The Worthy Physician

Unlocking New Levels of Growth and Fulfillment with Dr. Shai Efrati, MD

• Dr. Sapna Shah-Haque MD

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What if unlocking the full potential of physicians goes beyond medicine? Join us in an engaging discussion with Dr. Shai Efrati, as we uncover the secrets to enhancing efficiency and peak performance in the demanding world of healthcare. We explore the often-overlooked roles physicians play and how the drive to surpass "normal" benchmarks can lead to unparalleled growth. By addressing both biological and non-biological barriers, Dr. Efrati provides intriguing insights into how simple habits, like morning phone checks, can impact a physician's focus and productivity.

Beyond the clinic, personal development and mental resilience take center stage. We delve into the parallels between elite athletes and physicians, focusing on self-assessment and discipline. The conversation touches on setting personal and professional goals, highlighting the benefits of mental framing and resilience. Dr. Efrati shares his evolved understanding of mental health, particularly PTSD, providing a fresh perspective on these challenges.

In the quest for mindful performance optimization, we emphasize the power of purpose. Discover the art of managing attention and interactions, as we discuss strategies for navigating daily transitions with a clear "why." Dr. Efrati shares personal techniques for self-reflection and growth, from using verbal reinforcement to fostering a humorous approach to self-assessment. Through these strategies, we inspire listeners to take control of their routines and unlock new levels of personal and professional fulfillment.

Striving for peak performance in healthcare requires physicians to identify and overcome personal and professional bottlenecks. Dr. Shai Efrati emphasizes the importance of motivation, daily missions, and self-reflection as key elements for continuous improvement in practice and life.

• Understanding the multifaceted roles of physicians 
• The importance of identifying biological and non-biological bottlenecks 
• Strategies for managing time and attention effectively 
• The role of self-reflection and weekly evaluations 
• The necessity of having a personal ‘why’ as motivation for improvement 
• Emphasizing gratitude and its impact on patient care 
• Encouraging the adoption of daily missions for greater focus 
• The impact of physical health on overall performance


Connect with Dr. Efrati:

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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!
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Battle of the Boxes

21 Day Self Focus Journal

Dr. Shah-Haque:

Welcome to another episode of the Worthy Physician. I'm your host, dr Sapna Shah-Hawk, reigniting your humanity and passion for medicine. With each episode, we bring you inspiring stories, actionable insight and expert advice. Get ready for another engaging conversation that could change the way you think and live as a physician. Your income is your greatest asset. Protect it with pattern light. The easy, stress-free way to find the right disability insurance, with unbiased comparisons and no jargon. Pattern helps you to choose the best policy for your needs. Secure your future today at Pattern Life. The link is in the show notes.

Dr. Shah-Haque:

Let's dive in. What if I told you that there's a way to level up your efficiency and your peak performance? What if I said we're going to unveil that secret today? I have Dr Shai Efrati, who's going to be here discussing this with us, as we were discussing before the recording. Many physicians we have so many hats that we wear it's not just physician and then we're done at the end of the day or at the end of our shift or at the end of cases. A lot of us are parents, spouses, friends and have other roles in the community. How do we really max out our efficiency and our performance?

Dr. Efrati:

So it first starts with the desire to do something. That's a good beginning. If you want to be an athlete and you want to win the Olympics, you first need the desire to be there, because without that desire we are just moving from one task to the other. We are not asking ourselves can we do it better, can we improve our biology beyond the normal? Because as physicians, we are trained to refer to the normal for age, the normal for sex, the normal for your education level, etc. Etc. So being at the normal and most physicians a bit above the norm, then it means that you don't need more than that. But if you want to perform better, first you want to want it. Okay, you have to be willing to invest in that, and investing is not necessarily time. It starts with the thought I want to be better, I want to use my time better, I want to perform my tasks better. I want to refer to myself just like an elite athlete. I want to be the elite in my profession. Before discussing what can we do? That's the first thing. Okay, and forget the normal. The title of the book Beyond Normal Don't refer to the normal as the desired thing. Let's start with that.

