PracticalDermatology

Aren’t you tired? Don’t you feel like we just need to get 2016 over with? I am just exhausted…between the recovery from the ugly political debate that divided friends, the end-of-the-year demands to wrap up the business books, the recent passing of colleagues, and the fatigue of being pulled in all directions…I am wiped out, and I am sure you are, too.

That being said, what has 2016 meant to us?  Like it or not, the year seems to have been dominated by politics.  We had the American Academy of Dermatology election for President-elect impacted by candidate regulations, only to have our friend Allan sadly leave us not even six months later. We had to endure one of the most negative political campaigns for US President on record, which turned friends against each other both online and in person… it really made politics very personal on levels we didn’t even realize were there, and we often heard or saw a part of someone close to us we didn’t know existed. Closer to work, our specialty once again has to brace for major changes in 2017 (can you spell MACRA?) just like we did with ICD-10…although in the end it wasn’t really that bad.

So now what? “Why so serious?” The end of the year brings reflection, along with a little retro-remorse for what we could have done better for our practices, our patients, and ourselves. Many of us look back at the business decisions that might have impacted the practice: expansion to another location, new employees or practitioners, and management of expenses are all changes that might come back to haunt a practice the following year. The anxiety of where the practice is going can cause a lot of second guessing. With the rising costs of managing overhead, the easy exit presented by consolidation, and the unknown presented by a new administration, we have already lost plenty of sleep about work. Now we are faced with dilemmas like “Everyone is selling, what about me? “and “What if I get left behind and stuck with nothing?”

Then there is remorse about that one patient we didn’t help get better, or who slammed us online and left us with a bad taste for months. The efforts put forward for many patients that we helped and made the difference for are often overshadowed in our memories by the one or two that pushed our buttons…or made us want to quit on the spot. I had another one of those encounters in the past few weeks: A patient was in disbelief that we could actually get her prescriptions to her faster and cheaper by using a specialty pharmacy. She was convinced it was a scam, told us it was impossible, and threatened to go online and to the police, all because the pharmacy called her after 5pm and told her that her usually “expensive” medicines would cost $15. Later that day we had 10 other patients thank us for the same outcomes…OK then.

And while it’s easy to focus on these few negative interactions, rarely do we take the time to ask ourselves the harder questions about the year: Did we do enough to take care of ourselves—to avoid risking burning out or losing our drive? Did we attend the right meetings (or too many or few of them)? Earn enough money? Or take enough vacation? And of course, did we find that elusive work-life balance that we think everyone else has and we will never achieve? Many of us keep the wheels turning without remembering that they could stop any second—and as Dr. Schlessinger did in the last issue, we sadly realize this when our friends and colleagues leave us.

My goals for 2017, the year my son turns 2 and I turn 50, are to take a few of these steps back and make sure there isn’t any “buyer’s remorse” for the upcoming year. Every January we are reminded it is time to reset the gas and brake, learn from what we did well, and fix what needs work, none of which is breaking news. But what is important that Derm workaholics forget is we need to focus on our own balance, and put our own oxygen masks on first before helping someone else. The fortune cookies will tell us to hug our children, learn to say no, be kind in the face of adversity, and all that stuff. My wish for all of us in 2017 is very small: Be good to yourself, and remember how many people will benefit from it.

Happy Holidays and have a great 2017! n

—Neal Bhatia, Chief Medical Editor