Ep 194 Launch week day 1- New attending mistakes
Summary
Dr. Amy Vertrees, a surgeon, author, podcast host, and certified coach, delivered the first session of a launch week series aimed at new attending physicians. The presentation focused on common mistakes new attendings make and strategies to avoid them. Dr.Vertrees emphasized that the information shared was based on her own experiences and lessons learned throughout her career.
Dr.Vertrees began by outlining the week-long series of presentations, which would cover topics including office manager insights, money management for physicians, handling complications, legal risks, time management, and efficient note-taking. She emphasized that these sessions were designed to be interactive, encouraging participants to ask questions through chat or Q&A features.
A central theme of Dr.Vertrees' presentation was the importance of mastery and recognition for job satisfaction. She explained that mastery means being good at one's job, while recognition involves being acknowledged for one's skills and contributions. Dr.Vertrees noted that this formula applies not only to physicians but to everyone in the workplace, highlighting the importance of recognizing others' contributions and allowing them to develop mastery in their roles.
Dr.Vertrees discussed the significance of understanding organizational culture, including the mission, beliefs, and values of one's workplace. She advised new attendings to consider whether their personal values align with their organization's culture, as misalignment can lead to dissatisfaction. She also emphasized that new physicians bring valuable perspectives and should feel confident in suggesting changes, though she recommended approaching such suggestions carefully by first asking questions to understand existing practices.
The presentation covered strategies for dealing with difficult colleagues, emphasizing that communication breakdowns can make any colleague difficult. Dr.Vertrees offered practical advice for improving interactions, including focusing on what people actually say rather than interpretations, examining what meaning one assigns to others' words, and understanding one's own stress responses (fight, flight, freeze, or fawn). She suggested that recognizing these patterns in oneself can help in understanding others' behaviors as well.
Dr.Vertrees addressed the topic of being reported or receiving negative feedback, advising attendees to view such situations as opportunities for growth rather than threats. She emphasized the importance of participating in leadership positions and committees to have influence in one's organization, noting that "you're either at the table or you're on the menu."
The presentation also covered personal development topics such as overcoming imposter syndrome, which Dr.Vertrees defined as feeling inadequate despite demonstrated success. She offered strategies for challenging negative thoughts by turning statements into questions and comparing oneself to past versions rather than to others. Dr.Vertrees distinguished between confidence (which comes from repeated experience) and self-confidence (the courage to act despite fear).
Dr.Vertrees discussed the importance of marketing oneself effectively, emphasizing that marketing involves knowing one's values and being authentic. She encouraged attendees to embrace their unique qualities rather than conforming to stereotypical surgeon personas. She also addressed the topic of getting paid appropriately, emphasizing the importance of timely documentation, proper coding, and understanding the revenue cycle.
The presentation concluded with advice on tracking various aspects of one's practice, including finances, cases, clinic metrics, and complications. Dr.Vertrees stressed the importance of adapting to life changes and having contingency plans, including knowing one's contract details and having an exit strategy. She offered strategies for dealing with negative emotions, particularly shame, and emphasized the importance of seeking help when needed.
Throughout the presentation, Dr.Vertrees maintained that physicians should give themselves permission to quit if necessary, while also finding purpose in their work. She concluded by emphasizing treatments that address root problems, including therapy, coaching, journaling, community support, and sometimes medications.
Chapter
Introduction to Launch Week for New Attendings 00:00:02
Dr. AmyVertrees welcomed participants to the first day of launch week, designed specifically for new attending physicians. She explained that the purpose of these sessions was to share information she wished she had known when starting as a new attending. Dr.Vertrees encouraged interaction through chat or Q&A features and introduced herself as a surgeon, author, podcast host, and certified coach. She outlined the week's topics, including office manager insights, money management, handling complications, legal risks, time management, and efficient note-taking.
Mastery and Recognition: The Key to Job Satisfaction 00:03:20
Dr.Vertrees identified mastery and recognition as the fundamental elements of job satisfaction. She defined mastery as being good at one's job and recognition as being acknowledged for one's skills and contributions. She emphasized that this formula applies to everyone in the workplace and highlighted the importance of recognizing others' contributions. Dr.Vertrees cautioned against the mistake of doing everything oneself, as this robs others of the opportunity to develop mastery and receive recognition.
Understanding Organizational Culture 00:05:28
Dr.Vertrees discussed the importance of understanding the culture of one's organization, including its mission, beliefs, and values. She advised attendees to consider whether their personal values align with their organization's culture, noting that misalignment becomes evident over time. Dr.Vertrees emphasized that new physicians bring valuable perspectives and should feel confident in suggesting changes, though she recommended approaching such suggestions carefully by first asking questions to understand existing practices.
Navigating Difficult Colleagues and Communication 00:07:46
Dr.Vertrees addressed the challenge of difficult colleagues, noting that communication breakdowns can make any colleague difficult. She offered practical advice for improving interactions, including focusing on what people actually say rather than interpretations, examining what meaning one assigns to others' words, and understanding one's own stress responses (fight, flight, freeze, or fawn). She suggested that recognizing these patterns in oneself can help in understanding others' behaviors as well.
Handling Reports and Feedback 00:11:52
Dr.Vertrees discussed how to handle situations where one is reported or receives negative feedback. She advised viewing such situations as opportunities for feedback rather than threats, noting that a report simply generates paperwork that someone needs to address. She emphasized the importance of maintaining a good headspace to respond appropriately, whether the feedback indicates an area for personal improvement or a situation to be cautious about.