Dr. Efrati:

Most of us are not doing that. We are just living the day. Okay, we have another day, I saw my patient, I was treating them at home, I fed my children. Now I need to go to sleep. That's happened to many of us. Because I need to sleep, because tomorrow I have a new day or another shift, etc. I survived this shift. That's the kind of language many of us use. So, instead of using that language, you said okay, how can I perform better? How can I do better? That's a different thing.

Dr. Efrati:

Now, once you have this desire, then you start to ask yourself questions and you ask yourself what is my bottlenecks? What are the bottlenecks that prevent me from performing in a better way? And these bottlenecks can be divided into two major groups. One of them is biological bottlenecks, and we can get into that, and the other one is non-biological bottlenecks. What everybody has the bottleneck can be some limitations that I have with my family, with somebody I need to take care of, limitations that I have since the war. My war demands me to do that and that, but what are the bottlenecks? What are the bottlenecks? That if I will open that bottleneck, it will open a whole flow of things that can happen. And, by the way, what's good in bottlenecks? Every time you're opening one bottleneck, then you have the next one and then you have the next one.

Dr. Efrati:

It's a never-ending story. That's the beauty of it. Okay, and world record would not have been broken unless we will move from one button next to the other where all the previous button neck of the previous record were solved. So now we will look in what is the next button. So think in a better way, in a better way thinking. For example, if you have a supermarket, you have the big supermarket, but you have one cashier, it doesn't matter how much the supermarket will grow unless you have more cashier. That's the bottleneck that prevents the performance of all the supermarket. So you have to define what are your bottlenecks. Now I will not get into bottlenecks related to the personal issue or non-biological issue, because I can speak about it, but everybody has different stuff related to that. I will speak about the biological bottleneck. I will speak about the biological bottleneck Now, of course that also with biological bottlenecks, things are different from one person to the other, but let's try to speak about several bottlenecks that are related to all of us.

Dr. Efrati:

You have to work on yourself knowing when are the times that you perform the best. Is it during the morning, is it during the night? And I would give an example If I'm waking up in the morning and the first thing that I do is this one and I'm holding my cell phone and I'm just opening it. Just open it, okay, I'm not doing anything above that. And then I see the messages that I have and I started starting to work on these messages. I'm lost. I'm lost If, in that way, my intention was to something new that I want to enrich myself, if, in that day, I wanted to have a discussion about something in particular, else I lost it because, at the end of the day, we have a limited brain power. We have a limited brain power. So if your brain, if your attention is on that, it will not be on other stuff. For example, I take to myself every week. I take a day that I'm taking it to myself. I'm escaping. I'm heading three departments in my hospital and in the university the nephrology, the research unit and the hyperbaric. But at least once per week I'm escaping from everybody a whole schedule of dates with myself on what I'm going to discuss, what is the topic that I'm going to discuss with myself, and when I'm doing that, I will never open the cell in the morning, and in between the day, I have 15 minutes that they keep as a gap, that in that period of time I will look at the cell and see what's going on, and see what happened and if somebody called me, if somebody wants something, etc.

Dr. Efrati:

But you have also to manage your brain attention and we are living in a period where our attention is the most important thing that we need and lose during the day. Because everybody fights for this attention the messages, the Facebook, the colleagues, the notice, the pump up with the news every time. So everybody fights for our attention and if you don't have attention, you cannot be a lead atlas. Think about a lead atlas that is waking up in the morning and when he wants to go out do the daily exercise, somebody tells him hey, just a minute, don't start yet. I want you to come with me to here to see that. And then he says he's going and now we have the next mission. We say don't start yet, I want you to go with me to that place, I want to show you something, and then coming back again. But I have that. He will lose the day, he will not become a professional, okay.

