Ever feel like the healthcare system is wrestling control out of physicians' hands? That's precisely what Dr. Bradley Block and I tackle in a riveting conversation where we unpack the challenges and solutions surrounding physician autonomy. As host of the Physician's Guide to Doctoring, Dr. Block brings a wealth of knowledge to our discussion on the tug-of-war between bureaucratic constraints and independent decision-making in the medical field. We explore the generational shift in prioritizing work-life balance and the intriguing potential of physician-owned hospitals to revolutionize patient care—drawing parallels to the ethos behind my own practice.
Navigating the doctor-patient relationship maze can be as complicated as the most perplexing medical cases. In a candid exchange, I confess my struggles with patient turnover and how I turned to social engineering to craft more efficient yet meaningful interactions. Delve into the art of being fully present in consultations and how I've expanded these communication strategies through my podcast. By engaging with experts across fields—from political lobbying to professional efficiency—we broaden the scope of conversation to encompass the full spectrum of effective time management and its impact on various professional settings.
The skills we nurture in the exam room do not end there; they spill over into every facet of our lives. As I share my personal battles, we discuss how the communication and relationship-building techniques honed through podcasting have enriched my life beyond the clinic. We also touch upon the development of diagnostic heuristics, striving for a delicate balance between engagement and efficiency in patient care, and the importance of intellectual engagement in preventing career stagnation. Join us as we explore the art of maintaining curiosity and compassion in medicine, and discover how these tools not only improve patient outcomes but also lead to a more fulfilling personal and professional life.
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
Ever feel like the healthcare system is wrestling control out of physicians' hands? That's precisely what Dr. Bradley Block and I tackle in a riveting conversation where we unpack the challenges and solutions surrounding physician autonomy. As host of the Physician's Guide to Doctoring, Dr. Block brings a wealth of knowledge to our discussion on the tug-of-war between bureaucratic constraints and independent decision-making in the medical field. We explore the generational shift in prioritizing work-life balance and the intriguing potential of physician-owned hospitals to revolutionize patient care—drawing parallels to the ethos behind my own practice.
Navigating the doctor-patient relationship maze can be as complicated as the most perplexing medical cases. In a candid exchange, I confess my struggles with patient turnover and how I turned to social engineering to craft more efficient yet meaningful interactions. Delve into the art of being fully present in consultations and how I've expanded these communication strategies through my podcast. By engaging with experts across fields—from political lobbying to professional efficiency—we broaden the scope of conversation to encompass the full spectrum of effective time management and its impact on various professional settings.
The skills we nurture in the exam room do not end there; they spill over into every facet of our lives. As I share my personal battles, we discuss how the communication and relationship-building techniques honed through podcasting have enriched my life beyond the clinic. We also touch upon the development of diagnostic heuristics, striving for a delicate balance between engagement and efficiency in patient care, and the importance of intellectual engagement in preventing career stagnation. Join us as we explore the art of maintaining curiosity and compassion in medicine, and discover how these tools not only improve patient outcomes but also lead to a more fulfilling personal and professional life.
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
What does autonomy really mean to a physician? How do we reclaim it? We're going to dive right into that conversation with Dr Bradley Block, ent, as well as the host to the physician's guide to doctoring. Let's dive in. Welcome to another episode of the Worthy Physician. I'm your host, Dr Sapna Shah-Haque,, and today I have Dr Bradley Block, who is talking to us from Long Island, new York, today. So thank you so much for being here.
Dr. Block:Thank you so much for having me. I've been excited for this interview.
Dr. Shah-Haque:It's life has happened, hasn't it? It's just. I guess that's just part of balancing all the hats that we wear.
Dr. Block:We scheduled, we had to cancel. We scheduled, we had to cancel. But we're finally making it happen. And we canceled because we have autonomy, so we're able to make that decision for ourselves.
Dr. Shah-Haque:And that's the nice thing is that through our training I would hope that we have some common sense to be able to make those decisions, but a lot of times we're not given that opportunity, particularly medicine nowadays.
