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A publication of the Maricopa County Medical Society

Get ahead of burnout pg. 22

Putting the pieces together pg. 16

Winter 2020


David Geier, MD, discusses physician burnout at MCMS Doctors’ Night 2019.

Page 22


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5 TOP

Medical Apps For Physicians

1 2 3 4 5

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ARIZONA PHYSICIAN | Winter 2020

*All apps available on both iOS and Android

EPOCRATES

Providing medical information to physicians at the point of care, use Epocrates to check drug prescribing and safety, search healthcare insurance formula databases, and stay current on medical news and research updates.

UPTODATE

A wide library of medical knowledge archived at a central location, UptoDate sends regular notifications when new items are added to the medical literature. Stay current on practice changing updates and drug interaction information and take advantage of integrated patient education features and medical calculators for quick and accurate readings for different medical measurements.

MEDSCAPE

Much more than simply a curated news feed for doctors, use Medscape to stay on top of all the latest medical news and findings as well as a searchable glossary of drug information, disease symptoms, and pharmacy directories.

PEPID

A clinical reference and decision support tool, PEPID helps doctors diagnose and treat patients even while offline. Search more than 3000 disease profile and clinical conditions, including high-definition illustrations, radiographic images, and pill identification tools.

DOXIMITY

Developed by the founders of Epocrates, Doximity is a private networking application for physicians. Collaborate on patient care, send HIPAA-approved messages, connect with industry leaders and search employment opportunities.


VOLUME 2, ISSUE 1 EDITOR-IN-CHIEF JOHN MCELLIGOTT, MPH, CPH

Contents

MANAGING EDITOR EDWARD ARAUJO ASSOCIATE MANAGING EDITOR DOMINIQUE PERKINS PHOTOGRAPHY DENNY COLLINS LAYOUT & PRINTING PRISMA ADVERTISING

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MARICOPA COUNTY MEDICAL SOCIETY BOARD MEMBERS: LEE ANN KELLEY, MD MAY MOHTY, MD, FAAP TANJA GUNSBERGER, DO, FACO KENNETH POOLE, JR., MD, MBA, FACP RICARDO CORREA, MD, ESD, FACP SHANE DALEY, MD JOHN PRATER, DO DARREN WETHERS, MD, CPE, FACP KARYNE VINALES, MD

Putting the Pieces Together: Finding Balance in a Fragmented System, with Anita Murcko, MD

16

Features

5 Things You Should Know 20  Why You Should Be 12  About the New Arizona Taking Advantage of LLC Act

What Physicians Think: 8  Are the Obstacles to Work-Life Balance Insurmountable?

arizonaphysician.com Twitter: AZPhysician Facebook: ArizonaPhysician Instagram: AZ_Physician

Subscription Services

earning to Prevent 22 LBurnout for Yourself and Your Team

26 Doctors’ Night 2019

In This Issue 2 Top 5 Medical Apps for Physicians 4 MCMS in 2020: Executive Director’s Update 6 President’s Page: Fighting for Our Role as Physicians Winter 2020 | arizonaphysician.com

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MCMS in 2020

E X E C U T I V E D I R E C T O R ’ S U P D AT E

I

am honored to serve as the Executive Director of the Maricopa County Medical Society. The organization has such a long and admirable history of representing physicians in the county. I relish the chance to lead a strong and capable staff. With your help, we will build on the Society’s legacy and create a future in which the Society has more members, greater influence, and plays an increasing role in improving the health of Maricopa County residents. Our mission is to promote excellence in the quality of care and the health of the community and to represent and serve its members by acting as a strong, collective physician voice. To execute that mission, the Society will provide support for and services to member physicians, services to the community, and preserve and enhance the quality of medical care.

Who is John? I am the second of four children, born in New Jersey and raised in Illinois. I graduated from Xavier University in Cincinnati and served as a Peace Corps health volunteer in Côte d’Ivoire and Madagascar. After returning to the U.S., I earned a Master of Public Health degree from the University of Arizona. That’s where I met my wife, Leslie. For a couple of years, I worked for the Arizona Department of Health Services in Phoenix. Then came the big move to Washington, DC, to work in health policy, my graduate school area of focus. I learned the ropes of federal health policy and advocacy at two membership associations. From 2012 to 2019, I was Deputy Executive Director of the Commissioned Officers Association of the U.S. Public Health Service. It was a wonderful experience to collaborate with Members of Congress, congressional staff, the Executive branch, and like-minded organizations. Outside of serving you at the Society, I continue to serve the Nation as an officer in the U.S. Army Reserve. Currently assigned to the 492nd Civil Affairs Battalion in Buckeye, I’ve had the pleasure of jumping out of airplanes and sleeping in muddy foxholes. The best part of my Army service, and what I’ve already found at the Society, is the opportunity to lead motivated people who care about the mission.

