Monthly Archives: August 2016

Can Doctors Be the Next Big Startup?

This article originally appeared on in-Training.org.IMG_3953

Everyone has heard of startups. For many of us, the term “startup” is a reference to technology companies in Silicon Valley, companies like Google and Apple. These companies are so well-known to us because their products and services have and continue to significantly shape and define the world we live in today, from how we purchase almost everything we buy to how we communicate with almost everyone we know. But startups seem to have become more than just providers of goods and services — they’ve become lore of our capitalistic society: a standard for what it means to be truly successful. When we think of startups, we sometimes find ourselves dreaming of having the next big idea and then turning our idea into the next big company. This would be our ticket to the top, the membership fee for the one-percenter club. According to Forbes magazine, approximately 90 percent of startups fail, but that is not part of the public’s perception, nor is it part of the dream of walking shoulder-to-shoulder with luminaries such as Musk, Cook, Bezos and Page.

Even as a young physician, I can still recall an era when doctors were viewed with the same admiration reserved in today’s world for CEOs of highly successful startups. Doctors were seen as healers, curers of disease and life-savers. They were considered intelligent, compassionate and dependable. In short, doctors were the best our society had to offer. In my lifetime, this idea that medicine and doctors are to be admired for their positive contributions to society has been replaced by admiration of top startups and their CEOs. Going even further, it seems that the public sentiment towards doctors has shifted all the way from affectionate and appreciative to distrustful and disrespectful, an opinion frequently expressed by doctors.

Unfortunately, in my short career up to this point I have only occasionally experienced the old mentality regarding and belief in the power of medicine. Instead, I am left with patients who don’t trust me or the healthcare system, taught by doctors who miss the “good ol’ days” of medicine and who are plotting their exits from medicine before the next hot startup can take over our lives. My medical decisions are increasingly controlled by administrators and third-party payers. I long for those bygone days when doctors were just doctors, not controlled by outside pressure from third parties with their own financial agendas.

The doctor-patient relationship that was so useful for treating people for decades no longer even exists. I don’t need to look far to find an answer to the question of how this sea change went down — insurance companies, pharmaceutical companies and the government have slowly taken over the healthcare system and in the process have sidelined doctors. Just follow the money, as the old adage goes, and this is where we find ourselves now: knee-deep in the industrialization of medicine. It is only fair to admit that some of the changes in healthcare have benefited patients. The Affordable Care Act has provided millions of people with access to healthcare and has eliminated preexisting conditions as grounds for insurance companies to reject applicants. However, the practice of medicine is not the same as it used to be and what it means to be a doctor has fundamentally changed.

My desire to help the next generation of doctors — whether currently a pre-med, medical student, resident or fellow – comes from my desire to help my profession as a whole. The recent trends in healthcare are alarming. I write from the perspective of a young physician. Doctors sacrifice a decade on average to reach attending physician status, often times saving lives and curing disease along the way, just like doctors of the past had been doing for generations. However, the serious lack of respect and financial reward make it difficult to justify the toll it takes on our lives to become doctors.

It takes most startups an average of 10 years, employees who work long hours and the ability to survive ups and downs, before success is ultimately achieved. When I hear these stories, the first thing that comes to my mind is the journey I took through medical school and residency. A journey filled with moments of exceedingly long hours and lots of ups and downs: a journey that lasted just about 10 years. So why does a tech company get more respect than a doctor if they’re both putting in the same amount of time, effort and sacrifice to master their respective crafts?

The influence of startups is undeniable, but isn’t the influence of doctors and medicine at least equivalent? Maslow’s hierarchy of needs places physiological needs at the base of the pyramid, emphasizing that our health is the most important prerequisite for a fulfilled life: even more so than having an iPhone or owning a self-driving car. So what can we do as current and future physicians to earn back some of the respect we’ve lost? How can we end up on the cover of magazines espousing success rather than be front page news trashing our profession?