Dr. Block:Yeah Well, I'm sure medicine for long, forever, since forever was you are not given that autonomy, and I'm not sure why we bristle more than the well we're just getting right into it, aren't we? We've had it more than the generation before us, Like the boomers who practice medicine. They lived in the hospital and that was fine. They didn't see their kids very often and that was fine. Like for us, that's not fine, and I wonder what changed, what led to that? I don't know.
Dr. Shah-Haque:I think maybe getting smarter about. We see what happens when people try to buy their kids love or experiences, and we were talking about that earlier. But you really need to. I think kids really need parents that are there not necessarily for everything, to hold their hand through everything, but definitely ones that they can count on at major turning points and for major events. And I would have to say that there's a sense of abandonment at some point, or maybe at inner child wounds, if that security is not possible.
Dr. Block:Yeah, yeah, I think it might also be that they yeah, one. It could be that we're just more aware of it, but another could be that they, because they had more autonomy to begin with, it was more of like their decision to do that, not that it was put on them by some outside. We've become, we were always hierarchical, but I feel like nowadays, as opposed to back then, we have so many especially non physicians who are, who are lower over us and give us more responsibility and give us more things to do and give us more boxes to check, and they didn't have that. If someone gave them more stuff to do, they'd be like no, who are you? Who, I'm sorry, who are you? Why are you? You're telling me to do no, I've got patients that they, I've got rounds to do, I've got surgeries to do and then I'm going to go home.
Dr. Block:It was a different balance of power and so, because they had more independence, more autonomy, they were okay doing that because it was still on their terms. Now, this is conjecture. This is conjecture coming from me, but I think that has something to do with it, because it was an internal locus as opposed to an external locus making demands on them.
Dr. Shah-Haque:Now I definitely think that there's a lot of truth to that and there wasn't. If the doctor ordered something, it got done. There wasn't insurance trying to push back what's the medical necessity, or we need a prior authorization, or have you tried this so there also weren't other things pushing back. There wasn't everything having to be cut right, so reimbursement wasn't being cut as much as it is now. You didn't have as much regulation.
Dr. Block:I don't think there were like now it's death by a thousand paper cuts, yeah, or clicks with the EHR, yeah exactly.
Dr. Shah-Haque:There's so much more bureaucracy in medicine. I just don't know how we got here, and part of it is these are bodies that govern right, cms, and then the ones with deeper pockets, like the insurance companies and big pharma, and other than that, I don't know how we got here.
Dr. Block:The American Hospital Association just put out a statement against physician-owned hospitals because they're like physician-owned hospitals are. There's a conflict of interest here. You know completely neglecting the fact that there's a conflict of interest in the presence of the American Hospital Association putting out a statement about why he doesn't want competition from physician-owned hospitals, ignoring that. But the inherent problem is the conflict of interest. So physicians are only going to admit more less indigent population, less medically complex populations in order to line their own pockets, and it just all of that was conjecture and all of that was using very old data and all of that was clearly he's going to cherry pick the data that works for him. Why else? Right, anyone who's trying to make an argument is going to cherry pick their data. But surgery centers that are physician-owned tend to operate more efficiently. It's just there's a lot out there that says that we can do this well and we can do this better, and that, I think, would be a big answer to this to physician-owned hospitals.
Dr. Block:Part of the problem with the conflict of interest is, yes, it shouldn't be one physician that owns the hospital, but if you're one of hundreds of physicians, that has a very small share, and then you elect a board of physicians who run it, and you're answering to your like. That's how my practice works. We're physician-owned, we're physician-run. We elect a board of physicians that then drive the ship and, yes, we have a C suite of non-physicians who do the day-to-day and come up with a lot of the great ideas that we and they act upon, but it's all. At the ultimate, the ultimate decision maker is the board of physicians, and it's better for patients. It operates much more efficiently and I think it's a we're like a shining beacon of what private practice could be and what hospitals could be physician-run, of what hospitals could be.
