Posted on Dec 12, 2011 in Weblog | 1 comment

This is a continuation of my thoughts on “Manage Your Energy, Not Your Time,” by Tony Schwartz and Catherine McCarthy, as published in the Harvard Business Review. The first series in the post dealt with physical energy.

  • Defuse negative emotions — irritability, impatience, anxiety, insecurity — through deep abdominal breathing.
  • Fuel positive emotions in yourself and others by regularly expressing appreciation to others in detailed, specific terms through notes, emails, calls, or conversations.
  • Look at upsetting situations through new lenses. Adopt a “reverse lens” to ask, “What would the other person in this conflict say, and how might he be right?” Use a “long lens” to ask, “How will I likely view this situation in six months? ” Employ a “wide lens” to ask, “How can I grow and learn from this situation?”

Renewing emotional energy is harder to accomplish when on a high-stress high-stakes service like internal medicine or surgery.

The residents that I have seen who were in charge of their emotional energy had a certain amount of detachment in terms of their ego: they didn’t particularly care about their own personal feelings. Whenever an attending physician would verbally abuse them, they would just smile, shake their head, and move on with their lives. One resident employed the aforementioned “wide lens” and said that the main reason why he still powers through each day was so that he could learn more internal medicine, while he can still get the supervision. He viewed the experience as an opportunity, and he wanted, not needed, to do his work.

Another resident I observed was incredibly efficient at getting things done: for instance, he didn’t bother leaving overly-complex text messaging pages, and instead simply paged doctors with his number to get them to immediately call back. When a patient presented with shortness of breath, he thought through the symptomatology only for a brief second and algorithmically ordered the most appropriate tests, then moved on to the next patient. As the saying goes, “When you hear hoofbeats, think horses, not zebras.” But despite his incredible efficiency, he still took time to go over patients with families and his medical students. He’d also bake desserts for us — which consequently brought up team morale.

As physicians, we need to keep ourselves emotionally-centered. Regular meditative thoughts on how fortunate we are to be in a position to help others — despite the lawsuits, the pressure, and so forth — can replenish our emotional reserves, and checking in with peer support groups advances those feelings. Capitalize on the positive aspects of life, and either ignore the negative, or do something to change it in a positive manner.

(Parenthetically, I’ve never seen so many unhappy employees than while on internal medicine. The neverending stream of paperwork, mountains of documentation, complex and buggy computer systems that require 20 clicks just to order normal saline IV, and insurance companies who want to eject your patient from the hospital — and the occasional Cluster B personalities — easily frustrated residents. Much yelling, cursing, and fist-pounding ensued, that, while cathartic, still did not address the root cause of their problems.)