Board Forum: Enough Is Enough

What have you “quit” recently from a professional standpoint? What prompted the decision and what has the outcome been?

Gregory Buford, MD: I've recently pared back on several “time sucks.” One example is email. Before, I would literally check my inbox several times a day thinking that there were emails that I absolutely couldn't miss. Now that I check only twice a day, I find that there rarely any emails or urgency, and I realize that people can always reach me through the office line if they really have an issue that is time sensitive.

Another time suck is social media. While I am a huge advocate of it for patient education, I found ways to automatically post throughout the day so that it appears that I am active...while I am really not.

The final time suck are meetings—especially meetings outside of the office…I carefully pick who I connect with and generally have them come to me. I find that most people are very considerate when it comes to my time and are more than happy to be flexible.

Jeanine Downie, MD: I have quit traveling for companies who are not paying me appropriately for my time. I need to feel valued in order to leave my office, as I lose money every time I leave the office for travel for these companies.

I have also had to quit or break up with a couple of problem patients that were either too demanding or very nasty to me and my staff.

Paul Carniol, MD: Perhaps surprisingly, I haven't quit anything. Part of this may relate to some choices I have previously made. For example for a mainly aesthetic practice, at this time, have not seen a benefit from an EHR, and therefore have none (we schedule and bill electronically).

Joel Schlessinger, MD: I echo Paul Carniol. Quitting is a tough thing for me (and likely for most of my colleagues).

On the other hand, we all know that there are times we should quit something or refuse to do a lecture, consult, article, etc. that isn't in our best interest. In some of these cases, I have started to say no.

The biggest thing that I have started to “quit” is days in the office when it comes to family or friends. I used to keep my office time as sacrosanct and inviolable, yet after 22 years in practice I am more than willing to go on a trip, attend a board meeting, or take my wife to a weekend away if the opportunity arises. Luckily, I have a wonderful staff that keeps my practice going while I am away.

Additionally, I have recently offered more vacation days to my staff so they can do the same!

Brian Beisman, MD: I quit attending a business group that I really enjoyed. It was a local chapter of an international organization that did bring some real value… The deal breaker came when it came time to enforce the group's retreat policy. There was a mandatory retreat, which required travel. That in and of itself as OK but part of the goal of the retreat apparently was “bonding” in addition to working sessions. The bonding activities essentially were unstructured “hang out and play” time. I have a solo practice and already travel a great deal for speaking at and/or attending professional meetings of Derms, Plastics, Facial Plastic, Oculo Plastic, Laser, and multidisciplinary type meetings, investigator meetings, and other business reasons. I typically try to fly in, stay as long as is required, and then return home to our family and the office. Taking extra time to play during a work meeting is just not my MO.

S. Randolph Waldman, MD: I really have not quit anything since resigning in 2005 as the Co-Chair of a longstanding Aesthetic meeting in Newport Beach, CA. I left to concentrate my efforts on the conference that we organized and continue to hold in Las Vegas every June: The Vegas Cosmetic Surgery and Aesthetic Dermatology Symposium, which has become the largest independent aesthetic meeting in North America.

Have you quit any relationships professionally?

Dr. Waldman: I am still married to the same woman and have the same partner as I had 14 years ago in my practice.

Dr. Carniol: I have not quit any relationships at present. However, as dues bills come in from several societies in 2015, I will review them in terms of: does their mission fit the current practice? If it doesn't fit, then I will not pay further dues.

Dr. Beisman: I am less willing to take care of patients who I deem challenging from a personality standpoint. I don't mind tackling complicated medical issues (e.g. patients who have had poor results or complications after multiple other surgeons have operated, complicated scarring, etc.) but am less willing to work with patients who are unappreciative of our efforts no matter what my staff or I do for them.

I also find myself empowering my outstanding employees as they have demonstrated their dedication to our practice and our brand.

Dr. Buford: I haven't quit any professional relationships lately except for my decision to leave Entrepreneur's Organization. This decision was spurred by my decision to move from group coaching to a more personal one-onone format with a Life Coach. So far, my decision has been an effective one!

How do you maintain balance? How do you know that you've had enough/that something has to give? How did you learn to do this?

Dr. Buford: That's easy. I simply look at how happy I am. If I'm stressed out all the time and not seeing a vision with respect to the direction of my actions, then I step back and reassess where I am heading.

Dr. Downie: I maintain balance by exercising every day for at least 30 minutes. I also take breaks with family and friends whenever I can. I know something has to give when I start dreaming about work issues too much.

Dr. Beisman: I do not maintain balance nearly as well as I would like. One of the things that my wife and I did a while ago when it seemed that we barely had a chance to just sit down and talk between the logistics of both of us working, running a small business, and having three teenagers was to institute a policy where one night each week we would go to dinner. On Sunday evening we decide which night made the most sense and we both put that date in our respective calendars and protect the time. It has given us a great opportunity to take a break from the hectic activities of daily life, to catch up on little things as well as to discuss issues that take longer to present and process and is really nice and fun.