Dr. Shah-Haque:I think that we, as physicians in our field, we know what the flow is. We know we have again going back to, we're pretty well educated and we have pretty good decision-making otherwise we wouldn't be physicians, and so we're also quick learners. If we don't know a skill set, if it's something we can read or pick up, we're going to pick it up, especially if it's an interest to us. So I think physicians know what their clinic or the hospital needs or their practice needs. They know the flow. They can be efficient, like what you said. Yes, surgical centers that are physician-owned are more efficient because of exactly that they cut out the fluff.
Dr. Block:Yeah, exactly, and more fiscally efficient for the patients. So there's a big argument for us. But how do we take the power back? How do we? It's a game. It's a game, it's lobbying and which lobbyists and whose ear do we need to be speaking? And everyone who we're working against knows this game and plays this game, and because we're not unified as a physician, as a profession, it really works against us.
Dr. Block:You have the AMA, which owns the rights to what is it? Cpt codes and ICD-9 codes. So there's a conflict of interest there with their billing practices. So I think the answer is I think the answer is actually local Join your local societies, join your specialities, be a part. When they put out a memorandum, a recommendation like this law is probably going to be passed soon write your local congressperson, write them, call them. They don't get that many calls on any particular issue. So if you're one, you might be one of seven people that called them about that issue, but you're a physician and they're going to respect what you have to say. So you, we've got to do that, we've got to look out for ourselves, and I think that's the biggest return on investment is local, your local societies, your specialty societies, and then being politically active in that regard. I think that's how we start to move the needle, because that's where the decisions are made. They're laws. How else do we take the power back? I couldn't agree with you more.
Dr. Shah-Haque:I couldn't agree with you more Get involved and exercise. But I don't have time.
Dr. Block:The pushback is, but I don't have time. I don't have time. I've got children, I've got my work, I've got my employees, I've got all these other responsibilities.
Dr. Shah-Haque:A lot of these places also have a website you can go to and send an email, mail a letter.
Dr. Block:On your commute, make that phone call. There are windows for doing that and these are high return on investment activities.
Dr. Shah-Haque:Instead of be part of the solution, be part of the solution. We do have that power. We do have that power. Yeah, no, you're absolutely right about being part of that change, and even if it's that you don't have time to do it tomorrow, then schedule that time when you do. Make it, put a pop-up on your phone, make it a priority.
Dr. Block:And if you don't, someone else will, and they're going to do things that are not in your best interest.
Dr. Shah-Haque:So, on top of being a physician and having a family, how did you get into the world of podcasting?
Dr. Block:Actually lobbying this conversation. These ideas are coming from one of my first episodes. It was like one of the first three episodes that I did Podcasting. What I saw was, in my practice a lot of my partners were able to see patients more efficiently than me. I found it very stressful. I could barely keep up with three an hour. Sometimes they were seeing five an hour. Remember, I'm in a specialty so some of the patients would come in with just earwax, pop out the earwax. It takes like when I say five an hour, it seems oh wow, that's a lot even now for me, but it's doable. Also, there's a significant no-show rate. Each day there are some no-shows that happen. So the question was how do they see patients efficiently and how can I do that?
Dr. Block:So I discovered this world of social engineering. Social engineering now is used to guess people's passwords. So if you look up Google, what is social engineering? But really it's engineering, a social engagement. Now, this doctor-patient thing is not a social engagement, it's a professional one. But I think professional engineering. If you Google that, you're going to end up building a bridge or something.
Dr. Block:It's just how do you methodically develop report with your patients? That was my question is how do. I do this methodically, just like we do everything else. Now I learned how some things in medical school right. We were always told listen, make sure you listen and listen and listen and listen. Now get it, I should listen. I'm not a good listener, I'm a terrible listener. I need to listen more, but that's not good advice. The way that I spin it now, based on what I've learned, is be present, so be undistracted Anytime you find yourself thinking of something else when your patients no stop. You've got to be paying attention to the patient. You've got to be focused on nothing but the patient, and you have to be undistracted even in your demeanor. Yes, you can dictate, yes, you can type, but you have to find a way to do that in such a way that the patient knows that you're present. You need to be methodical in your interaction with the patient, the same as everything else that we do in our lives. So I went in search of that and found that those people are out there. A lot of them are covering sales or dating or other things like that, but that can be repurposed for the doctor-patient interaction. So that was the impetus for my podcast, which has now been out for five years.
