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Thursday Dec 21, 2017

Resolved! Eight goals for the new year for family physicians

Every January, millions of us ignore the prevailing criticism that New Year’s resolutions don’t work, and we resolve once again to get healthy, get organized, get out of debt, and so on. Why do we do this? According to one set of researchers, we are motivated by the “fresh start effect”:

“The popularity of New Year’s resolutions suggests that people are more likely to tackle their goals immediately following salient temporal landmarks [e.g., the outset of a new year]. … these landmarks demarcate the passage of time, creating many new mental accounting periods each year, which relegate past imperfections to a previous period, induce people to take a big-picture view of their lives, and thus motivate aspirational behaviors.”1

So, if you have the resolve to make a change this year but you need some ideas, here are eight practice-related resolutions from your family physician colleagues.

1. Thank a staff member (and yourself) every day

My professional goal is to remember daily to thank one staff member at least, with specific details, for their contribution that day. We work hard and I have a fantastic staff, but it’s easy to take for granted the heartfelt commitment they show, day in and day out.

On a personal level, I want to stop feeling like my laptop and EHR are joined to me at the hip. I want to take time when I get home not just for needed daily tasks but to do something I enjoy, such as read 20 minutes of a novel, before I start in on the WAC (work after clinic).

— Sumana Reddy, MD

2. Deprescribe medications wherever possible

Pharmaceutical drugs play an important role in medicine, but too many of our patients are taking too many drugs (sometimes five or more), for too long, in too-high doses, and suffering harmful effects. Knowing how and when to deprescribe a drug is a special skill, but we need to learn it. One of my resolutions last year was not only to write fewer prescriptions but also to get more of my polypharmacy patients off their drugs altogether, and I intend to keep pursuing this goal.

— Ranit Mishori, MD, MHS, FAAFP

3. Pull up a chair

I resolve to sit when seeing patients on hospital rounds. Hospital rounding can often be a rushed entry into the patient’s room, with the physician towering over the patient delivering a battery of questions, instructions, and information in rapid fire. Pulling up a chair to sit by the bed changes the dynamic to a “me-and-you” conversation and can lead to a more positive interaction(www.ncbi.nlm.nih.gov), improved understanding by the patient of what is going on, and even a feeling that the visit was longer. So, for 2018 I resolve to pull up a chair to sit when doing hospital rounds.

— William E. Cayley Jr., MD, MDiv

4. Be a voice for change

With family physicians working so hard and facing so many burdens these days, my New Year’s resolution is to keep my chin up, try and do a good job, and use my voice as an advocate for patients and for primary care.

— Jean Antonucci, MD

5. Pause before moving on to the next thing

Sometimes I have a tendency to rush through my day trying to catch up and keep up. I get to the end of the day harried, exhausted, and with little sense of true accomplishment. The single greatest piece of advice I have received came from fellow family doctor Dike Drummond, MD. He advises physicians to take a "squeegee breath," a form of micro-meditation. The basic idea is to pause for a moment – long enough for a deep breath in and out before entering the next exam room or meeting. It's just enough time to transition myself from the last interaction and get re-centered before moving on to the next one. Now if only I can remember to do it more often!

Margot Savoy, MD, MPH, FAAFP

6. Create the practice culture you want

In 2018, I plan to be even more deliberate about helping to create a thriving practice culture by design through more fully integrating the elements of the STARRS acronym:

  • Service – give my teammates recognition and offer small gestures of kindness,
  • Teamwork – check in with my teammates and understand their joys and struggles,
  • Attitude – choose a positive and encouraging attitude,
  • Reflection – pause and reflect on our mission and what adds meaning to my work,
  • Renewal – take time to play and celebrate successes,
  • Self-care – model a healthy lifestyle.

— Mark Greenawald, MD

7. Choose being grateful over being frustrated

My resolution is to be more mindful of how fortunate I am for the role I play in people’s lives and to remember that being a family doctor is the best career in the world, even if the frustrating parts (like the EHR and quality reports) are more present than ever. I want to enjoy everything, even the challenges, as life is good. Also, drink more wine(www.ncbi.nlm.nih.gov).

— Frank Domino, MD

8. "Be there. Give a damn."

I resolve to remember the sage words of family medicine pioneer Dr. G. Gayle Stephens to remind myself every day why we do what we do: "Be there. Give a damn." Meditating on this every day will keep me present with my patients and those I lead.

— Jay W. Lee, MD, MPH, FAAFP

What resolutions are you making this year? Let us know in the comments section below.

1. Dai H, Milkman KL, Riis J. The fresh start effect: temporal landmarks motivate aspirational behavior. Management Science. 2014;10(60):2563-2582.

Posted at 09:30AM Dec 21, 2017 by Brandi White

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