It starts with doctors acting more like startup CEOs. We’re all smart enough to do it. Going to medical school already puts us in the highest achieving class, but we cannot stop there. We need to think bigger, the way Steve Jobs, Bill Gates, Elon Musk and Mark Zuckerberg all have. People that dream capture our imagination. They also ultimately define the future. By embracing the tactics of these successful entrepreneurs, we can help redefine the future of medicine and the roles of doctors for the better. Check out Inc.com’s list of “17 Game-Changing Health Startups” for some inspiration and motivation. It’s our turn to be the next big startup.

Why Reading (Still) Matters in Medicine

IMG_3953This article originally appeared on in-Training.org.

The road to medical school mostly requires good grades in the hard sciences, high entrance exam scores, volunteering and other quality extracurricular experiences. Once in medical school, the curriculum is a roller-coaster ride of learning anatomy, physiology, pathology, diagnosis and treatment. At first glance, the journey seems to leave little room for anything else. Along the way, we also often hear about cultivating behavioral decorum and social intelligence as soon as our third year clinical rotations begin, or possibly even sooner.

Those medical students with careers or a family of their own prior to entering medical school will have real life experience and wisdom that they can carry over to their medical training. However, for younger future physicians without such previous experience — especially the ones who took no breaks after their undergraduate education — the world demands that they grow up very fast.

The social narrative that we’re often exposed to during our medical training is that becoming a doctor is an end-all-be-all magic prize that absolves us from every other responsibility of life. After having gone through the entire training process, including preparing for residency, I’ve come to realize the potential consequences that getting lost on this path can have on an individual’s overall growth as a person. Here are some additional points to consider:

  • Medicine is a trade that focuses on identifying pathology and prescribing management through the permission of our medical licenses. That’s it! It does next to nothing to teach us about practical life skills. We’re still responsible for teaching ourselves a plethora of other critical skills that we’ll need to build the life we ultimately desire.
  • The physician’s lifestyle puts us in a dangerous position to damage our own physical health without proper understanding of wellness and efficient time management. As such, medical school does not do enough to address this preventive approach to well-being.
  • We spend a lot of time in highly demanding work environments with individuals who are extremely driven. Engaging in these high-pressure situations for extended periods of time should not be taken lightly. We’re exposed to constant psychosocial stressors that cause us to push our own mental health into a higher risk demographic for burnout, and all the associated problems that come with it.
  • Unless you’ve studied finance or economics before, you’ll be ill-prepared to handle your own finances, business management and networking in your career.

During medical school, I developed a routine in which I would put in my hours for my rotations, study and then spend any other free time I had purely on entertainment and social outlets. Medicine is difficult, and mastering its content alone requires a Herculean effort that, in reality, should justify some downtime to relax and recover. If you have any desire to be well-rounded and to equip yourself with knowledge for personal growth outside of medicine, following only your syllabus will not be anywhere close to enough. Binging on Netflix any chance you get will only make you crave for continuous stimuli that will leave you drained once the dopamine rush wears off. Once I started to accept the fact that this complacent attitude was not going to just go away on its own, I realized I had to accept responsibility for improving my actionable knowledge in my weak areas. To accomplish this, I’ve found there is no better way than to read. You literally have to read books. Let me give you some examples of what I mean.

While in medical school, I was having a lot of trouble controlling my weight and seeing results in the gym. I read books on nutrition and fitness such as Eat Stop Eatby Brad Pilon and was able to create my own system to rectify ten years of bad habits. My sleep was becoming disrupted so I read Sleep Smarter by Shawn Stevenson and corrected my habits. I was trying to comprehend the psyche of high functioning experts such as my attending physicians to get good grades. I read books like 48 Laws of Power and Mastery by Robert Greene and was able to tailor my behavior during rotations. I wanted to get a financial plan going before starting residency so I summarized White Coat Investor by James Dahle and now I have a good idea of what to do with my money.

Unfortunately, reading takes a lot of time and concentration. English is not even my first language so I always had trouble getting through a book efficiently. The following reading method is introduced by Malkhaz Geldiashvili in his YouTube channel called “Fight Mediocrity”:

  • Purchase the physical or digital copy of the book.
  • Install Audible from Amazon on your tablet or mobile device and purchase the audiobook version.
  • Read your book while listening to your audiobook on 2x speed.
  • Put in consistent, dedicated reading time per day (30 to 60 minutes is a good start).
  • If you spend a lot off time commuting, then just listen to your audiobook on high speed while you’re driving or riding to your destination.