Dr. Block:But I started off with my own network because I couldn't just I didn't have a podcast. So how can I just ring people, email people, be like, hey, I'd like to interview you on this podcast? That doesn't exist. So I needed a podcast first. So I reached out to my network. So all you physicians out there within posture syndrome that are like I don't know any experts to have on my podcast yeah, the people that I reached out to was one of my friends from medical school, one of the spouses of one of my co-residents and my brother. Right, those are my first three episodes, so one of those.
Dr. Block:We talked about using your time efficiently in the political realm. Right, lobbying I'm not a lobbyist, but how do we put our time to good use? What's got the highest return on investment? That's exactly what I was just talking about. So what started off as a podcast that was just going to be about the doctor-patient interaction really exploded into now.
Dr. Block:Ted Lasso has since come and gone, and so is it. I steal from him the tagline of everything. The tagline was really originally everything that we should have been learning while we were memorizing KREBS cycle, and it's now helping physicians be the best versions of ourselves in and out of the exam room, and so that's what I cover on the show. So I really run the gamut on everything from we cover some different specialties there's a little medicine from here and there personal finance, side gigs, made gigs, doctor-patient interaction, managing staff, like everything that has to do with parenting. I have got a couple of episodes of parenting as from a physician's perspective. So everything to help us be the best versions of ourselves. So that's how I got into podcasting and that's the evolution that it's taken over time.
Dr. Shah-Haque:I think that's great, because there's so many aspects to life. It's not like we were talking about where we're living in the hospital At least that's why we're sitting here having this conversation and there are other things that we do outside of being a physician, but it's all intertwined. It's all intertwined. It's how we present ourselves. It's a mannerism. A lot of times it's a way of, it's a part of, it's a part of life, and so I'm glad that you're tackling that, because these are things that help us, I think, live a more fulfilled life.
Dr. Block:Yes, definitely it makes my office hours more fulfilling instead of me Like. Certainly it gets stressful when I'm falling behind, but I do that less often. I get home on time and all of my visits are more fulfilling when they're otherwise would have been because I've learned all of these skills from doing, at this point, like 250, 270 interviews, many of which have helped me build rapport in the exam room and that also translates to out of the exam room. Like those skills that you learn in order to help you interact with your patient also are going to help you in networking. So I've got some episodes on that In the social setting.
Dr. Block:I know it might not seem that way. I still have significant social anxiety. It is funny because my wife is the introvert. She's the one that wants to stay at home and she's the one that can navigate a cocktail party like nobody's business and have everybody think that she's their best friend by the end. And I'm the one who's second guessing everything that I've said the whole time, but I'm the one who wants to go out and interact more. It has helped me. I'm still not at her level, but it has helped me in so many other ways rather than just in the exam room.
Dr. Shah-Haque:I think we forget how at times it's very easy to forget how important communication is, and not just what we say, but how that message is delivered. That's a big part of it.
Dr. Block:Yeah and be that's what I'm saying be deliberate and be methodical. There are ways to do that. When you're delivering your message, for instance, when you are seeing a patient and you're not quite sure you're here and I see this as an EMT, as a specialist you're here for a cold. You have a cold. Why are you seeing a doctor, let alone a specialist, for a cold? You can say that and be like, oh my job, all these people coming in and wasting my time, I'm not using my skills, I'm not. Like it's not intellectually challenging, it's they're wasting their time. Now they have to. They're going to be pissed because they paid a copay, only to find out that they have a cold.
Dr. Block:Asking a simple question what is it that worries you about this? Like why is this? What's the reason that you made the visit? What's so concerning to you? Why dig a little deeper and get at their thought process about what made them? Because if they knew it was just a cold, they probably wouldn't have, or maybe they would have made the appointment. And there's a reason there. I would challenge you to find that out in your visits, that where it's not readily apparent. Like asking that simple question what worries you about this. Add that into your, your compendium, your lexicon of things that you might want to ask. Often I find should ask in most visits not my earwax visits Not going to ask them what worries you about your earwax, but there are plenty of occasions where that question can ultimately save you time too. The patient's going to find it to be a more fulfilling visit and you'll get through the visit more efficiently because you asked that question. So now you're able to get to the point faster because you really picked off the scap and you got underneath.