Dr. Efrati:

So you have to decide what is your day mission, okay.

Dr. Efrati:

What is your daily mission?

Dr. Efrati:

What is the hour mission?

Dr. Efrati:

What is the two-hour mission? So a lot of people ask me again how can you manage all of the department? And I have a big research you need and there are big departments actually and a lot of people that works with me under my supervision people how can you do that? I say I'm not doing all of that Every time. I'm doing only one thing. Okay, if I'm with somebody, I'm with him.

Dr. Efrati:

Now, full, all bored, no cellular, nothing else. And that holds also for the family. Okay, if you are at home now you are at home pay full attention to your child, pay full attention to that. So the attention should be managed and as physicians, this is a precious resource that we have. So that's another thing. Beyond that, there can be other bottlenecks that are totally personal dependent. So if you have the brain injury, if you're aging and your regenerative capacity is going down, so seek for things that will open the bottlenecks, but think in a way that asking yourself so what is a bottleneck? What prevents me from reaching the point that I have? Once you're doing that, you will get to the solution.

Dr. Shah-Haque:

So first identifying bottlenecks.

Dr. Efrati:

Oh, you can open this bottleneck, yes. And once you open that bottleneck, don't rest, enjoy it, but then say can I do better? Do I have another bottleneck that I need to?

Dr. Shah-Haque:

open. It's this mindset of going beyond the normal and constantly improving.

Dr. Efrati:

Think just like an elite athlete. Professional athlete would think, Think like professional CEO would think Okay, that's how he thinks. If he's successful, he's looking at the system and saying where do I have the?

Dr. Shah-Haque:

buttonness, where do I need to focus my attention? And that's the way of thinking. Then also structuring your attention, and that's so important because it's so easy to go down those rabbit holes. But, like you were saying, there has to be a structure, there has to be a system in order to be productive, because 20 minutes here, 30 minutes here but a big thing that you said was really checking in with yourself every week and holding that space for yourself in order to what's the benefit of that. Can you tell us what the benefit of that is? I think I know what the benefit is, but I would I want to hear it from the expert.

Dr. Efrati:

I will give you an example. So every week on Friday, I'm sitting with myself alone in one of the offices that they have. I'm sitting with myself and in one of the offices that I have, I'm sitting with myself and I'm going through the weekend. Okay, what happened in that weekend? What were the missions that I have that I defined the Friday before to myself, and where did I did good, where did I didn't did so good and why? Now you're giving time to yourself to judge yourself, judge the performance, okay. Again, just like an elite athlete. He went to the race, okay, he didn't have the score that he have, or even win the race, okay. But he can ask himself okay, I did good, why did I do good? Okay, and after you understand, why did you do good? You ask yourself can I do better? Okay, so that's the kind of way of thinking and I'm going day to day.

Dr. Efrati:

I'm looking at the mission that I have. I'm seeing what I'm planning for the next week I will have a mission. And once I have a planning for the next week, I will have a mission. And once I have a plan for the next week, I'm looking at daily missions. Okay, what will be my daily mission for Monday. What will be one daily mission? Okay, there are many sub-works, but it should be one daily mission that I need to accomplish. Okay, that's the way to work and I'm to accomplish. Okay, that's the way to work and I'm always learning, and every week I'm saying my mission for next week and standoff doing the standard. My next week mission is to learn that. Okay, so I'm learning new stuff that most of it are not related to medicine. From time to time, I have some gaps to cover medicine, but I decide what are the things that I want to close the gap on? It can be related to philosophy, it can be related to language, to mathematics, to physics, to whatever it is. That's the kind of way that I do it. That's the kind of way that I do it. In addition to that, of course, we need to see if we have biological bottleneck, because, at the end of the day, this is the machine that we are driving, this is the car that we are driving, and if the car doesn't move in a good way, even though we want to reach that destination, the car will take us no-transcript Having another mission.