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ARIZONA PHYSICIAN | Winter 2020

John McElligott, MPH, CPH

What’s Next? You’ll hear more from members of the Board of Directors and me throughout the year. For now, here is my big-picture view of what’s next. Maricopa County is the fourth most populous county in the United States, and it’s growing. As the leading voice for physicians in the county, the Society should be growing as well. We should have more members, more events, and more impact on the health of the community. I commit to leading our team to increase membership, host quarterly events, and become known as an organization dedicated to physicians and improving the health of our fellow residents in Maricopa County.

Who Does What? John McElligott: The buck stops here. You can find me at 326 East Coronado Road, Suite 101, in Phoenix. I welcome visits by MCMS members and potential partners who can help us to achieve our mission.

Alex Miles: Director of Operations, who directs both the Bureau of Medical Economics, which provides medical account specialists, and the Greater Arizona Central Credentialing Program, which provides primary sources and credential verification services. Sewit Ghermay: Controller, who is responsible for all accounting-related and human resources activities for MCMS and our business services. Edward Araujo: Communications Coordinator, who oversees our website, social media, recruitment of sponsors and marketing partners, and helps to coordinate the publication of Arizona Physician. Shirley-Ann Hart: Membership Coordinator, who leads efforts to recruit and retain members of the Society. Dominique Perkins: Former MCMS Communications Coordinator, now part time writer and editor for Arizona Physician.


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President’s Page

Lee Ann Kelley, MD

“The boiling frog is a fable describing a frog being slowly boiled alive. The premise is that if a frog is put suddenly into boiling water, it will jump out, but if the frog is put in tepid water which is then brought to a boil slowly, it will not perceive the danger and will be cooked to death.” - Wikipedia DEAR ARIZONA PHYSICIANS,

I

n our long-awaited return to print media, the focus of our first 2020 Arizona Physician magazine issue is physician burnout.  In my private practice of psychiatry over the past several decades, I have seen first-hand the face of doctor burnout. I see increasing numbers of my physician-patients who are very unhappy with their lives. Many are disillusioned with their choice of career. The ideals that led us to make enormous personal sacrifices to pursue what we consider our “calling” is becoming a faint memory to many of us. I sadly inform my physician-patients that they have become “boiled frogs,” with their life-force fading due to various factors that have slowly chipped away at their quality of life and quality of patient care -- forces such as the burden of crushing debt, healthcare insurance companies, corporate medicine, government regulations, the need for tort reform, and the tendency for the employers of physicians to increasingly place the burden of clerical tasks onto powerless employee physicians. The relatively new Maintenance of Certification (MOC) requirements feel like time-consuming busy-work with high financial rewards for the board-certifying organizations, but a questionable educational reward for the physicians. The electronic health record has replaced our doctor-patient relationship with a doctor-computer relationship; our personal connection to our patients has been eroded by shorter visits marred by employers’ demand that we feed endless and needless data into our computers rather than actually making eye-contact and listening to our patients. We are tasked with ticking off boxes rather than practicing the art of medicine.  

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ARIZONA PHYSICIAN | Winter 2020

“Patients deserve more than a frustrated physician.” - Kevin Pho, MD (KevinMD) - keynote speaker, MCMS Annual Event, 2017 Research shows that over 50% of physicians are now suffering from symptoms of burnout on a regular basis, and about 44% have full burnout syndrome. As physicians in the United States, we have the highest suicide rate of any profession, losing 400 doctors to suicide every year. I have lost colleagues to suicide, and I’m certain that most of you have been touched by the tragedy of peer suicides as well. We are all acutely and personally aware of the contributing factors to this burnout, as well as the immense personal toll these factors take on our own lives and the lives of our colleagues. Furthermore, we recognize that a dwindling quality of patient care is the natural consequence, as burned-out doctors make twice as many medical errors.

