Thursday, December 16, 2010

What's Ahead in 2011

  • The “sick tax” is still with us and not likely to go away in light of a gigantic state deficit.
  • The federal government has yet to fix the flawed Medicare physician payment formula, causing insecurity for our colleagues and our patients.  Will it be fixed in 2011?  I am not holding my breath. . .
  • Federal and state health reform legislation has passed, and I have a mixture of hope and concern about how this will affect our ability to care for our patients.
  • Greater consolidation is occurring among hospitals and clinics in order to survive economically.
  • The Baby Boom generation is nearing retirement age.
  • Some of us are beginning to wonder if we will ever retire, and if so, who will take care of our patients?
Well, this is starting to put me in a sour mood, so I think I’ll turn to my New Year’s Resolutions, which this year focus on me living my beliefs about physician wellness - the theme of my presidency.

  • I resolve to do better to establish and maintain a personal wellness regimen including sensible diet, exercise, work, play, meditation, prayer and cooperation with my colleagues.
  • I resolve to support, affirm or hug a physician daily.
  • I resolve to be part of solutions instead of problems.
  • I will remember why I entered a serving profession and love those whom I have the privilege to serve.
  • I will continue to work with others in the MMA to address the overall wellbeing of my colleagues. 
  • I will be a positive role model for young people considering medicine, for students and residents.
  • I will attend the MMA Day at the Capitol and respectfully educate my legislators who impact our daily lives.
  • I resolve to stop making my resolutions public, really, it’s just too much pressure.
But that’s next year. For this year, please hold me accountable. I will be able to succeed with your encouragement. Please feel free to share here your own concerns and resolutions.  Happy New Year!

Patricia Lindholm, MD,
2010-2011 MMA President
Recently a reporter interviewed me for a story to be published at year’s end about a certain politician’s legacy regarding Minnesota health care. As is often the case, there were positives and negatives to report. I had to carefully consider which statements I was making on behalf of the Minnesota Medical Association, and which opinions were my own.  I hope that I represented MMA’s positions clearly and accurately. Anyway, the end of the year talk got me thinking about my own concerns and hopes for 2011. First, here are some of my top concerns:

Thursday, December 2, 2010

Learning to say no

Patricia Lindholm, MD,
2010-2011 MMA President
We all have multiple roles in life, and I recently found myself filling several of them during my father’s terminal illness and death in early November. 
Several weeks ago it was apparent that my father was very ill and needed to be hospitalized.  The working diagnosis was pneumonia, but it soon became obvious that something more serious was afoot when a thoracentesis uncovered a significant lung mass.  He allowed the physicians to order scans, cytology, etc.  Later he confessed that he already knew about the cancer as it had been diagnosed in another medical facility; he confessed this to his sister, not to the physicians. (Imagine trying to diagnose and treat a patient who decided not to share such information with you!) My father liked to keep secrets.
I was the health care proxy and executor of my father’s estate.  He lived in Florida, so before getting there, I was doing long-distance work with him and the doctors/relatives/social worker, etc regarding pain management and hospice placement.  It seemed relatively easy initially to be on the “family” end of a health care crisis.  My siblings and I arrived in Florida barely in time to say farewell.  Then it was a blur of arranging cremation, cleaning up his apartment, and selling and giving away household items.   During the two weeks I was away, I carried out some media interviews for the MMA and answered e-mails and even participated in a conference call.  As physicians, we are able to go into “crisis management mode” and defer our own emotional reactions to a later time.  This state of numbness (brain-dead is what I felt at the time) continued for a little while.  Thankfully, the long drive home from Florida was a buffer between the intensity of the family loss and the return to work and life as usual.
Since returning, I have taken more time to grieve and process what has happened, and I’ve  surprised myself by saying “no” to a couple of things. Saying no is something I have spent years trying to learn, and with practice I get better at it.  As physicians, we have been trained to rise to any occasion, to get up and work in the middle of the night, to work with little sleep, and to function in spite of whatever personal issues we are facing.  We were not trained to nurture ourselves when needed.  Saying “no” was somehow shameful. I encourage us all to practice the art of saying “no.”  Obviously this must be done judiciously.  Sometimes saying “no” to more work and responsibility is actually saying “yes” to life and health.  One test that I use to decide whether to say “yes” or “no” is to ask this question: “Will this activity suck the life out of me or give me life?”  It is simplistic, but it works for me. 
Are you doing what works for you?