1. White Coat Tension Strategies for Thriving During the Clinical Training Years Kendall L. Stewart, M.D. August 14, 2003

2. Why should you pay attention to this presentation? Now, more than ever before in your life, people will make big decisions while looking to you for guidance. The stakes are high. For much of the next several years, you will be uncomfortable; that is a good thing; discomfort facilitates learning. You will now see physicians at their best and their worst. What you learn, what you refuse to learn and what you unlearn in during your clinical training will have a lot to do with whether you turn out good or bad, happy or miserable. The experiences just ahead will be exhilarating, daunting, troubling and inspiring. It will help to have a plan. The next 15 minutes will offer you an opportunity to think about a plan. I strongly suggest that you do more than just think about it.

3. What are some suggested strategies for succeeding in your clinical training? If you don’t already have a blueprint for your life, draft one now. How you behave will now be more important than what you know. Remember that. Instead of diseases, tests and treatments, concentrate on people. You are about to experienced a great deal of discomfort. That is a very good thing. You are going to meet a lot of negative people. Don’t let it rub off on you. You will be given a lot of opportunities to waste time. Don’t take advantage of them. Coming up with the right answers is a good thing. Asking the right questions is better. If you don’t naturally have a strong work ethic, fake it. Life really is a stage and, as a physician, you are on most of the time. The outstanding physician’s cardinal values are excellence, service and teamwork. Adopt these. You will be presented with a variety of role models. Choose wisely. There’s a reason why it’s called the Golden Rule. Be nice. Prepare like it really matters. It does. Emotional arousal has great power. Respect it. You will need to learn a lot of stuff. Get the most important stuff down first. If you are not interested in the rotation you are on, pretend you are. Being a brilliant doctor is not the most important thing. Being a good person is. Now learning really matters. Develop learning habits you will sustain the rest of your life.

4. Draft a blueprint for your life. Why should you? –Because if you don’t, others will draft it for you. –Without a definite plan, you will have trouble Being clear about where you are headed, Staying the course, Avoiding distractions, Setting priorities, and Making decisions under pressure. –And if you have trouble with these things, you will not be content with your life—or with your career. How can you? –Decide to be in the top one percent of the people on the planet with a building plan. –You wouldn’t think of running a small business without a plan; Isn’t your life at least that important? –Identify and list your top 10 values. –List 3 to 5 behavioral objectives of ways you intend to live out these values. –List a few performance indicators that will document your success. –Anything not on this list is a waste of time.

5. Adopt the outstanding physician’s cardinal values —excellence, service, teamwork. Why should you? –Living your professional life in the pursuit of these values is the basis of joy and satisfaction in your work. –Embracing these values will cause you to stand out in the clinical environment. –The pursuit of these values will put you in the company of the most delightful people. –Adopting these guiding values will immunize you against the viruses of excessive sensitivity and discontent. How can you? –Identify those colleagues who live out these values and associate with them. –Identify evidence-based clinical protocols and then follow them consistently. –Go out of your way to provide excellent service to your patients and colleagues. –Concentrate on being a good follower as well as a good leader. –Build a team wherever you are. –Clarify your expectations by asking for others help.

6. Respect the power of emotional arousal and harness it. Why should you? –Ignore emotional arousal and You won’t communicate effectively, You will waste a lot of emotional energy, You will be miserable a good bit of the time, and You will make those around you miserable. –The physician’s emotional arousal has a huge impact in healthcare environments. How can you? –Monitor your own emotional arousal. –Observe others’ emotional arousal and its impact on them and those around them. –Manageable discomfort is a powerful catalyst for learning; excessive discomfort is paralyzing. –Acknowledge the role of emotional arousal in a given situation and manage it.

7. What conclusions can you take away from this presentation? Your reactions to the experiences during the next few years will have a lot to do with how your life will turn out. You will be better prepared to learn, unlearn and refuse to learn the right stuff if you have a plan. A plan based on a few simple principles is easier to execute under pressure. This brief presentation has offered some solid principles for developing an effective plan. Don’t miss this chance to take charge of your life.

8. Where can you learn more? Stewart, Kendall L., et. al. A Portable Mentor for Organizational Leaders, SOMCPress, 2003 (This book can be ordered from www.Amazon.com)www.Amazon.com Stewart, Kendall L., “Physician Traps: Some Practical Ways to Avoid Becoming a Miserable Doctor” A SOMCPress White Paper, SOMCPress, July 24, 2002 Stewart, Kendall L. et. al, “On Being Successful at SOMC: Some Practical Guidelines for New Physicians” A SOMCPress White Paper, SOMCPress, January 2001 Stewart, Kendall L., “Bigwigs Behaving Badly: Understanding and Coping with Notable Misbehavior” A SOMCPress White Paper, SOMCPress, March 11, 2002 (For a limited time, this White Paper can be downloaded from http://www.somc.org/NRSOMCPress/WhitePapers.ht m.) http://www.somc.org/NRSOMCPress/WhitePapers.ht m Stewart, Kendall L., “Relationships: Building and Sustaining the Interpersonal Foundations of Organizational Success” A SOMCPress White Paper, SOMCPress, March 11, 2002

9. How can we contact you? Kendall L. Stewart, M.D. Medical Director Southern Ohio Medical Center President & CEO The SOMC Medical Care Foundation, Inc. 1805 27th Street Portsmouth, Ohio 45662 740.356.8153 stewartk@somc.org Webmaster@KendallLStewartMD.com www.somc.org www.KendallLStewartMD.com

10. Southern Ohio Medical Center   Safety Safety  Quality Quality  Service Service  Relationships Relationships Performance  What questions do you have? www.somc.org