“We need to take steps to recognize burnout, and then take steps to prevent it and treat it if it happens... There are things we can do on a daily basis to reconnect with why we do what we do to take better care of ourselves so that we don’t get burned out in our jobs... [Burnout] has basically three categories of symptoms: energy depletion and emotional exhaustion, increased distance or feelings of distance from your work, or negative feelings about your work, and decreased work performance or work productivity. Or in simpler terms, exhaustion, cynicism, and feelings of ineffectiveness...


“We must fight for our unique and irreplaceable role as physicians, not merely “providers,” not just datagathering cogs in a machine, as we care for our patients, not for ‘consumers’.”

People don’t want to get help; they don’t want to ask for help; they don’t want to be seen as weak... We know that weak social connections and loneliness can lead to a reduction in lifespan, equivalent to smoking 15 cigarettes per day. - David Geier, MD - keynote speaker, MCMS Annual Event, 2019 Research shows a number of different ways to reduce physician burnout. Interventions on both an organizational/ institutional level as well as an individual level will be necessary to combat this problem and reverse its course. We must ask all involved parties to face the severity of the situation and come to the table to start working jointly toward finding answers to this complicated problem.

“Here’s a profession that you cannot live in a vacuum to do. You have to have people in your life that understand what you do, and that’s not lay people. I’m talking about people who do what you do, who you can vent to, who you can tell your problems to, and they will understand.” - Lynette Charity, MD, keynote speaker, MCMS Annual Event, 2018 Why join MCMS? Studies show that organizations such as MCMS can help fight burnout by fostering physician communities, thus decreasing our sense of isolation by increasing the amount of time spent in the physical presence of our peers. This isolation has been exacerbated by the loss of doctors-only dining rooms, lounges, locker rooms, and other spaces that previously were held sacred, spaces which implicitly paid respect to the status and authority of physicians. At MCMS, we believe in the value of providing this crucial peer-topeer contact via social activities, professional development, informative forums with opportunity for interaction with key players, in-person continuing education opportunities, and mentoring future physicians. During my term as President

of MCMS, my goal is for the organization to provide all of these benefits. We will be promoting physician and public awareness of the personal and financial cost of physician burnout on all levels, as well as the inevitable impact of physician burnout on patient and public health outcomes. By increasing public awareness of this crisis, we hope to harness public opinion to become a force for change. For all of these reasons and more, physician burnout will be a primary focus of our organization in 2020. Maricopa County Medical Society is an organization led by physicians, with membership open only to physicians and medical students. We must fight for our unique and irreplaceable role as physicians, not merely “providers,” not just data-gathering cogs in a machine, as we care for our patients, not for “consumers.” We must recognize and demand respect for the value of our many years of medical education, as well as honoring the diagnostic prowess and wisdom honed by our years of experience, which can neither be matched by nor replaced by intermediate-level healthcare providers.  By focusing on improving our own physical, emotional, and spiritual health, and banding together to fight the forces that divide and potentially defeat us, we can alter the downward course of our collective and individual well-being. We can and will affect positive change. We are confronted with many challenges ahead of us as we face these problems. We will be asking for your input and involvement throughout this year to help take concrete steps toward change. As physicians, your voices WILL be heard. At MCMS, we hope to be part of the solution. Please join us today to help create a better tomorrow. Sincerely,

Lee Ann Kelley, MD

President, Maricopa County Medical Society

Winter 2020 | arizonaphysician.com

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What Physicians Think:

Are the Obstacles to Work-Life Balance Insurmountable? by Dominique Perkins


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Winter 2020 | arizonaphysician.com

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ARIZONA PHYSICIAN | Winter 2020


50%

of physicians spend 6 hours or less in recreation or family time.

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Winter 2020 | arizonaphysician.com

