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Mind Matters

By: Richard G. Fried, MD, PhD

Modern medicine is littered with distractions. Apart from the daily tasks of running a practice, we can also be distracted by EHRs, HIPPA, Meaningful Use, ICD-10, and the plethora of new healthcare reform regulations. All of these have the potential to impact our practices and our ability to deliver medical care. In addition, they can distract us from the fundamentals of keeping stability in our office. This underscores the need for a setting that allows us to be fully present, attentive, and interactive with our employees, colleagues, and—of course— our patients.

Findings from a recent Medscape patient survey included some staggering numbers with regards to how patients perceive doctors and their distractions. According to the results, patients noted that 35 percent of the time their physician was interacting only with their computer, as compared to only nine percent of physicians who interacted only with a paper chart.

Individually and cumulatively, these distractions inevitably lead to frustration and dissatisfaction for both the clinician and the patient. Minding your business is, and has always been, an essential survival strategy in medical practice. In general, minding one’s business infers keeping our eye on the ball. This proverbial ball is the intangible but emotionally palpable force that propels and leads our day-to-day medical business. It includes the structural nuts and bolts that secure the infrastructure and function of a medical practice. These living “nuts and bolts” that we call staff and colleagues must be strategically and securely placed and fastened to ensure efficient, competent, and compassionate medical care that adheres to our own moral and professional ethics and those of the Hippocratic oath.

Succinctly stated, minding your business means examining your own desires, values, and goals. What is it that you wish to develop, grow, and achieve? What is the emotional tone and milieu you wish to permeate the atmosphere experienced by staff, colleagues, and patients? Hopefully, it is one of warmth, caring, respect, and professionalism. This type of nurturing and healing environment motivates staff and patients to flourish. Unfortunately, both internal and external performance evaluations aimed at maximizing efficiency and productivity can sometimes undermine an environment of trust, warmth, and respect. Blogs and other ratings services can be distracting and disheartening, as well. As humans, we are endowed with competing drives—those that motivate us to conform and please versus those that drive us to challenge and rebel.

Minding your business means finding that sweet spot that elicits the human drives to conform and please. It does not imply being uninvolved. In fact, it suggests just the opposite. Each practice has its own sweet spot, but there are a few near universal truths. Viewing your practice with a factory production mentality hoping for a “well-oiled machine” staffed by incentivized Pavlovian rats devoid of feelings will surely backfire. Conversely, a completely laissez-faire, anything goes posture will also likely fail. Centered between these extremes lays the sweet spot. Minding your business in the sweet spot implies an approach that appreciates the need for efficiency and productivity while simultaneously valuing the emotional aspects of the “people factor.” Showing genuine interest in your staff and colleagues lives (e.g., birthdays, pregnancies, engagements, new haircuts, etc.) conveys an appreciation of them as valuable human beings. Valued people are drawn to please the people who value them. Minding your business implies sharing your vision for stability, respect, and long-term commitment. Minding your business means being mindful of the priorities and values that define you and your practice.

When feeling the inevitable sense of frustration that is part of modern medicine, be mindful of the enormous power you have to make a dramatic difference in the lives of your staff, colleagues, and patients.