Eye on Wellness - Simple Burnout Prevention Steps

Are you overwhelmed at work to such an extent that you feel deflated, depleted, and emotionally drained? You may be experiencing burnout – and you’re not alone! Burnout can ruin careers and lives, but only if we let it. What many don’t realize is that burnout has a positive side. The key to managing burnout is to leverage the positive side over the negative. In this article, we are going to offer up a few tips that can help save your career from the perils of burnout.

Focus on Sleep

Many surgeons simply do not get enough sleep. Me included! I am very well trained in sleep deprivation. Until fairly recently, I was proud of this ability. One way to train FOR the worst case scenario is to train IN the worst case scenario. While I am still able to turn on my system in the middle of the night in ways others might not understand, I now see some changes in my ability to handle periods of frequent middle of the night call duties. I am continuing to address my performance and self-care. Start to recognize how much sleep you get every night, and see where you can add more if needed. Power naps and changes to improve quality of sleep are other ways to improve our sleep recovery.  It may seem like you need to burn the midnight oil to get your work done but being well-rested can improve your proficiency at work – allowing you to get more done in less time. Where is your threshold?

Strategically Disconnect

With social media, constant texting, and email updates continually ringing in our pockets, many people feel the need to respond immediately and always be available. It’s no wonder we feel drained! Do your best to strategically disconnect. Strategically is the keyword here. Obviously, you shouldn’t disconnect yourself from everything if you’re on call, but when you can – turn your phone off, don’t respond to emails, and schedule time for yourself to do leisure activities that give you pleasure and recharge your batteries.

Don’t Feel Defeated

Remember that you are not “giving up” in recognizing that you are feeling the effects of burnout. There is no defeat in recognizing that you need to make some changes to improve your wellness. It generally means that you have not allowed yourself enough physical, mental, and emotional rest and recovery in between the bursts of intense performance for our patients.

Connect with the SurgeonMasters Community

If you or a physician you know are experiencing warning signs of burnout, SurgeonMasters is here to help. We are a wellness and coaching organization focused on helping surgeons combat burnout and build sustainable practices. How do we do that? By providing a variety of educational materials, including podcasts, blogs, webinars, and meetups. Join a community of like-minded surgeons helping each other build lifestyle-friendly practices. Contact us today to learn more or join our mailing list to get the latest updates.

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The Hook Model and the Power of Coaching

Note: this is part 4 of our ongoing series on Habits & the Power of Coaching. Read part 1 here, part 2 here, and part 3 is here.

In the fourth and final installment of this series, we examine the Hook Model, created by Nir Eyal.

The Hook Model

In his book, Hooked: How to Build Habit-Forming Products, Eyal outlines the Hook Model, in which he explains why we habitually use certain products over others. There are four steps to the Hook Model:

  1. Trigger. An internal or external prompt to perform a certain behavior. Facebook initially triggers you with notifications to open the app, but eventually, you begin to associate using it with internal triggers, like boredom or anxiety.

  2. Action. A simple click, a tap, some scrolling, or whatever gets the user to interact with the product.

  3. Reward. Finding a funny video in an otherwise boring feed gives you a little dopamine hit. Varying rewards at different times make us curious and spark a desire to come back — over and over again.

  4. Investment. Now that you’re happy, companies ask you for something in return: time, data, and money are some examples. Ideally, you’ll even load the next trigger yourself, for example by commenting on a friend’s photo, to which they’ll surely reply and get you to come back.

Applying this framework to our own lives, we can get a better understanding of the products and services we’re addicted to (even though we may not even realize it).

  • If you find yourself mindlessly scrolling through Facebook several times a day but you’re not sure what brought you there… You may be hooked.

  • If you find yourself scrolling through your preferred BREAKING NEWS website 30 minutes after the last time you checked in on the world… you may be hooked.

  • If you find yourself curating your Instagram feed instead of preparing for your next important case… you may be hooked.  