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LLC 14

ARIZONA PHYSICIAN | Winter 2020


A.R.S. § 29-3101 et seq. A.R.S. § 29-601 et seq. 3 An operating agreement cannot supersede any of the New Act’s mandatory rules set forth at § A.R.S. 29-3105(C). 4 A.R.S. § 29-3105(A)(2)-(3). 5 In simplified terms, a fiduciary is a person who owes to another person certain duties, such as good faith, trust, special confidence, and candor. In the business context, fiduciary duties help ensure that each officer, director or manager of a business is acting in a manner consistent with the company’s objectives and in the interests of other owners. 6 A.R.S. § 29-3409. 7 A.R.S. § 29-3405. 8 A.R.S. § 29-3407. 9 A.R.S. § 29-3409. 10 A.R.S. § 29-3408(A). 11 A.R.S. § 29-3407 provides that in a member-managed LLC, most decisions will be made by a “majority in interest” of the members, unless otherwise provided by an operating agreement or by the New Act (e.g., the actions at A.R.S. § 29-3407(B)(4)(a)-(e), including the requirement for unanimous approval to amend the company’s operating agreement or articles of organization or admit a new member, or authorize a member to act outside the scope of the company’s stated purpose). A.R.S.§ 29-3102(12) provides that, a “majority in interest” means one or more members that hold in the aggregate a majority of the interests in the company’s profits held at that time by all members. 12 A.R.S. § 29-3410(D). 1 2

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Putting Pieces

Finding balance in a fragme


I

f anyone should have an opinion on maintaining balance, it is Anita Murcko, MD. From starting and closing practices, founding companies, volunteering with medical associations and organizations, this woman has a lot going on. We sat down with her to talk a little bit about how all of these seemingly unrelated endeavors come together in her life to form one continuous fight to improve health and care for all patients.

All Paths Converge in Medicine  

the Together

ented system, with Anita Murcko, MD by Dominique Perkins

Murcko grew up in a large, close-knit family in Pittsburg, so she had plenty of family around to lend their advice on how she should approach her life. Luckily, she didn’t always listen, particularly to well-meaning voices who assured her that she should find a nice doctor to marry instead of going through all the work and sacrifice to become one herself. In fact, Murcko admits that she is obstinate enough that talk like this just made her dig in harder, rather than give any thought to backing down. A life devoted to healthcare was a passion that grew in a very organic and natural way for her throughout her life. Family members over multiple generations had served in various aspects of medicine, and she took lessons from each of them, from an aunt who served as a Lieutenant Colonel in the Air Force Psychiatric Ward to her grandmother, who was a pharmacist. Early volunteer work as a candy striper further exposed her to the inner structure of the healthcare system, and she came to appreciate the value of each aspect of healthcare delivery, from chemotherapy to a carefully made patient bed. “It’s not a hierarchy, it’s a team,” Murcko said. “And I grew up with this kind of total-person feeling, and that’s what’s permeated my life, really, from the very beginning.”

Winter 2020 | arizonaphysician.com

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The view of healthcare as treating the entire person, rather than segmenting off each part, has led Murcko on a rich and varied career path. All-told she has over 30 years of healthcare experience, more than 20 years of teaching I various settings, and over 15 years of experience in quality improvement and healthcare redesign. She has founded medical practices and consulting businesses, conducted research, served on association boards and committees, treated patients, led teams and educated hundreds of future physicians, researchers, and healthcare providers. It’s no wonder that occasionally friends and family members can’t help but ask, how do these things possibly fit together? However, the unifying motivation that has propelled these seemingly disparate projects is simple. “My general trajectory is, okay, how do we deliver better care?” Murcko said. “And we deliver better care if we have the right kind of people, processes, and tools.” Throughout her years of experience, Murcko sees opportunities to help guide these processes, tools, and people in applications such as electronic health records, prior authorization, and integrated, interactive patient care. Currently, Murcko is a clinical associate professor in Arizona State University’s College of Health Solutions. “I’ve been able to kind of help bridge some of the academia informatics gaps with local healthcare community, and help with research projects, and placing students, and overseeing projects that they can see how the skills and knowledge that they are acquiring can be directly applicable and also help them with their job experience and getting jobs,” she said.

A Daily Struggle With her many years of experience, and new projects and interests presenting themselves all the time, balance is a daily challenge. In the face of maintaining such a busy schedule, Murcko is not the only physician who finds it hard to prioritize her own health. More and more physicians are feeling overwhelmed, exhausted, and hopeless. Murcko employs a few strategies to try and keep ahead of her frequently daunting “to-do” lists. First, she puts a premium on the daily basics of good food and enough sleep. “Sleep is when our body repairs and heals itself, and without that, we’re not a lot of good for anybody, or thinking clearly,” Murcko said. Secondly, she sets a focus for each day – grouping like tasks together and designating a few priorities to accomplish in each. The key here is to be realistic and know you can’t do every single thing every single day. For example, since she teaches on Fridays, Tuesdays are the days when Murcko focuses on preparing for class. “But if I looked at the rest my project list on that day and tried to get things done on every one, I wouldn’t get through it,” she said. Murcko also carefully makes time to spend with those she cares about and to participate in hobbies and activities that enrich her life and restore her energy. A key strategy here is to build in a level of accountability into the events.

