Balancing Act

Several years ago Randy Danielsen, PhD, PA-C, DFAAPA and Christy Wilson, PA-C, and presented a workshop on “Balancing Your Life After PA School.” The program discussed everything that was not taught in PA school that the practicing clinician should know.

To prepare, they asked their peers what they wished they had known in their early years of practice. The response was over­whelming. Here are the top 20 items that emerged which we feel are still relevant today:

20. Learn to manage your time. No, really. Find ways to build downtime in your schedule. There is no doubt that the first years after school are not unlike a “residency,” as you learn how to practice medicine effectively. You should develop a ritual of good habits. Refocus and drop activities that sap your time.

19. Enhance your professional relationships. Be sure to know the ins and outs of a professional contract. Be nice to everyone—not only the other clinicians, but also the office staff and the cleaning personnel. It is a small world even if you live in a big city.

18. Enhance your relationships with your patients. Remind yourself why you do what you do. Continue to look at your patient as an individual—not a disease, condition, or room number. Be honest and empathetic, and prepare for the times when you will have to give bad news or when a bad outcome occurs. It is important to remember that patient satisfaction may not be compatible with just good medicine.

17. Understand your medical liability. When it comes to medical malpractice insurance, should you have your own? Should you have tail coverage? Learn ways to reduce liability. The better care you take of yourself in a legal sense results in less time you may have to spend with an attorney.

16. Understand the business of medicine. Who knew how important this would be? There is just as much politics in medicine as there is in Washington, DC. Learn to lobby for what you want. Electronic medical records (EMR) and CPT coding have become extremely important in the practice of medicine. Get involved in the know-how of these items.

15. Care for your body, mind, and spirit. Your physical and mental well-being depend on nourishment. Don’t skip meals, and find regular time for exercise, even if that just means taking a short walk or using the stairs instead of the elevator. Get enough sleep. Surround yourself with positive people. You may find it equally healthy to give something back by volunteering in your church, hospital, civic club, and alumni association, by being a clinical preceptor, or by doing some pro bono work.

14. Deal with fear. Cut yourself some slack. You don’t have to do everything—just the right things. It is not uncommon for us to worry all the time about our patients or other issues. It is important that we find time to compartmentalize. Find an outlet to vent when you have a bad day.

13. Take care of your finances. Financial planning is important. What does your practice/company offer you in regard to retirement and/or disability insurance? Don’t delay getting those student loans paid off.

12. Stay up to date with your professional requirements. Keep on top of hospital credentialing, state licensure, and national certification. Don’t let them lapse.

11. Understand when to order the appropriate diagnostic tests. Know when to order an MRI versus a CT or ultrasound. Don’t be afraid to ask if you don’t know.

10. Always remember the five Ds of prescribing: the right diagnosis, the right drug, the right dose, the right duration, and the right time for discontinuation or withdrawal.

9. Be involved in your profession. Get and stay involved in your state and national professional associations. It is always better to work from within an organization, even if you are unhappy with some of the things they do, than try to make changes from the outside.

8. Don’t forget your family. Don’t let your career take the place of your family. Set both career and family goals.

7. Be professional at all times. You never know who your next patient will be. Dress, act, and speak in a professional manner.

6. Find some quiet time. It is OK to turn off your smartphone and enjoy some peace and quiet (unless you are on call, of course). Ignore the idea that everyone takes precedence over you. If you are able to, outsource any of your time-consuming household chores or errands. Do something you enjoy; it will reenergize you.

5. Be “interested,” not “interesting.” Sit down with your patients and find out about them. Place follow-up phone calls to make sure your patients are doing better.

4. Learn how to handle mistakes. Honesty is important. If you make a mistake, own up to it. Everyone will appreciate you for it.

3. Develop a referral base. Establish professional relationships with colleagues in specialties to whom you may refer patients. Also, it is important to develop relationships with the ancillary services for the same reason (eg, physical therapists, occupational therapists, audiologists). Support interprofessional collaboration.

2. Show your appreciation. A written note to a patient or a colleague goes a long way. Take the time to thank someone for the referral or for something nice they did for you.

1. Hugs! Yes, it is OK to give and receive appropriate hugs from patients, colleagues, and family members. A hug is just as healing as medicine.