Dr. Shah-Haque:I couldn't agree more. And somebody comes in for a chronic it's been going on for a while. Okay, what change that made you say I got to go get it checked out now, and the answer is always very much. That's very, I would say it's more. Gives to a lot more history and starts to answer the big question of what can I help you with? What can I help, what can I do to help you feel better?
Dr. Block:Although sometimes it's. I met my deductible, and so that's why I made the appointment where I finally got insurance and that's why I made my appointment. Sometimes that stuff comes up too. It's not always, and that still gives you a little more information about the patient. So it's not, yeah, but I think it's one of those questions that should be top of mind, that should be asked. Certainly now I ask it more than I used to yeah, so again, like there are things like that that you can incorporate into each visit.
Dr. Block:Another one would be some expression of compassion, some expression that you like feel for the situation that they're in, and it's going to come up when I say it now. It's going to sound so forced because it is because we're role playing right now, not because it sounds forced during the visit, but that sounds really uncomfortable, that sounds really hard. Oh, that sounds awful. Like when people come in and see me and they have vertigo and they were vomiting, like oh, wow, oh, that sounds awful Like some expression of empathy or compassion that lets them know that you understand just what they've been going through. That's another thing, that a little turn of phrase, little turn of phrase, goes a long way. It does now that when I'm saying it these things during a podcast interview, I get that it does sound like a little unnatural, but nonetheless, when you're actually saying it to a patient who's going through these things, it doesn't come off that way and they appreciate it a lot. A couple more seconds to your visit and yet big impact.
Dr. Shah-Haque:I think patients want to be seen and heard authentically and it sounds like that's what you're doing and that just puts a smile on my face because I would go to you as an ENT If you were an ENT in my Kansas.
Dr. Shah-Haque:Yeah, in Kansas not New York, but if you were an ENT in Kansas, I would want that. I would want that why? And the genuine connection, because I think a lot of times the physician-patient relationship is diluted from all those forces we have talked about previously and it's more of a. We got to turn out patients, we got to keep going and, okay, it's almost like this is going to be a Kansas reference, but it's almost like you're using a cattle prod to get them in and out. That's not why we went into medicine.
Dr. Block:I just had an oncologist on my show and what she said was it needs to be viewed as a relationship. So you said it yourself doctor-patient relationship. But then when you described it it sounded more like a transaction, right with the cattle prod Like in and out, next, next, next. That's a transaction. But if you view it more as a relationship, it's relationship-building. You're going to view things a little differently. You're going to take a little extra time when you have it, which means when you next time they're going to be more understanding because you have that relationship. So it's changing the perspective a little bit. So it's relationship-building.
Dr. Block:And I've got plenty of other stuff 270 episodes, an episode that at the time of this recording isn't even out yet. I had a guy on my show. His name was Nick Boothman. He wrote a bunch of books, one of which was famous for how to make people like you in 90 seconds, and so some of the stuff that came away from that is recognizing the eye color of everyone in the room, not just your patient, everyone in the room.
Dr. Block:Look everyone in the eye long enough that you notice what their eye color is. And I've started doing that and I realized that I wasn't doing it and I realized that I was. I will still do it. I'll look them in the eye and I think I look them in the eye, but then I'll be like, ooh, did you notice their eye color? And then I'll look back again and it's important, every you have to acknowledge everyone in the room, every single one in the room Maybe not a two-month-old that's sleeping. Leave them alone, don't notice their eye color, don't poke open their eyes a little bit just to see, but everyone else in the room, because they're all there. There's a reason they're all there.
Dr. Shah-Haque:That's an excellent point. That's an excellent point. Thank you for bringing that up. And yes, it is about the physician-patient relationship and those that come with the patient to the visit. They're from moral support and a lot of times in medicine, what we interpret as it's nothing scary, the patient might have a completely different perspective.