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ARIZONA PHYSICIAN | Winter 2020

For example, she and her husband maintain a set date night, and one of their favorite activities is to attend musicals and shows. So, they often purchase season tickets. The monetary commitment helps them keep their commitment to the tradition, especially on nights when it would otherwise be so easy to cancel when busy, tired evenings come around. Murcko implements a similar strategy in her hobbies and personal interests. She loves music and is currently singing with the North Valley Chorale in Phoenix, where she has served as president for the past seven years. Not only is this an activity she enjoys, but it also establishes an expectation of participation. “If you are going to sing, you need to sing your part properly, so you have some expectations that you will make enough time to prepare so that you are a benefit to the people you are singing with or performing with,” she said.

Watching the Signs One last piece of advice that Murcko has seen in her own life, and that she would like to pass down to young physicians feeling buried in the struggle to keep on top of their career while also maintaining a sense of resilience and self-identity, is to expect priorities to change. Balance is a concept that will mean different things to different people and at different points in our lives and careers. Looking back on her life, Murcko can cite specific times that her priorities changed, and she had to step back, reevaluate what she wanted, and make adjustments. Whether that meant stepping back from practice so that she could invest more time in a new project, or taking on more teaching and volunteer hours to be closer to home, she has been able to make necessary changes to meet the ebb and flow of life’s challenges. To those trying to take the temperature of their own life balance, she recommends keeping an eye on the signs. “Little but sometimes not so little reminders about where your love is, where your passion is, and how that fits with those that you love,” she said. Feeling splintered in your time, or feeling bound to one set of expectations while drawn in another direction are definite signs that a reevaluation is needed. While physician burnout is an ever-growing concern, and even classified by some as a public health crisis, Murcko has never cared for the term, “burnout,” feeling it implies fault on the physician


“I think [burnout] is really a symptom of what is happening with the fragmentation and all the distractions that we have.” side – as though they have given what they have to give and are now floundering due to personal failing. By contrast, in her experience, a person can be working as hard and as effectively as they can, and it is the environment, not their effort or desires, that causes the fatigue and dissatisfaction we call burnout. “I think the term is really a symptom of what is happening with the fragmentation and all the distractions that we have,” she said. What’s more, many of the current solutions and coping mechanisms, while seemingly good and helpful things are mostly superficial.   “Some of those are more like bandages that are on top of a very gaping wound that is the way the system is handling and organizing our workforce,” she said.

Preparing to Take on a Fragmented World The healthcare landscape is continually changing, and up-and-coming physicians are facing more challenges than ever. While good ideas and possible solutions have been created, they have not been well-executed, creating confusion for patients and frustration for those trying to deliver care efficiently and effectively. Though she feels most providers are still motivated by helping and serving their fellow men, the evolution of the business of healthcare into a corporate and profit-driven system is in direct conflict with this goal. “With that system has come fraud, has come abuse of information, and greed. And I think that the ability for those types of behavior to creep in have also caused a lot of the issues that we have seen today,” she said. However, as Murcko sees it, there is plenty of hope for the future. She, and others like her, continue to feel motivated by all the good that can be done, and the responsibility that comes with the knowledge, technology, and research achieved so far. These advances in the hands of an intelligent and innovative generation could be what we need to build a more effective system, provided we can also be cautious, attentive, and ethical. “Teaching in the graduate as well as the medical school, with ASU and with the various health professions, I kind of trust the wonderful people that are taking our places as we grow older,” she said.

ON THE PERSONAL SIDE

with Dr. Anita Murcko 1. Describe yourself in one word. Passionate 2. Family? Husband of 30+ years, parents, 4 sisters (all in health), 12 nieces/nephews 3. Hidden talent that most people would not know about? Taught figure skating 4. Career you would be doing if you weren’t a physician? Entertainer 5. Best movie you’ve seen in the last ten years? 12 Years a Slave 6. Favorite food, and favorite restaurant in the Valley? Dessert – anywhere with a beautiful view and I can sit outside 7. Favorite Arizona sports team (college or pro)? Phoenix Suns 8. Favorite activity outside of medicine? Travel


Why You Should be Taking Advantage of Subscription Services

I

t’s hardly news that the internet has changed the way we shop. But for physicians leading such incredibly busy lives, adding subscription boxes to your routine can save you even more time, while also adding a little variety and fun to your life. While traditional online shopping merely saves you the physical trip to the store, today’s best subscription services are more like having a personal shopping assistant. However, with monthly boxes for everything from shaving kits to house plants, where should you begin to add the best value? We’ve grouped services into 4 categories to consider adding to your life.