Staying connected with friends and family. Being informed about our world. Partnering with influencers to share a message. We can find positives in most of the things we do. However, if the activity is distracting you from being productive in other areas, then there might be an opportunity for improvement. The trick is to identify and eliminate the trigger for this addiction. In an April 2018 blog SurgeonMasters contributor Jonathan Cabin detailed several strategies that can help us eliminate the action once we have identified our trigger.

How Coaching Supports the Hook Model

Bad habits are easy to come by, and difficult to break. Coaching can support, or more appropriately break, the Hook model in two important ways. One way coaching breaks the Hook model is by raising awareness around our triggers, actions, and rewards. It can be difficult to identify why we engage in a certain behavior, but this is an important first step in eliminating any habit. Coaching supports the process of guided inquiry and goal setting.

Why are we engaging in this behavior? What “need” is it fulfilling? If we can identify our internal triggers then we can take the next step.

Our next step is to terminate the action. Coaching supports this process of action planning and even constructive feedback on our actions. Is there another action we can take when we feel compelled from boredom to check out our timeline? Can we structure the action to create a similar reward or a proactively determined alternative reward? If we are able to identify our trigger and adjust the action, we are on our way to breaking the model and eliminating the habit. Of course, this is much more difficult than it sounds. With the assistance of a coach we flatten the learning curve.

You can learn more from Nir Eyal online, Resources for Hooked: How to Build Habit-Forming Products.


Harnessing the Power of Surgeon Coaching

Not everyone is ready or wants to work with a coach as there are very few examples of this in medicine. Most professional talents work with a coach (or coaches) on a regular basis to get to and stay on top. Surgeons can work with a coach (or coaches) to maximize their physical, mental, and even emotional skills. Working hand-in-hand with a coach can significantly increase your ability to create and maintain healthy habits. At SurgeonMasters, we offer coaching services to surgeons in all specialties. Let us help you create healthier habits and a more lifestyle-friendly surgical practice.

Want to learn more about surgeon coaching, perhaps to do a little of this rewarding activity on the side? Sign up for our inaugural training program on January 20, 2019 at the Kona Kai Resort & Spa in San Diego.


The Four Tendencies and the Power of Coaching

Note: this is part 3 of our ongoing series on Habits & the Power of Coaching. Read part 1 here and part 2 here.


In the third installment of this series, we examine The Four Tendencies, created by Gretchen Rubin, for creating habits. Gretchen is a four-time New York Times best selling author of The Happiness Project where she spent a year thinking about happiness and setting up networks of like-minded people pursuing happiness. Her work focuses on habits and what makes people happy.

The Four Tendencies

Before we get any further, let’s briefly outline The Four Tendencies framework. In this framework, Gretchen describes four types of people, broken down by how they respond to expectations (both inner and outer):

  1. Upholders. Upholders meet inner and outer expectations readily. They love rules, always have a clear plan, and are self-motivated and disciplined. They struggle in an environment that lacks structure.

  2. Questioners. As skeptics, questioners meet their own expectations, but resist outer ones. Questioners need to see purpose and reason in anything they do. Clarity as to why they should do something is all-important.

  3. Obligers. This is the most common type. Obligers love satisfying other people’s expectations, but struggle in prioritizing their own. Being held accountable by a friend, coach, or boss helps them a lot.

  4. Rebels. This category defies both inner and outer expectations. Freedom to choose feels most compelling to rebels. They want to be challenged, but not pressured into doing things.

If you’re interested in seeing which category you fall into, take this short quiz.

When it comes to creating new habits or changes in old habits, it is helpful to know how we respond to inner and outer expectations. When you understand which category you fall into, you can adjust your environment to better suit your tendencies. This process of reflection bearing out awareness is the first step in creating any habit.

How Coaching Supports the Four Tendencies

Personality tests are often scrutinized because our personalities can change over time. I also believe our personalities might change depending upon the situation. Therefore, the reproducibility of the test can vary depending on the surrounding circumstances. Ultimately, the purpose of using a personality test for habit change is not to give someone a label. It is to create an opportunity to explore whether incorporating the strategy increases your likelihood of success. If it works for you, this is a powerful tool! If it doesn’t, we cross this off the list and try another resource.  