Dr. Efrati:

One of your missions is to give your body the respect that it needs. So I can tell you about myself. I hate doing exercise. I hate it. I hate it. I think that the best thing in exercise is the shower afterwards. I just hate it.

Dr. Efrati:

Okay, in the morning, when I wake up in the morning and I'm going to work and I'm waking up early, I'm waking up usually around 5 am. I'm going to the morning and I'm going to work and I'm waking up early. I'm waking up usually around 5 am. I'm going to the hospital. I'm happy. I'm the happiest guy in the universe. But in the days that I have in my out-to-calendar exercise two hours, it's hard for me to get out of bed. It's terrible to do exercise, but I still do that. Okay, why do I do that? Even though it's not fun, to say the least, you have to do it because the benefit is have a better car. Nobody wants to put the car in the garage, but you still have to do it. It's clear to you if you will not do it, you won't have a car, even though you need the car in that day. So that's the kind of discipline that you need to do it. You just need to do it, otherwise you lose.

Dr. Shah-Haque:

And how did you develop that discipline? It might be easy to say, oh doctors, we've gone through so much, the training is rigorous and we're all about the patients, we're all about medicine. But how did you change your mindset?

Dr. Efrati:

How do I?

Dr. Shah-Haque:

make myself do it? Yes. How do you make yourself get up and do things that you hate?

Dr. Efrati:

Yes, Start the day with the things that you mostly hate. Look at it first and say if I were to do that, I would get the prize to go to my work at the hospital, to go to the lab. If I will not do that, I will be punished. So I'm taking the things that I hate the most for the beginning of the day, because if I will leave it to the end of the day at least me, no way I will do any of this, no way. But if I'm having it at the beginning of the day, I can never say, oh shit, now I need to go to the gym for two hours. Oh, my God, okay, I cannot tell you. There are people that are doing exercise and happy, I do it, I hate it, I just hate it. So I hate it for two hours. So I'm cursing for two hours. So I'm saying, once you will finish that you will have a shower and then you will have the privilege to go to work.

Dr. Shah-Haque:

Wow, that's my treat. And with that, how much do you think like mental framing plays into your outlook Mentally?

Dr. Efrati:

probably the most important thing, the most important tool that we have. I don't want to say that mental is everything Right, but if you don't have your mental resilience, that's the first thing that you should work on. And I can tell you that during the last 20 years, there was a big switch in the way I look on mental issues, a huge switch in me. I can share with you that we are doing a lot of research on PTSD. Yes, now, if somebody would have come to me 20 years ago or 16 years ago and he would have told me that Shai, you will have a whole research program on PTSD, I would say no way. This is my wife's issue. She's a social worker. She speaks with the patient and thinks that something will happen. I'm dealing with physiology. No way that I will deal with that. No way. I used to say this crap, but don't citate me is not me. This is my wife. And a lot of the time I have started to notice that I might be mistaken and I'm thinking very rational. What convinced me is a model that's been done in Israel in the Ben-Gurion University by a colleague. Her name is Hagi. She has a rat model of PTSD. So you can say how do you cause PTSD to a rat? If you take the rat, you put the rat in a cage with the urine of a cat for one hour. You don't touch the rat, you just don't touch him. And then, a couple of months after, you can take the brain out. That's what's good in rats you can take the brain and look. So taking out the brain and looking at the microscope, you can see a wound. You can see a wound and when I saw that I said, oh my God, I was totally mistaken. The body-mind connection is so tight that you cannot check. We can kill ourselves just by mental issue. It's the same system and again, that's you're hearing from me. I was in the total opposite direction and having the appropriate mental status is high, important and the way you see yourself and if people are suffering from ptsd, it's a biological. It's a biological limitation.