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ARIZONA PHYSICIAN | Winter 2020


Food & Drink So much time and effort is spent on mealtimes, and for good reason. What we eat has such a dramatic impact on our health and wellbeing. Unfortunately, when life gets hectic, making the time to plan, select, and shop for costeffective and healthy meals can be of the first things to fly out the window. Meal subscriptions like Blue Apron, Hello Fresh, or Home Chef eliminate so many of the steps usually associated with preparing daily and weekly meals, and you still get to cook and enjoy a fresh, home-cooked meal. While there are several companies to choose from the basic premise is simple: decide when and how often you want to receive deliveries and pick the menus you want to try. Then, when your box of fresh and precisely proportioned ingredients arrive, follow the instructions on the recipe card to prepare your meal. For grocery needs outside delivered mealtimes, find a grocery store along your typical commute route that provides an online shopping option, either for store pick-up or home-delivery. Explore other subscription services for food and drink needs outside of at-home meal prep. Snack boxes for healthy office snacks, coffee or tea subscriptions to add variety to your morning routine, and wine, beer, or other drink subscriptions to explore new tastes and experiences.

Wardrobe Presenting a polished and professional appearance is still an important aspect in physician life. While scrubs are certainly required in some settings, many other circumstances call for a bit more formality. But maintaining an appropriate and current wardrobe can take time and effort you just don’t have. Today’s clothing subscription services give you many of the same advantages of hiring a personal shopper. Fill in your profile with sizing, color and style preferences, as well as more detailed questions such as where you spend most of your time and what goals you might have for your appearance. An unseen virtual shopper then sends you a selection of clothing items to try. You keep what you like, and return the items that don’t work for you. Most services keep track of the successes and returns to further customize your offering. While some of the broader, more general subscriptions also include accessories and other items, a variety of other companies specialize in specific items and categories, from jewelry and watches, to workout clothes, to a tie-of-themonth. A few minutes and the search engine of your choice will provide a wide selection.

a sample box subscription. Whether you find you enjoy the constant variety, or use the samples to find your new tried-and-true favorites, services like Dollar Shave Club, Ipsy and BeautyFIX consistently deliver quality products to up your self-care game, and often save a little money at the same time.

Home & Hobbies Subscription services are not merely for the day-to-day necessities of life. Not only can they save time, money and effort, they can also make life more enjoyable. Some subscriptions can supply you with fun things to do with your family or friends, and new experiences to try together. Demanding schedules don’t always leave very much time to spend at home. From escape-the-room kits and other family games, to pet toys and treats, to science projects and art supplies for kids of all ages, having a new adventure to explore can help make quality time where quantity is consistently unavailable. And don’t forget a little quality enjoyment for yourself! With physician burnout a very real concern in so many of our lives, we must carve out a few moments to disconnect from emails, texts, phone messages, and all the other ties to work stress and pressure. Sign yourself – or a loved one – up for a book or record of the month subscription. Or perhaps something a little more whimsical – scented candles, colorful socks, even a hot sauce of the month! There are so many options to put a smile on your face in the midst of an exacting or frenzied schedule.

Personal Care In line with maintaining a professional appearance in dress, health, hygiene and personal care supplies are something we need and use continuously. If you always use the exact same products, try and find a regular delivery subscription, or employ an online shopping and delivery schedule to save time and effort. However, with countless options available today, consider Winter 2020 | arizonaphysician.com

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LEARNING TO PREVENT

BURNOUT

FOR YOURSELF AND YOUR TEAM: Lessons From Professional Athletes

by David Geier, MD

B

urnout has become a pervasive problem in the workplace. In fact – The World Health Organization recently recognized burnout as a legitimate medical syndrome. Whether this is due to new technologies and social media practices that keep us connected continuously and on-call, or the ever-increasing pressure physicians face in today’s healthcare landscape, more and more of us are exhausted both at work and at home. We don’t spend enough time with our spouses, our kids, and our friends. We don’t exercise. We don’t eat well. We don’t sleep well. And it’s not sustainable. At the Maricopa County Medical Society’s 2019 annual event, we were privileged to hear from David Geier, MD, well-known orthopedic surgeon, sports medicine specialist, and author. Drawing on lessons learned from the lives of professional coaches and athletes, he shared strategies physicians can employ to avoid and overcome burnout in their own lives, and help lift their employees and team members. 