Dr. Block:Yeah, in fact, doctor's appointments are always not always, but are often scary. It's a very anxiety-provoking place we're in because we'll sometimes diagnose people with new conditions. They're there because they have something that's worrying to them. Right Fine, if they're there for their annual physical and they're just checking the thing off their to-do list because their significant other was like it's your birthday month, it's time to make your yearly. They might, but more often than not, if they may have their appointment, it's because it's something that's worrying. So there's already a threshold of anxiety. So that's another thing. There are opportunities to dispel some of that anxiety, even educate them on the reason they're having anxiety.
Dr. Block:I'll say that to people in kids, adults. I'll say the reason that you're nervous right now is because you're doing something you've never done before, and so your brain is saying pay attention, that's all it's doing. Ugh, I'm so nervous, I'm such a nervous person. No, here's the thing. The reason you're nervous is because everyone that came before you was nervous about bears, and none of them were eaten by bears because they were nervous. They survived. So this is an adaptive function, not a maladaptive function. You're nervous because it's not always something bad. You're nervous because you're doing something new, that's it. Your brain is just telling you're in a new place, pay attention. So what are you doing, paying attention? And then I go.
Dr. Block:If I'm doing a procedure or something, I'll say, okay, you can't relax. You can never tell someone to relax. When's the last time you grabbed someone by the shoulder and you were like relax, and then they relaxed. Right, does that ever work, especially with our children? Relax, no, never. But if you can tell them to relax something, okay, because I do procedures on my in their faces and their noses and mouths and ears. I say relax your brow, just don't tense up your brow. Concentrate on keeping your brow relaxed. Concentrate on taking your making your breathing slow, deep breath in, hold at the top, even longer, breath out. So that's telling their brain that everything's okay, instead of holding their breath and scrunching up their face, which increases their heart rate and anxiety and lowers their.
Dr. Block:Okay, I'm not sure if this is true, but action potentials for their nerves right, it becomes a much more stimulating event. So you get them to concentrate not on relaxing, but relaxing a specific place that they tense, their tensing up, and it makes the whole event Not as anxiety provoking, not as anxiety filled. These are a lot. There are a lot of arrows to have in your quiver, when each visit is going to be different, but having those arrows there is going to make it a more pleasant experience for you and for them and it's going to help build your practice and help move it efficiently. It'll help your day move along efficiently and help build your practice, because they're going to love you, they're going to be your evangelists. You're not going to have to pay for marketing because they're going to be like oh, you've got to see. Oh, you've got to see, this person is the best.
Dr. Shah-Haque:And so we've really talked about a lot of things efficiency, autonomy and even the art of medicine and you just gave us several great ways to try to reclaim that, because it's being lost in all the factors we've mentioned as well. How did you come to this, besides what you've learned through interviewing on your podcast? How did you become efficient and having these great ways to approach patients? These things are not readily taught in medical school. As a resident, I was really beating myself up because it took me forever to see the inpatients, and one cardiologist told me something that just takes a lot of time, a lot of practice, but how did you find your groove? Alrightlaité, Thank you so much.
Dr. Block:So some of it was, a lot of it was the podcasting and a lot of it is.
Dr. Block:You're right, as the cardiologist told you, it takes a while to find your groove because when we're first learning, we're absorbing everything and trying to figure out from the thousands of different diagnoses what are the possible ones that it could be. And actually I have an episode on this where we talk about these heuristics. We notice these patterns. With enough experience, we start to pick up on these patterns where you walk in the room and it will not take you very long to figure out what the diagnosis is and you gain all your evidence. You make sure you listen and you make sure because you've got these heuristics in place. It also allows you to keep your mind open, as long as you choose, to other possibilities. Very quickly you can arrive at the diagnosis, also looking for red flags that are like listen, this refutes my diagnosis. I need to do more research. I need to do more imaging. I need to do some lab work. I need to look for this on my exam we. I forgot who wrote it, but the book is called Thinking Fast and Slow, and so we go from thinking slow when we're learners and you get enough experience and you just you know you got the diagnosis. How many times have you walked into one of your outpatients and, within a few seconds, exactly what the diagnosis is. That never happened at the beginning and now it happens all the time. We have to be careful to not step in a trap and rely too heavily on those heuristics right to keep our eyes open. But that also frees up our mind a bit to be more engaged with the patients, because we don't have to think as hard as we once did to figure everything out. It allows us to be more present and engage more with the patients, as as they are. So it's yes, some of my efficiency comes from my podcast. Some of it just comes from experience and developing these heuristics, learning the being able to arrive at the diagnosis faster, and then some of it also comes from not doing the things that I was taught to do Like.