Dr. Efrati:

Okay, today we understand that the problem is p with PTSD is how we encode the event. If you take two persons that were exposed to the same event, one of them developed PTSD, the other one didn't develop PTSD. What is the difference? The one who did not develop PTSD. The event is encoded. It can be a terrible event, but it's encoded in the past. It has a day, it has an hour, it has a minute that it happened, but the past is a past. It can be a terrible past, but it's a past. And if you will take somebody who developed PTSD, it means that the past is not the past. He still lives there, he still lives the event and it still lives there. It still lives the event. And if it still lives there, then it means that it can be in the same space with somebody else, but you are not experiencing the space that you are in the same manner.

Dr. Efrati:

At the end of the day, there is no real reality. Everything is between our ears. If I will look at that chair that I'm sitting in front of now, you can see him, but if you look with the x-ray, there is nothing. If a dog will sit next to me and hear voices that I cannot hear, if we take a father with a child with PTSD in the Luna Park waiting in the line to buy ice cream for the child, it's an amazing event All the toys around the playground, the fireworks, ice cream great event. The father with a PTSD is in the battlefield. So everything is between our ears, the way we see the world whatever it is. We all share the same space, but we experience it in a completely different way. Our mental status is of immense impact on how we pass the day, and that's highly important, and only on that we can do a whole podcast.

Dr. Efrati:

So, that's extremely important.

Dr. Shah-Haque:

I'm sorry that I went into that. I know that. No, I I think it's, I think it's necessary. I think it's necessary because there's uh, I think there's a lot to that, just with the human experience. But also physicians are quite resilient. But we're having this discussion because it's like how can we possibly reach that next level? And you have outlined it from the beginning, saying okay, we'll stop thinking normally and that's going to be impacted by how we sense the world. So, depending on how we sense, then, what our normal is, how do we elevate from that? But going back to set your mind to it? So you have to be in a good mental space to do that. You have to be in a good mental space in order to define the bottlenecks. You have to be in a good mental space to be able to know how to manage attention and not get so distracted on everything in the periphery, to have the discipline to not pick up the cell phone that keeps us prisoner of our own thoughts and of scrolling.

Dr. Efrati:

But you have to be in a good mental space to do that and you desire to do better, yes, yes, don't just say I want to do better during the day, and let's see how I can do that.

Dr. Shah-Haque:

And so when we're doing that, you say have a daily mission, and then you sit down on Fridays and you review how your week went and you're not beating yourself up, but you're looking at your performance during the week. Is that correct? Yeah?

Dr. Efrati:

You're looking at your performance. It's okay to fail with a mission, but what's important is how did you perform, Not whether you fulfilled the mission, yes or no. That's not the goal. Whether you fulfilled the mission or didn't fulfill the mission, it's not related to how you perform. Okay, we want to think of ourselves as superpowers, but we're not. Most of the things are not related to us, unfortunately. Whether we succeed or not is not us, it's usually the environment.

Dr. Efrati:

Napoleon he chose his commander not based on the skills that they have. He concerned only on one skill whether this commander has luck, yes or no. If he's a lucky commander, that's the most important skill that he has. If you have luck, then you can be his commander. If you don't have luck, no matter how fast you are, how strong you are, how smart you are, it's neglectable. So we need to realize that most things are not related to us. Not related to us, not related to our performance. Most of the things, the big things. Nevertheless, we want to perform at our peak, okay, at our maximum.

Dr. Efrati:

So when you are seeing so during Friday, you can look at the week that passed, you can look at the week forward. But again, when you're starting the day, instead of opening this cellular phone, the attention destruction, what I'm at least doing. I'm thinking, okay, what do I have in this day? Okay, and just going through the day in my mind and telling to myself again what is the most important mission that I have for this day that I don't want to miss, Except of doing that during Friday. I'm doing this also in the morning, okay, Before I'm cursing that I have to go to run and things like that. So that's another thing. And then, when you're going through the day, you have things set in your mind so you control your attention. Nobody else should take control of that. I don't know if I'm a successful model, but at least that's what I'm doing.

