Performance Training in Golf, Yoga & Surgery


My golf game improved the most when others were tracking my handicap. In fact, that summer I received the “Most Improved Award.”

At the time, I didn’t realize the correlation. Why? Because I wasn’t focused back then. I was given the opportunity to practice regularly. I also received some private and group coaching. I wasn’t intending to be competitive. I was just given an opportunity by my father to get better at something I might enjoy doing. The intention was to have more fun.

The Game of Golf / The Game of Life

In many ways, the game of golf is a reflection of the game of life—a long journey laden with ups, downs, hazards, rules, difficult shots, easy putts, and an ample sprinkling of both misfortune and good luck.

Golfers like that.

The sport offers its players beauty, unpleasantness, hilarity, disappointment, exuberance, heartbreak, and just about every other feasible emotion. No two rounds are alike and, in much the same way, no two days are alike.

Golfers like that as well.


But, most importantly, golf transcends skill or athleticism—it employs handicapping which makes it possible for any group to go out and compete.

I can go out tomorrow and play competitively with professional golfer Jordan Spieth, President Jimmy Carter, and Serena Williams, not because we’re all equally skilled and athletic, but because our respective handicaps level the playing field.

I like that aspect of the sport the most.

Age, strength, speed, height, skill—the handicap accounts for and then offsets all of these differences and more.

Golf brings people together, but not at the expense of competition. Handicapping offers golfers a way to measure their development and performance, but against the game as opposed to against the opponent.

It is an incredible principle, and one that would be fascinating if we could adapt it to other segments of life and Surgery!


I really enjoy yoga—but I’m not nearly as talented at its practice as many others. During the early part of my yoga practice, I would only measure my performance by the standard of “I’m still not as good as that person.”

With yoga, I give myself the opportunity to practice regularly. I also receive some private and group coaching. I am not intending to be competitive. I am giving myself the opportunity to get better at something that is good for me. My intention is physical wellness.

In fact, I should receive “The Most Improved Award!”

Informal Handicapping

While yoga doesn’t have a formal handicapping system, it does have an informal one.

Yoga is about self-improvement which can be measured in our well-being.

I have learned that I’m "competing" against myself—getting incrementally better—but sparing me the indignity of having to measure my talents or skills directly with someone who is lightyears ahead of me in practice.

Yogis like that as well.

Measuring Development Against the Practice, Not Others

Yoga encourages us to strengthen, stretch, balance, focus, and look inwards without judgement. Yoga allows us to appreciate how each day is different. We can come in tired, stiff, sore, stressed or steeped in emotion, but we will almost always leave each session stronger, more energized, flexible, relaxed, focused and healing.

Yogis like that as well.

Yoga offers a way to measure our development and performance, but against the practice as opposed to against the others without a specific handicap.


How is performance improvement tracked in surgery? What about a handicap for surgery?

What if surgeons were given a handicap based upon their performance in their ten most recent cases?  

Surgical Handicapping System

I think this would be an incredibly interesting way to measure competence in surgery—I’m not saying it would be the best way, I’m just saying a handicap (or something like it) might be a way to stimulate performance improvement directed at the positive outcomes or final outcomes, without focusing on our background experience, years in practice, or negative outcomes.

Applied to surgery, a handicap could help us closely monitor our development—or regression—as surgeons, and that’s a benefit to us, our employers, and our patients.

And like in golf, the decision to share our handicap should be up to us or “the club” that we belong to.

Or like in yoga, the informal handicap could encourage each of us to improve our performance and development without judgment and against the practice of surgery as opposed to against others.

As a result of my practice of yoga, I am leading a healthier, more sustainable life and practice. I am more recharged, mindful, and a better surgeon. I give myself the opportunity to practice regularly. I also receive some private and group coaching. I am not intending to be competitive, though I could be. I am giving myself the opportunity to get better at something that is important to me. Being a surgeon.

Patients like that.

My intention is quality patient care.

Patients like that as well.

But, what do you think?

If the “handicapping” system isn’t right for surgery, what is? Is there something we as surgeons can adopt? Or something unique that we can create?

I’m curious to hear your thoughts. Share them below.