Participating in Organizational Leadership 00:13:31
Dr.Vertrees emphasized the importance of participating in leadership positions and committees to have influence in one's organization, stating "you're either at the table or you're on the menu." She encouraged attendees to get involved at hospital, state, or national levels, while being selective about which positions to take on. Dr.Vertrees advised being clear about one's motivations for taking on leadership roles and understanding that such roles are often what one makes of them.
Creating Personal Safety and Understanding Values 00:15:18
Dr.Vertrees discussed the importance of understanding one's personal culture and values, especially when working in a difficult organizational culture. She emphasized that clarity about one's values helps in making decisions and recommended values exercises to gain self-awareness. Dr.Vertrees addressed the concept of scarcity, noting that feelings of not having enough can trigger unhelpful "hustle" behaviors and that new physicians may trigger scarcity feelings in established colleagues.
Establishing Boundaries 00:18:32
Dr.Vertrees outlined five steps for establishing effective boundaries: defining the boundary, communicating it to relevant parties, outlining consequences for boundary violations, enforcing those consequences, and allowing oneself to make exceptions when appropriate. She used the example of after-hours patient calls to illustrate these steps, emphasizing that a boundary isn't truly established unless all five steps are followed.
Addressing Imposter Syndrome 00:21:09
Dr.Vertrees defined imposter syndrome as feeling inadequate despite demonstrated success, a phenomenon first identified in high-achieving women in academia in 1978. She explained that people with imposter syndrome have negative thoughts despite outward success, making it difficult for others to understand or help. Dr.Vertrees suggested turning negative statements into questions to challenge these thoughts, such as changing "I'm not doing this right" to "Am I okay?"
Challenging Common Negative Thoughts 00:24:50
Dr.Vertrees identified common negative thoughts that high-achieving people experience, including fears of being perceived as lazy, doubts about one's abilities, and comparisons to others. She emphasized that these thoughts can be challenged and reframed, noting that the job itself is genuinely difficult and that comparing oneself to others can be useful if done constructively rather than destructively.
Understanding Confidence and Self-Confidence 00:32:18
Dr.Vertrees distinguished between confidence, which comes from repeated experience, and self-confidence, which is the courage to act despite fear. She explained that confidence develops through muscle memory and repetition, while self-confidence involves trusting oneself to handle negative emotions and potential failures. Dr.Vertrees emphasized that these feelings are generated by one's own thoughts and actions.
Marketing Yourself Effectively 00:34:09
Dr.Vertrees discussed the importance of marketing oneself effectively, framing it as shifting from an employee mindset to a CEO mindset. She defined business as an exchange of value for money and emphasized the importance of understanding one's own value. Dr.Vertrees encouraged attendees to be authentic rather than conforming to stereotypical surgeon personas, noting that authenticity often receives positive feedback. She emphasized that marketing happens in every interaction, not just through formal channels.
Getting Paid Appropriately 00:39:16
Dr.Vertrees addressed the topic of getting paid appropriately, emphasizing that it's acceptable to expect payment for providing value. She described notes as invoices for one's work, highlighting their importance for patient care, mental health, pre-authorization, and communication with primary care. Dr. Vertries explained the revenue cycle (work → invoice → coding → billing → collections) and stressed the importance of understanding this process to ensure business sustainability and avoid fraud.
Tracking Practice Metrics 00:44:01
Dr.Vertrees emphasized the importance of tracking various aspects of one's practice, including finances, cases, clinic metrics, and complications. She recommended evaluating each clinic session by identifying three things that worked well, three areas for improvement, and one next step. Dr.Vertrees explained the concept of "clinic math" (the ratio of patients seen to operations booked) and how understanding this ratio can help in planning and potentially modifying one's practice.
Adapting to Life Changes 00:50:17
Dr.Vertrees discussed the importance of adapting to life changes, noting that jobs and personal circumstances evolve over time. She emphasized that tracking helps one see these changes while planning helps one adjust to them. Dr.Vertrees pointed out that people often fail to modify their work approach when major life events occur, such as having children, leading to frustration when previous patterns no longer work.
Important Documents and Contingency Planning 00:51:52
Dr.Vertrees highlighted important documents that physicians should be familiar with, including their contracts, hospital bylaws, and credentialing information. She emphasized the importance of having an exit plan, even when starting a new job, as this provides confidence and prevents feeling trapped. Dr. Vertries also mentioned the importance of tracking deadlines for licenses, DEA credentials, contract renewals, and continuing medical education requirements.
Managing Negative Emotions and Shame 00:54:24
Dr.Vertrees addressed the management of negative emotions, particularly shame, which she defined as the feeling that "there's something wrong with me." She credited Brené Brown for three steps of shame resilience: reaching out to a trusted source, talking kindly to oneself, and owning one's story to control the ending. Dr.Vertrees warned that shame leads to isolation and harmful coping mechanisms, emphasizing the importance of addressing it directly.
Permission to Quit and Finding Purpose 00:55:38
Dr.Vertrees shared her personal strategy of giving herself permission to quit every day, which paradoxically helps her remember why she continues in her profession. She acknowledged that eventually, one might take that permission and actually quit, which is acceptable because "this is your one and only life." Dr.Vertrees emphasized that this approach has allowed her to work harder while maintaining perspective on her purpose.
Helpful Approaches and Conclusion 00:57:17
Dr.Vertrees concluded by discussing approaches that help address the root causes of problems, including therapy, coaching, journaling, community support, and sometimes medications. She emphasized the importance of recognizing one's thought patterns, developing new patterns, and having accountability. Dr.Vertrees reminded attendees about the next session on office manager insights and encouraged questions from participants.