Dr. Shah-Haque:

No, I think it's a good, it's great insight, because we forget how much power we have to control our mind. Like I can control what I consume, I can control who I interact with and a sense of I don't necessarily have to pick up my cell phone and scroll right. I control what I see, what I hear and where my attention goes. Obviously, by going to work, I choose to put my attention there. By interacting with my children, I choose to put my attention there. But again, we have that power of choice. We have that power of I'm going to use my mind as I wake up to map out my day and this is probably what it's going to look like. What can I augment? What can I? Where can I be the most efficient and where possibly might be a bottleneck in my schedule for today that I can try to optimize it. How can I rearrange my day mentally? And it may not be always working out 100% that way, but at least I'm mentally prepared.

Dr. Shah-Haque:

I have a map of what it's going to look like. I have a map of what it's going to look like. I have a map of what my mission is for the day and by doing that I can also reflect on what here's plan A, b and C potentially. So it also gives me a chance to map out the day, because then I also know that on a 10-minute drive from work to home I'm going to be switching gears from being a physician to being mom. So I'm going to use that time to either decompress or, if I'm needing some time to refocus and get into family mode. That's going to influence the music I listen to on the drive home. That's also going to affect whether I'm making a call to a family member or not. How I'm feeling in that moment is going to reflect in my decision on how to use that 10 minutes. And there are some days where I need to completely decompress and so it's going to be complete silence.

Dr. Efrati:

Yeah, and I see that we don't have much time to get into the biology but the same thing I'm doing with my patient. Okay, for example, that's what they call enhanced medicine, but I assume if the talk is interesting enough for everybody, they can just read it, okay, in the book. But the principle is that if somebody is coming, a patient is coming to my room, first and most important thing, I'm looking to give him the why. Okay, why should I get better? If, like Nietzsche said, if somebody has the why, he can hold and resist anyhow. Okay, anything that happened along the way. And if you don't have the why, you are lost. Now, the why is not world peace, it's not that I want to get to the moon Okay, the why can be I want to get to my granddaughter's birthday? Okay, that can be a why. I have children, I have a wife, I have a garden that I need to take care of. Everybody has his why. So when somebody's coming in, you have to find the why, and that's why I'm asking what do you do? What's that, what is it, et cetera. If somebody doesn't have the why, you're lost. You will never be able to help him because there is no purpose for him to get better. So he will not get better. Once you understand the why, you can understand what the diagnosis of this patient have. But also from biological perspective, look at the bottleneck. Okay, think what is the biological bottleneck that this patient that's sitting in front of me now have? Once you understand the bottleneck, open the bottleneck.

Dr. Efrati:

Now, in classical medicine we've been trained to think in a way of enzymes, molecules, protein, that you should target that with this chemical or target that with this chemical. But in most of the time it's not enough. You have to change. For example, if somebody got infected, we will give him antibiotics okay, that will target a specific enzyme. So this is classical medicine. But you can do it in other way. You can give vaccination that enhance the immune system to be ready for the bacteria Okay, so giving vaccination, that's part of enhanced medicine.

Dr. Efrati:

Giving specific antibiotic or antiviral that works on specific enzyme this is classical medicine, etc. So we need them both. We need them both. But if we are able to find bottlenecks, if we are able to initiate a physiological cascade, a physiological state of mind or physiological biological cellular cascade, the benefit that we will get from that will be significantly higher than just targeting a specific enzyme. So that's also once you practice it in your daily and when you practice it on yourself and you are able to give the discipline to yourself. When you will tell somebody that you think you should do that, they will look at you and say I respect him, he's doing that, I will do that also, and that's important. That will help not only you, that will help everybody around you.

Dr. Shah-Haque:

Now that's a beautiful point, because we have to have that purpose. We have to have that why in order to get better and that's my family's my why I get out of bed and do what I do, but without purpose, without that why it's really hard to get up as a human being and to have that drive and to have that determination to do better. I don't know what that's, but I know that can be unforgiving and life can be very brutal, but we gotta hang on to that why and to that motivation and if you're down a bit, just speak with yourself.

