(Thank you all so much for making The Doctors Guide to Finding Joy in Your Work an Amazon Best-Seller. If you didn’t order a copy, what are you waiting for? Do you already have all the joy you can take? I believe everyone could use a little more joy in their lives.)
A thorn in the side of many physicians is the requirement to take call for the hospital emergency department. Some specialties get off easy, and don’t take call. Others take call but rarely ever get called. Then along came the hospitalist, which ended call requirements for a huge group of primary care physicians. For many other physicians taking call is a fact of professional life, whether they like it or not.
Some unfortunate specialties, including general surgeons and orthopedic surgeons, often get slammed with lots of consults when they take call. Most physicians don’t try to get out of taking call because they believe it is part of their job. For those who don’t think this way, they stop trying to eliminate their call once they feel the result they seek is impossible to achieve.
Just because you believe something is impossible; doesn’t mean it is actually impossible. But beliefs influence our actions. Flight was thought impossible, but someone invented the airplane. Walking on the moon was thought impossible, until rockets were invented. International communication was thought to be impossible, then along came phones, radios and satellites. Getting live visual updates of world events was thought impossible and along came television.
If you believe something is impossible, it will likely be impossible for you, because you won’t try to solve an impossible problem. Here is the story of one physician who was able to do something he was convinced was impossible: He stopped taking call for the emergency department. His story appears in Chapter seven of The Doctors Guide to Finding Joy in Your Work.
A client of mine mentioned something that I recognized as an Aha Moment. I stopped him from talking and drew his attention to his statement and had him write it down. As is often the case, he made the statement without recognizing it as an Aha Moment. His Aha Moment pointed to his need to stop taking call for the emergency department. This is a very tall hurdle to jump, so we had a long discussion as to why he felt dropping call was the right solution to his issue. After a series of why questions, he convinced me that getting off the call schedule was the right thing to do in his situation.
Interestingly, he was only on call three days a month. For an average physician, three days a month would be a very tolerable call schedule, even if the call was busy. However for him, those three days were truly too much.
If he only needed to get rid of three call days a month, it was a very doable prospect. He had a lot of other docs on the call schedule who could absorb these days. He should be able to come up with a plan to make this happen.
I gave him the task of creating a list of 10 ways to achieve getting off the call schedule. (This is called the List of 10 in the book) He stated right off the bat that this was a lost cause as there was no way for him to get out of taking call, no matter how many ways he put on the list. This was something he had already tried and failed. He was convinced he would just have to endure this call situation until he retired.
Over the years , I have witnessed several physicians get off their call rotation when they also thought it was not possible, and as a result I didn’t agree with his assessment of the situation. With a good reason, a good plan, and a motivated physician, almost any Aha Moment can be solved.
I asked him to ignore the little devil on his shoulder who was telling him it couldn’t be done and work on making his List of 10. He was not allowed to prequalify or eliminate any idea. If he thought of it, and it would solve the problem if he could pull it off, then he had to write it down.
To get him started, I offered a couple of ideas for his list. Of course, he told me those wouldn’t work. Since no one knew his situation and options better than he did, he would have to come up with the solutions that would work. I couldn’t create the List of 10 for him. He had to do it himself.
During our next session, I was happy to learn that he had created his List of 10. He had done a good job of thinking up creative solutions, including some he had never considered before. I thought he had several promising options. Then he commenced to tell me item by item why nothing on the list would work. He was absolutely convinced there was no point in trying. Getting off call was impossible.
My opinion was different, as I really liked one of the options in the middle of his list. This option was to pay someone $1,000 a night to take his call. In addition, the doctor taking his call would also collect extra billings generated from any patient encounters, which would boost their year-end bonus.
This surgeon was already financially secure but didn’t want to retire yet. Except for taking call, he liked his job. He also had no debt to service. Since he no longer needed all his income to live on, he could easily give up $36,000 per year to pay his substitute as well as receive a lower year-end bonus himself as a result of not taking call. He was willing to trade that amount of money to not be on call anymore.
He also knew of several young physicians in the call group who had debt and were spending a lot of money on their new doctor lifestyle. If he could convince three of the nine doctors in his call group to each take just one more call day a month, paying each of them $1,000 a day for their time, he could completely get out of taking call.
Most doctors would not consider it a burden to go from three call days a month to four, especially if they got paid extra to do so.
From our previous discussion of why he felt each item on the list was not viable, it was clear he was operating under the assumption that all physicians felt the same as he did about taking call. He reasoned that since he would never take an extra call day, even if someone paid him to do it, none of the physicians in his call group would want to take his call even if he paid them.
I explained his self-bias and told him not everyone was as averse to taking call as he was. He didn’t see how that could be possible as he never heard of anyone loving call. There is a big difference between loving taking call and being willing to do it. I explained to him that I did not “love” taking call either, but I was also not averse to taking extra call days when needed. Just think of all the doctors who moonlight or work side gigs. There is no shortage of physicians who want to earn extra money.
He finally agreed to pursue this option. His next task was to have breakfast with each of his three youngest partners and discuss his idea of paying them to take his call. He should also explain to them why he so desperately wanted off the call schedule. I explained to him that he needed to make a good faith effort with the assumption that they would say yes. He was to let them make their own decision without interjecting his bias into the conversation.
The first thing he said when we spoke next was that he couldn’t believe all three of them took him up on the offer! They each wanted to earn extra money and they did not hate taking call as much as he did. Each of the three agreed to take one of his monthly call days. He was currently off the call schedule for the next six months, and if this worked well, he could be off call indefinitely. I could almost hear him bouncing off the walls with joy and amazement.
Here was a physician who had an Aha Moment, thought it was impossible to fix, and yet found a solution that worked. By making the List of 10, he came up with options he had not thought of before and one of them worked. Never give up on removing something you hate from your life simply because you don’t think it is possible.
Anything is possible if a person believes.
—Mark 9:23 (NLT)
If you are ready for more joy in your life as well as in your work environment, pick up a copy of The Doctors Guide to Finding Joy in Your Work. This book does not just pertain to doctors. The concepts in this book apply to everyone.