Dr. Block:One thing is you have to sit down with each patient, because time moves a lot slower for them if you're sitting down, if you're standing the whole time, it seems like you're out the door the entire time and they think you rushed them through it, even though you may have taken even more time. I don't always sit down with patients because what they are coming in for might be super fast and I have to wash my hands and put on gloves, and I might be able to take enough of the history while I'm washing my hands and putting on gloves in and then examining the sort of figure out what's going on and then, if it turns out, I'm wrong and I need more time. Now I've just examined them and now I can sit down and take my notes and the visit now goes faster. And I've still taken, I've still sat down at some point, but I keep bringing up earwax For the patient that just needs earwax removed.
Dr. Block:I come in, I look, I take it out and they're out of there. They're satisfied because they're problem solved and they don't have to take up more time just to have me sit and take notes. That's ridiculous. So then, so I found ways to make things move faster given my own specialty and my own workflow, going against what I was originally thought, what I originally thought I needed to do for each visit. We need to be a little more nimble and less dogmatic.
Dr. Shah-Haque:Oh, I love that because a lot of the dogmas just very I always like to color outside the lines, if you will. I really like everything that you've said and I appreciate everything that you've said because you hit it about being active, being vocal, bringing back the art of medicine and what we have that. We do have control over that. We do have that autonomy. What words or pearls of wisdom which you have for the listener.
Dr. Block:Nurture your outside interests, in and out of medicine, as they apply to your career and even as they don't apply to your career. For me, it's podcasting. For me it's my family. For me, it's physical activity and physical fitness, and I'll play a sport per se, and so all of these things have defined me and all of these things have gotten my attention in fluctuating degrees throughout my life, but I've never given up on any of them completely, and there are things that we need to do for our jobs and there's things that we need to do for ourselves. Make sure you are continuing to do those things for yourselves and, if possible, find a way to tie them together so that you can. We talk multitasking Well, like if I'm doing physical activity with my kids, that's really multitasking. Find a way to nurture your passions. This just sounds so corny. What I'm finding in my own career is that there are some ways in which I'm finding I'm stagnating because the things that I see, the visits, tend to be repetitive and less intellectually stimulating. And the way that I keep it more intellectually stimulating is twofold my podcast. I take what I learn on my podcast and I apply it. I figure out what else I need to learn, to continue to improve, and then I'll have a new episode on that and then I will incorporate that and so it becomes a very iterative process. So I'm trying to hone my skills because that's my particular passion. Is that being methodical about the doctor-patient interaction, being intentional about it. So that's me using my own passion and integrating it into practice.
Dr. Block:That it's for other people it might be leadership. For other people it might be like there has to be something aside from just seeing patients that you can nurture and it will help you when you get mid-career. It'll help you from stagnating because hedonic adaptation it's going to set in and everything becomes less stimulating than it once was. Everything brings you just becomes rote. Right, that fancy car that you spent all that money on it will stop bringing you joy because you'll just go back to baseline. It'll just stop, and your job can do that too. Find something that's peripherally related. I took a really circuitous path to get here. I'm sorry, but that's the advice is find something that you're peripherally related to in your occupation and find a way to allow that to continue to nourish you through your professional journey.
Dr. Shah-Haque:I couldn't agree more, because we have to keep that exciting and yet connected and being creative. And, bradley, thank you so much. If you enjoyed this podcast episode or have found it helpful, leave us a review.