Dr. Efrati:

Another thing that help is to speak with yourself loud, not to fear. Speak loud and speak loud, really loud, with yourself, because you know, in medical school, when we needed to memorize so much, I hate it, I hate, I hate it. People think that you're smart, but you're a memorizing machine. You are zero smart, you only memorize. In medical school we always laugh. I always laugh and say, if you will take a donkey and we tie him to the medical school for seven years, how would you call the donkey? At the end of the seven years, you will call him MD. People look from the outside and say, oh, he's smart, he's a physician. No, he knows how to smart, he's a physician. No, he knows how to memorize. He's a physician, okay.

Dr. Efrati:

So I wanted to shorten the period of time that I would need to memorize. I said, okay, this is a bottleneck to my quality of life memorizing. I have to do it faster. I need to find a way to do it. And one of the things that I realized is that if I'm speaking with myself now loud, teaching myself loud, then I can memorize faster and things are more clear to me. And why is that? Because when you're speaking to yourself, you actually organize your in a way that you can say it, somebody understand what you're saying, and then you say meaning, you're moving your vocal cords in a way to take this thought out. So it has to be shrink to the way that the vocal cords are moving and then you hear yourself. So you have full attention on yourself. And if you will come and you will see me, you will see me speaking to myself and then I say Shah, you're stupid, this is not it, you are.

Dr. Efrati:

I think that and I took that also took this tool to my children. I have two girls in the university now and two are in high school. And if you will come to our house, you will see that in each room the door is closed and you will hear a person speaking with me, something saying it's like a nut's house, everybody's crazy. Everybody speaks with themselves in a different room. Because once they've started to do that, they realize that it's easier for them, that it's classical for them. But I use this tool also to speak with myself about the day, about the week. I'm saying, shai, what did you have this week In that way that I'm speaking with you now I said on Sunday I did that my mission was that. Oh you mistake, your mission was otherwise. And that keeps the attention in the subject that you want to discuss with yourself. For me it's helpful. I don't know if it's helpful for everybody. At the beginning it sounds very weird that you speak out with yourself, but for me it's very effective.

Dr. Shah-Haque:

It sounds like an effective tool in order to really be with your own thoughts and hear how they're coming out, how they're landing, and I don't think that they necessarily have to be rough thoughts or it's not like you're trying to beat yourself up. You're literally just trying to evaluate your performance. So this is not a session to beat down shy or to beat down sup. Now. This is a part in order to okay, today was brutal, was running behind because of something that was a little bit out of my control, but here I am. That was a blind spot, but here I am, we're talking, and then in about an hour, I have something else I need to do. I'm still doing this, I'm still having a great conversation, and it's not to beat myself up from a football that happened 20 minutes ago, as an example but it's to okay, how can I prevent that from being another blind spot? Or so it doesn't always have to be beat yourself up, beat yourself down.

Dr. Efrati:

It's literally looking at performance and giving honest self-feedback, and and if you were really bad today, you can punish yourself by doing a run.

Dr. Shah-Haque:

I'll leave that up to you. A sense of humor is great, and being able to laugh at yourself and say, yeah, okay, I messed up, but again I can do better. How can I do better tomorrow? How can I do better than in the next half of the day? And so it's a lot of. I find that it's also a lot of reframing, and self-compassion allows you to get better, allows you to see your blind spots, indeed truth. So for the reader, the listeners, if they wanted to learn more about your work, you've written a book. Can you tell us about that?

