How to Be Happy in Practice for 30-Plus Years


These eight lessons can help you avoid burnout and enjoy medicine.

Fam Pract Manag. 2018 May-June;25(3):40.

Author disclosure: no relevant financial affiliations disclosed.

I have practiced family medicine for 43 years — 32 years in solo practice. I have had the same head nurse the entire time, a second nurse for 31 years, three receptionists, and only a few others. In large part, it is this remarkable continuity that has made my practice so productive and pleasant for all these years, but there are some additional factors. I share them here with the hope that some of you rookies will pluck a pearl from my experience and avoid the burnout I have read so much about but never experienced.

1. Stay small and nimble. Amazon adheres to the rule that any new business should be built by a team small enough to be fed with two pizzas. I'm with Jeff Bezos. You don't have to be in solo practice to do this. Large groups can grant autonomy to small “practice pods” that are nimble enough to take action.

2. Put people before efficiency, and you'll get both. Treating staff or patients like widgets looks efficient but is counter-productive. Efficiency comes by knowing people. When I see a name on my schedule, I see a face; when my staff hears a voice on the phone, they see a face. With those visions come memories — of personalities, medical problems, predispositions, etc. From those memories come reciprocal trust, diagnostic accuracy, and cost-effectiveness.

3. Do today's work today. We don't waste patients' time with phone trees. They get a live person with every call, and if they need to be seen today, they are. It may seem impressive to be “booked” weeks in advance. It's not. It usually means something important is being shelved today.

4. Get out of your staff's way. Physicians who feel weighed down by administrative work need to meet my nurses. After all these years, they know what I'm going to say, and probably what I'm going to think, so I never talk on the phone during office hours except for occasional calls from colleagues. They do the forms and deal with prior authorizations. All I do is medicine, and I rely on them to catch my occasional


Dr. Iliff is a solo family physician practicing in Topeka, Kan. He is a former member of the FPM Editorial Advisory Board.

Author disclosure: no relevant financial affiliations disclosed.


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