DEFEATING BURNOUT IN YOUR EVERYDAY LIFE: THREE STRATEGIES FOR SUCCESS 1. Find your passion. Find what excites you about your job, what gets you motivated, what gets you out of bed in the morning. And then find ways to devote more of your time and energy to it. Arguably one of the greatest basketball players of all time, Michael Jordan’s passion for the game was unmatched. Throughout college, the Olympics, and the NBA, his dedication showed in everything he did. And he continued to play as long as possible – returning to play again and again.For Jordan, this was about more than just earning a paycheck. While it is true that there is no greater privilege than being able to do what you love – what you’re genuinely passionate about – every day, it’s unrealistic to think that you will love every aspect of your job. There are parts of your job, though, that you do love.  Maybe you love talking with your patients, helping them when they need it the most. Perhaps you love the challenge of a difficult surgery or the satisfaction of solving the mystery of a tricky diagnosis. You might enjoy the organizational aspect of administration and helping your team members succeed.  Whatever the aspect of your job is that you do love, do more of it. In medicine – a profession plagued with high rates of burnout among physicians and healthcare providers – studies have shown that burnout is 275 percent more likely among physicians who spend less than 20 percent of their work time on what they find personally meaningful.

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2. Reconnect with your purpose. Professional athletes train for hours each day. They know that if they want to be the best – and compete against the best – they have to push their bodies harder than everyone else. But it’s hard for most people – even pro athletes – to push themselves day after day, month after month, and year after year. To keep up this level of dedication, the best athletes focus on their purpose; they consistently connect with why they do what they do. Carli Lloyd is widely considered one of the best players in the history of American Women’s Soccer. Two Olympic team gold medals, two FIFA Women World Cup victories, and multiple individual awards decorate her career. But her remarkable success did not come easily. In fact, early in her career, her coach cut her from the national team. Determined to achieve her goals, Lloyd did not give up. She hired a personal trainer, James Galanis, and worked for years to become the best player in the world. He pushed her hard, and she pushed herself even harder, squeezing in extra training sessions wherever she could, even once she had made it onto the team.  We often lose our passion in the day-to-day grind of our jobs. From professional athletes to physicians on a hospital rotation, we must all reconnect with our “why” – our purpose – to keep us moving forward instead of burning out and quitting. Think of why you chose your profession. Why did you start working at your first job? Why are you here? Take the time to reconnect with why you do what you do and for whom you do it. Knowing and connecting with your purpose at work and in life will help propel us through the tough times we all face.

Much like Coach Garrido’s Circle of Focus, develop a practice to include gratitude in your day to day life. You might write down three people or things you’re grateful for every morning. Or, each time you open a door or enter a different room at your job, think of why you are thankful to be there. Take a moment to remember your gratitude for your coworkers, or for your opportunity to help your clients and customers. Carry a special object in your pocket and think of something you’re thankful for every time you touch it. Focusing on gratitude will help you through the struggles we face every day. Those thoughts will lift our spirits and fill us with positive energy.

LEADING THE WAY FOR YOUR TEAM: THREE STEPS LEADERS CAN TAKE TO HELP THEIR TEAM MEMBERS AVOID BURNOUT: 1. Help them restore energy in their lives. As we all work long hours and face challenges in our jobs, we must connect with ourselves and our families, taking care of ourselves and maintaining our energy. Throughout his career, Kobe Bryant placed an incredible focus on taking care of himself and his body. One of the greatest basketball players of the last 30 years, Bryant was drafted straight out of high school and played for 20 years in the NBA, winning five championships.  After every game and every practice, while his teammates headed straight for the showers and home, Bryant put two bags of ice on each knee, a bag of ice on each shoulder, and each foot and ankle in a bucket of ice water.  He also employed contrast therapy to loosen up his joints before practice, alternating between cold and hot water. Like our jobs, the NBA season is long and taxing, and Bryant knew what his mind and body needed to fight inflammation and regain his strength and energy.  In addition to taking care of ourselves, as leaders we have a responsibility to help our team members find the balance and energy they need. Every manager wants a productive team, but make sure your push for results doesn’t run them into the ground.  How you help your employees or team members restore their energy might be different for each one. You might end the workday earlier, or offer incentives to join a gym or health program. It might mean more flexible hours for parents or the opportunity to work remotely one or more

“From professional athletes to physicians on a hospital rotation, we must all reconnect with our “why” – our purpose – to keep us moving forward instead of burning out and quitting.”

