Tuesday, April 6, 2010

Jennifer Frank, MD: Discipline

While swimming this morning, I entertained self-congratulatory thoughts about my dedications and discipline. I got up this morning early to go to the pool before work. Okay, in all honesty, I slept through my alarm and was awoken by my youngest one’s cry to be rescued from his crib. Because I didn’t go back to bed like I wanted to, I count this as a plus in the discipline column.

I thought further about how I am trying to follow a workout routine (parts of which I really don’t like) in order to prepare for the triathlon. I have a workout schedule that I follow pretty faithfully. Having it written down in black and white seems more inviolable than just having an idea of what I planned to do in my head. I could continue with this illustration – swimming is methodical repetition of the same thing over and over again and involves “staying in your lane” while doing it. Both of these ideas have application for parenting and being a physician.

I recently received a rather strongly worded e-mail from the Wisconsin Medical Licensing Board stating that I (and all other licensed physicians) should read the quarterly newsletter to find out about new information that applied to our licensing. I ignored the first e-mail but did take a few minutes to read it after the second e-mail arrived.
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I never found the new information but I read with morbid curiosity about all the board actions against physicians occurring over the last few months. Truly shocking and surprising in both quality and quantity. Having sex with patients, dispensing vast amounts of controlled substances to patients or yourself, gross negligence.

Reading through this newsletter of shame, I realized why professionals need to have specific guidelines (you have to wait two years after termination of the patient-physician relationship before initiating a romantic relationship with a former patient, you cannot prescribe yourself or a close family member narcotics). These both seem pretty obvious, but I think it is easy to fudge the lines slowly, gradually, and unintentionally over time, so that you are no longer “swimming in the right lane.”

Just like the difficulty in getting up super early to immerse yourself in cold water, it can be difficult to adhere to standards when a questionable case is before you or when your own “needs” seem to be so compelling.

As a parent, self-control and discipline are important as well – not only to teach to your kids, but also to demonstrate yourself. It can be so hard to be consistent when you are tired, overwhelmed, or just at the end of your rope. It often seems easier to give in to their demands than to take the more challenging role of parent – in control and the same today as yesterday.

In all my roles – as fledgling triathlete, family physician, and mom – it is essential that I not only practice self-discipline but also recognize my own natural tendencies to fudge the lines when it is convenient to do so.

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