state medical society. This
could result in a greater sense of understanding, and ultimately, a
sense of control.
Variety in our lives and jobs is another fundamental need. For
some, continuous variety is a must; for others, too much variety
can lead to dissatisfaction and anxiety. Patient encounters are
infinitely varied, and it is difficult to see how any physician
could ever want for more diversity in clinical challenges. Indeed,
the trouble often arises from too much variety, which may fall
outside our individual comfort zone. But, with experience, larger
patterns in patient visits may emerge that allow for enough
variety to keep the job vibrant and exciting, while also providing
a comfort level on a daily basis. Perhaps some self-reflection on
what type of schedule matches our desired need for variety might
increase our appreciation for this fundamental quality inherent in
our profession. Then we can take active steps, as we are able, to
tailor our day to better suit our need.
The third aspect of Robbins’ theory to increase personal
satisfaction, is the need to engage in significant and meaningful
work. This seems self-evident, but recently there has been a shift
to customer satisfaction forms, documentation requirements,
and the increasing pressure of volume. Let us never lose sight of
the fact that we have dedicated years of our lives and thousands
of dollars in tuition for the privilege of making a significant
difference in the lives of those around us. Let’s remind not
only ourselves, but also each other, of this fact on a daily basis.
I believe the simple act of saying “thank you” to a colleague
for a consult, for their contribution to the plan of care, for their
dedication overall, can have an impact so much greater than the
effort required to express that gratitude in the first place. Small
things matter, and within a profession that deals with such large
outcomes — life or death — those small things easily get lost in
the shuffle. A heartfelt compliment from a patient, an expression
of gratitude from a colleague and the simplest of kind gestures in
a busy day offer us the opportunity to see anew the true meaning
and significance of our work.
Connection also is a fundamental need which feeds human
happiness. We are social creatures and, within his theory,
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