Dr. Efrati:

The title of the book is Beyond Normal. Now you understand why. Because I hate the normal, by the way. Beyond normal is not only going above normal, it's also if you are way below normal. Again, we might think that if we are not able to bring somebody to the normal, then we should not do that to the normal, then we should not do that. For some people, moving the finger or being able to blink the eye, that's a huge achievement. That's a huge achievement. It's an achievement that's worth doing everything possible in order to reach that point. Because if you can move the finger, you can blink that, yes or not, you can blink if something is itching you somewhere around the body, so people can know.

Dr. Efrati:

So beyond normal. By that it's not only above normal, it's also reaching goals below normal that are well-deserved for you and all your patients. So you have to define what is an appropriate biological wish for the patient that you are treating now and focus on that. See if you can handle that. Of course, there are some biological wishes. If I wish to be two meters high, blonde hair, blue eyes, we'll never reach that, so that's a biological wish that we cannot target yet, but it has to set the expectations.

Dr. Efrati:

So the abnormal is not only above, it's also below, and in the books we discuss the principles of what I call enhanced medicine. That's how we practice medicine and the bottleneck issue. There are the basics that I practice and my colleagues, clients are practicing in order to achieve their goals, whether you are a successful CEO or elite athlete that is competing now in the Olympics, or, on the other hand, the different diseases of syndrome, of how we approach them and what do we do with them. So people can take for themselves, based on the scale that they are in, what is good for them. So that's what we are doing. So people are invited to read the book. It's on Amazon.

Dr. Shah-Haque:

And the link will be in the show notes. The show notes and shy if they wanted, if the listeners wanted to reach out to you and learn more about you and what you're doing what's the best way to to find you.

Dr. Efrati:

If they can write an email, that is. I'm doing my best to answer emails most of the time I'm able to clean it in 24 to 48 hours. If not, then during the weekend.

Dr. Shah-Haque:

And what is your email?

Dr. Efrati:

My email is ifratishai at outlookcom. This is my private email.

Dr. Shah-Haque:

And that'll be in the show notes, if that's okay for the listeners. What is one last pearl of wisdom, shai, that you would like to leave for our listeners?

Dr. Efrati:

You have to remember that we are coming. At least I try to remember myself that we are coming into this world for a journey. So it can be a successful journey. As long as you feel the wind on your face, you smell the air, you see the view, it's a beautiful journey. As long as you feel the wind on your face, you smell the air, you see the view, it's a beautiful journey. And if you're locked down in a car and the windows are closed and black, this is not the kind of journey that we all want to be part of.

Dr. Efrati:

So what makes it eligible or enable you to enjoy the journey? It's, of course, first and most important thing and we know it as physician is first our biology, because if you don't have that, then probably other stuff are less important the state of mind that we have always have a future, because if you don't have a future, if you don't play the future, the biology will not do much to bring you to that future. So we can always design forward. And the willingness to do better, to perform better. This is something that the core needs, the core. But doing better, it's not doing only to myself, it's how do I do better?

Dr. Efrati:

And we all know as physicians, that the most enlightening, amazing thing that we can get for ourselves is a gratitude or thank you from a patient. And this is a privilege that we all have. And I always tell people do good. And then they ask you what does it mean to do good? And I always say if somebody said thank you, it means that you did good. So be a thank you collector and collect as much as you can through the day or through the week. And I have a saying in our team. People from my team came to me and said I collected one, I collected two today, I collected three, today it was a good day I collected five. That's the kind of language that runs between us. So I wish we can do as good as possible, everybody in a way that he can do it, and we as physicians have the huge privilege to do good during the day. So let's do it.

Dr. Shah-Haque:

Thank you. That truly is beautiful and just a great way to look at things and just be grateful. Shai, thank you very much for your time and your words of wisdom, and the link to the book will be in the show notes. Thanks for tuning in to another episode from the Worthy Physician Podcast. If you enjoyed this episode, be sure to subscribe, leave a review and share it with someone who'd love it too. Don't forget to follow us on YouTube, linkedin, instagram for more updates and insights. Until next time, keep inspiring, learning, growing and living your best life.