Let’s look at physicians as an example. Most physicians fit the tendency of Obligers. As an Obliger, habits that relate to better service to others tend to be much easier to implement. If it creates efficiency and better patient care, the rewards are fantastic. However, the Obliger struggles to meet internal expectations. Being held accountable from a close colleague or coach can increase the odds of success for creating those healthy habits that seem to impact the Obliger most. It can also be very helpful to show the Obliger why the seemingly selfish habits are in fact unselfish because they meet the outer expectations of their friends, family, and patients indirectly (especially over time).


Take this The Four Tendencies Quiz and then consider how this might impact the most effective way to end old habits and begin new habits that are positive and create sustainability. We invite you to mail us what you found out! What is YOUR tendency? Did you reinforce what you already thought? Or was it different than you expected? Let us know your habit change, motivations, situational factors, and how it is going for you. Our team will follow-up with coaching questions to aid your self-inquiry. Your comments in private or on social media will also add to the conversations that we all need to be having.


Harnessing the Power of Surgeon Coaching

Working hand-in-hand with a coach can significantly increase your ability to create and maintain healthy habits. At SurgeonMasters, we offer coaching services to surgeons in all specialties. Let us help you create healthier habits and a more lifestyle-friendly surgical practice.

Want to learn more about surgeon coaching, perhaps to do a little of this on the side? Sign up for our inaugural training program on January 20, 2019 at the Kona Kai Resort & Spa in San Diego.

Happy Holidays 2018 - Best PRACTICEs for Working Hard in 2019

2018 was a challenging and rewarding year. I accomplished and learned A LOT. Much of the time outside of my surgical practice was dedicated to studying burnout, resilience and wellness.  Countless thought-provoking conversations, cramming every new article and study I can, and thinking about the issue a ton, I have come to understand just how complex and challenging a problem burnout is. For starters, symptoms manifest and affect each of us very differently. What causes mental unrest and takes a toll on me physically is likely different from many other surgeons who on the surface seem similar. And what works for one person experiencing the same symptoms may not work for another. It’s a very personal issue and needs to be approached as such. So while I can’t offer up tips that will definitely help every person, I can share my story and offer what I do as helpful suggestions for 2019.

Practice Self-Care

Everyone around me sees how hard I am working. My wife, my kids, my friends, and my colleagues. While many years of emotional and mental injury from my career has taken its toll, I have avoided full-on mental illness. Through my research on burnout and wellness, I have come to discover that I might have post-traumatic stress or PTSD. Falling witness to other people’s trauma takes its toll. Knowing and not knowing that I may have contributed to the suffering of another human being is a tremendous burden to carry. Mental health research also shows that many victims of abuse and bullying will have a higher risk of developing PTSD, depression, and anxiety. Over the last 5 years, I have been healing mentally, emotionally, and physically because I now focus on self-care. Throughout my entire career I managed to get through all of the tough work and life experiences by pushing through, which can lead to unhealed physical conditions and internal open wounds. Though scars may remain, recovery and healing requires ongoing self-care with active physical, mental, and emotional PRACTICEs. If you could see my hot yoga practice, you would confirm that it is hard work.

Love What you Do

I still complain about the parts of my job that I hate. I have work-arounds for almost all of my electronic medical records. I protest poorly considered policies and procedures that make it more difficult to care for patients. The difference is that my complaints have a purpose. My purpose is to make a major positive impact on other people's lives. My purpose is being a surgeon. My complaints are to point out to others that the current application of EMRs and many policies do harm to either patients, health professionals, or both. Consider my complaints as constructive feedback. Where several years ago I was losing my passion for my career, I now love what I do, and I am happy to work hard doing it.

Don’t Overestimate Yourself

We are all capable of overestimating ourselves. Even more commonly, we overestimate what others can do for us and how timely they will do it. Frustration is the most common emotion that I hear from other surgeons (and myself) in response. What if we validated this or any emotional response as reasonable from our perspective? What if we factored in the delays of others (and ourselves) as how that impacts our ability to do all the work that we do with less frustration? What if we acknowledge that there are indeed limits to always just working harder?