I was able to finish 5-6 unfinished books in a mere 2 weeks using this method. Since the audio is running in the background, you’re less likely to get distracted. In addition, because you’re reading while listening, the content is emphasized using two sensory inputs, so you retain the information better. If needed, you can adjust the speed to make sure you’re not missing any important details. Despite our hectic schedules, this method enables us to keep a steady pace of reading. If you read one book per week for 80% of the year, that’s forty books in a year, which is quite impressive!

So what books should you read? Well, that depends on your needs. If you’re trying to develop a business, then you’ll have to read about topics like marketing and leadership. If you’re trying to improve your dating life, then you’ll have to read about subjects such as sexuality and psychology. One great way to be introduced to high quality books is to subscribe to podcasts. Podcasts nowadays are exploding in popularity. They often feature interviews with acclaimed industry leaders and authors who recommend books that you’ll surely want to read. Here are some of my favorite podcasts:

  • “Art of Charm” hosted by Jordan Harbinger
  • “School of Greatness” hosted by Lewis Howes
  • “Inside Quest” hosted by Tom Bilyeu
  • “Tim Ferriss Show” hosted by Tim Ferriss
  • “Knowledge for Men” hosted by Andrew Ferebee

Reading is an excellent way to receive mentorship. If there is any particular individual you wish to emulate, odds are that person has been interviewed enough times with his or her recommended reading list. I’m currently trying to read books recommended by Tom Bilyeu, a CEO of the highly successful nutrition company, Quest Nutrition. He also hosts a podcast called “Inside Quest” that features some of the most incredible thought leaders on the planet, such as Carol Dweck and Tony Robbins.

I also recommend subscribing to Ryan Holiday’s website, which will send you a list of impactful books. Ryan is the author of the bestselling book The Obstacle is the Way, which is an interpretation of a school of western philosophy called stoicism. He is currently considered one of the most brilliant young entrepreneurs and authors within the marketing and publishing industry. His own reading is beyond voracious so he knows how to recommend some of the best books out there for you.

If you’re reading this article, odds are you’re in a good position for a great life. However, you still need to understand there is a whole world of insanely brilliant and innovative people out there who are breaking limits in disciplines outside of medicine including technology, psychology and finance. These very successful industry leaders abide by the same code of diligence, choose to pay it forward and embody humility. While doing my own research to learn their secrets to productivity and persistence, the truth became blatantly clear: in order to approach anywhere near their levels of success, I would have to read what they read.

Our trade is a path that has been paved for centuries. More recently, it funnels its participants through “the Match” and subsequent residency training. Just getting through that alone is quite a feat. Nevertheless, I want to encourage all of us to put in just a little extra effort to keep our eyes and ears open to people beyond our own practices. On top of mastering medicine, we should also strive to learn about the world of successful individuals who exist outside of medicine. For instance, there are many who’ve built entire businesses and careers from scratch by educating themselves simply through reading. They may not have had a formal education or residency training like doctors, but they’re still able to break entry barriers with enormous courage and work ethic that can be humbling to many of us. There are many lessons to be learned from these pioneers.

A non-fiction book is a carefully designed manual of an author’s dedication to solving a known problem. The more information you collect from such sources, the more complete of a clinician you become. Using a time efficient reading tactic like the one I’ve described is the closest we can come to actually experiencing the 1999 hit film The Matrix — literally downloading as much useful information as we possibly can so that we can then act on it in a meaningful and purposeful way to help our patients, ourselves and society as a whole. So, simply put, we should all try reading more. We can be anyone. We can do anything. It’s just a matter of reading.

This article was written by Dr. John Kim, DO. John is currently completing his family medicine residency training in Florida. He grew up in and attended medical school in Southern California. John is extremely passionate about teaching current and future doctors how to achieve health and wellness despite their often highly demanding and stressful lives in medicine. In addition to founding Doctors of Steel, he is also a regular contributor for Docs of Tomorrow.