3. Focus on gratitude. Studies have shown that expressing gratitude, whether through verbally thanking someone, writing a letter, or buying a gift, can benefit the giver just as much as the recipient. Augie Garrido, one of the most successful baseball coaches of all time, used a concept he called the “circle of focus” to help his players succeed. He had each player visualize stepping into a place of comfort, removing all distractions and fears. They were to focus solely on their immediate goal and remember their past successes and accomplishments to encourage themselves. Most importantly, Garrido challenged each player to feel and show gratitude for their chance to play and to use their talents. Focus and gratitude are just as crucial in the corporate world as it is in the sports world. But in our long, strenuous days, it’s easy to forget all the things and people we are grateful for. 24

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days each week. Perhaps implementing steps to disconnect from work on weekends and evenings, or encouraging team members to take their vacation time. As a leader, take time to consider how you can help each member of your team reconnect with themselves and their families and regain the energy they need to be productive in both their personal and professional lives. 

2. Help them focus on their purpose. While it’s one thing to place your focus on what personally motivates you in your career, how can you help your team members make this same shift in their perspective? An excellent example is UCLA women’s gymnastics coach Valorie Kondos Field. Barely into her freshman season, one of Kondos Field’s team members, Jamie Dantzscher, told her that she no longer wanted to compete.  Despite already being one of the most successful American gymnasts before she had even arrived at UCLA, Dantzscher had lost all motivation to move forward. She told the coach about her previous, rigid training experience to make the national team: there were strict rules on everything, even down to how team members were allowed to wear their hair. She had lost her personality, her individuality.  Kondos Field told Dantzscher that she understood and that she could absolutely quit if that were what she wanted. But, she also pointed out a group of young girls in the stand at a meet who were holding up signs with Dantzscher’s name on them.  She reminded Dantzscher that those girls looked up to her for who she was, more than how she performed.

Dantzscher decided that she could let go of the demand for perfection and focus her efforts on enjoying a sport she loved, for herself, and for young fans who believed in her. Just like professional athletes, employees who don’t find fulfillment in at least some aspect of their work are likely to become frustrated and burn out. Help each of your team members identify the parts of their job they enjoy most, and then help them to focus on why they do what they do and give them plenty of opportunities to do what they love doing.

3. Help them form personal connections with you and with the team. Duke University Head Basketball Coach Mike Krzyzewski was a firm believer in the power of relationships. He hosted dinners at his home for all the players. They met each other’s families, relaxed, and had fun. He also took time between seasons to meet with players one-on-one, to ask about their lives, families, classes, and more. Krzyzewski showed his team that he cared about each individual, and would help them in any way he could. What can you do to strengthen the personal connections in your team? As a leader, you set an example. Share parts of your life with your team members, so they get a sense of who you are, and ask your team to share with you occasionally.  Perhaps you could host informal dinners or social gatherings for your company, providing opportunities for coworkers to get to know one another and feel comfortable bringing their families. When a team bonds together as individuals, rather than just job titles, they grow stronger.

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n Saturday October 12, 2019 the Maricopa County Medical Society (MCMS) brought together over 140 physicians, their families and students together for its annual signature event Doctors’ Night 2019 at the Arizona Heritage Center at Papago Park. The keynote speaker, David Geier, MD, a nationally renowned orthopedic surgeon and sports medicine specialist, brought attention to ways in which physicians can better deal with physician burnout. The festivities included cocktail hour, a free exhibit showing for all participants, live music by Uncorked, and tasteful food by Alexi’s, This event wouldn’t be possible without the support of MCMS’s main sponsor MICA.

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Arizona Physician Magazine Winter 2020  

Arizona Physician returns with its Winter 2020 edition. From articles by nationally renowned physicians for physicians, a physician profile,...

Arizona Physician Magazine Winter 2020  

Arizona Physician returns with its Winter 2020 edition. From articles by nationally renowned physicians for physicians, a physician profile,...

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