Focus on One Thing at a Time

When combating burnout, focus on one task at a time. Trying to do everything at once can be overwhelming and lead to even more stress and burnout. Instead, find one thing that works and focus on that. Once you notice that it doesn’t feel like work, then move on to the next. It appears to others that you are working really hard. In fact, you are being more efficient at working hard.

At SurgeonMasters, our goal is to provide hardworking surgeons with the knowledge and skills they need to build sustainable practices. Our gift to you during this holiday season is a long list of blog articles, podcasts, webinars, and more. We also deliver surgeon and physician coaching to individuals and teams to power improved performance inside and outside the OR.

Contact us today to learn more about our offerings, or join our mailing list to stay up to date with the latest from SurgeonMasters!

Tiny Habits and the Power of Coaching

Note: this is part 2 of our ongoing series on Habits & the Power of Coaching. Read part 1 here (LINK).

In the first installment of this series, we examined Charles Duhigg’s model for creating habit loops. Here, we’d like to take a look at another model - The Fogg Behavior Model (FBM), developed by Stanford behavior scientist BJ Fogg. This model outlines triggers (similar to the cues in Duhigg’s habit loop model) that need the appropriate levels of ability and motivation in order to activate. Dr. Fogg now refers to these triggers as “prompts.”

Fogg uses his model to create an approach called “Tiny Habits.” These are habits which:

  • “you do at least once a day,”

  • “that take you less than 30 seconds,”

  • “that require little effort.”

Learn More:  behaviormodel.org

Learn More: behaviormodel.org

I would like to give you an example from my life. Before I begin each surgery, the scrub sink is the prompt for my boundary ritual. For the first 30 seconds while I’m washing my hands, I let go of ALL of my other roles and responsibilities in life and outside the OR. I remind myself of my purpose for this particular patient in the operating room.

This is just one example of a tiny habit that can have a huge benefit - especially when linked with other tiny habits throughout the day.

How Tiny Habits Compound

Here is a quick breakdown of the tiny habits I go through each morning.

When I unplug my phone each morning from the charger, I head to the bathroom. After that I play one or two games on my phone to get my brain awake. At that point, I go to my calendar for the day and assess what my day will look like. Is there a big event for one of my kids? What do I need to get done? This tiny habit triggers my next tiny habit to find my most important daily email - the priorities email that I receive from my team leader. What are the priorities for SurgeonMasters for the day and the next few days? Do I have emails requiring a response? If yes, then I will need my laptop, as I don't like writing emails on my phone. Do I have client calls? I will need to be in the right environment to provide my undivided attention and care. Do I have a podcast to record? I will need a quiet place. My days are complicated, and the tiny organizational habits I created build on each other to help me manage my day with less stress and frustration.

Creating tiny habits can make a huge difference in the ease of accomplishing tasks throughout the day.

How Coaching Supports Tiny Habits

Creating tiny habits is a great way to incrementally improve our physical health and mental well-being. Over time the benefits compound, and tiny habits can produce deep results. How does coaching support our ability to create tiny habits? A great example is when we are first beginning to take action. Sure, it would be great to “just do it.” Chances are it is not that easy. In an iterative, give-and-take process, coaches ask driving questions that address underlying motivations and situational factors. By answering these questions, coachees benefit from thinking critically about their process, how it can be improved, and what additional steps are required to make the desired incremental changes.    

What tiny habits will you create this next week? Tell us here, along with your motivations, situational factors and how it is going. Our team will follow-up with coaching questions to aid your self-inquiry. Working hand-in-hand with a coach can significantly increase your ability to create and maintain healthy habits. At SurgeonMasters, we offer coaching services to surgeons in all specialties. Let us help you create healthier habits and a more lifestyle-friendly surgical practice.

Want to learn more about surgeon coaching? Sign up for our inaugural training program on January 20, 2019 at the Kona Kai Resort & Spa in San Diego.


Source: BJ Fogg, PhD, http://behaviormodel.org/

You can sign-up for a free, 5 day session of the Tiny Habits program at TinyHabits.com.