A doctor’s measure of success

After an afternoon of being harassed by angry patients at our inner-city clinic, my exhausted resident (doctor-in-training) asked me how I define a successful day. A simple but critical question. In it lies the key to maintaining our sanity and joy as physicians.

There was a time when I measured my success by how my patients did. After all, if I was a good doctor, they should do well. Right?

I knew of a successful young surgeon – the star of her class. She got a top job at a top hospital. She went to work one day, and scrubbed in for an elective tonsil removal on a 25 year old man. Something went horribly wrong during the surgery. Her patient began to bleed uncontrollably, and she was unable to stop it. He died. His community was devastated. Her colleagues reassured her that it was not her fault, no one doubted that she had done everything possible. But she could not recover from the sense of responsibility and failure. She stopped practicing medicine for years.

Much as we like to believe that our contribution is important, how our patients “do” is not solely the result of our skill as a doctor.  Our patients’ outcomes are affected as much, if not more, by their own motivations, habits, choices, environments, thoughts, and by chance. We are but a tool in their box. Measuring success by how they do will be an emotional roller coaster over which you have no control. Worse still, you may begin to resent their “failures”, which will impact the therapeutic alliance you have with them, and will sap the joy out of your work.

Nowadays, I told my resident, having learned through a healthy dose of error, I measure a successful day by whether I have been my best, most present self for my patients. This is something that I do have control over. I take seriously, and am unapologetic about my self-care. Being present and grounded means I can listen better, and maximize my clinical acumen and skills.

If I measure success by whether I have been my best self, both me and my patients win.

How do you measure a successful work day?

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