Compared to our house, with 10 (yes, TEN) children, those scenes resembled a solemn funeral procession compared to the cyclone that hit our house at 5:30 AM on Christmas morning. Sometimes our parents would join us. Other times my father would sit up, grab an ashtray, and light up a Camel or Viceroy before giving his blessing to proceed without him and my mother.

As the oldest siblings, my sister Cathy and I would maintain some degree of order as we tried to keep the younger animals at bay and distribute presents in an orderly manner. Within a few minutes, paper would be flying, screams of joy could be heard, quickly followed by fights breaking out over who touched whom, and which toy was the best or doll was the prettiest.

The leadership lesson I learned was to surrender and stop trying to control the situation. Allow everyone to enjoy the moment. Make sure no one was hurt. Then supervise the clean up a couple of hours later, when the adrenalin had dissipated.

Many Years Later

It seems that Christmas was always destined to be an interesting time for me. Many years later, after college, medical school, residency, joining a small medical group, a failed marriage, two adopted children and starting my own practice, I met Kay, a sweet and engaging respiratory therapist. We married and melded our two families – her three girls, my son and daughter.

How does this relate to leadership?

Well, in many potential ways. It was always a busy time. Balancing kids from two families adds another dimension of complexity to life. But we made it through fine. We have my extended family of parents, nine siblings, their nine spouses, 30+ nieces and nephews and a few grand-nieces and grand-nephews to spend time with. Then Christmas morning with the immediate family (Kay, me and the kids). Then some time with Kay's side of the family, if it works out (her parents are deceased, unfortunately). That helps to instill focus and patience.

God Complex?

Another challenge has been that Kay's birthday is on December 25! She tells an interesting story from her childhood. It was always difficult for her parents to make Christmas special for her and her three sisters, while also making her birthday special. But, her mother tried to make it exceptional by bringing home a personalized birthday cake. One year, her mother brought home the birthday cake and when it was opened up, it was decorated with this on top:

The apparent mix-up at the  bakery did not help dispel the thinking that Kay might have a god complex, since she insisted she was born on Christmas day!

Special Christmas Thoughts From Others

There have been some really nice sentiments shared by various bloggers recently. Here is a sampling of a few that I enjoyed reading.

Skip Prichard – 3 Leadership Lessons from Santa Claus

Physician on FIRE – What to Give Those Who Have “Everything”

Michael Hyatt – Benefits of Generosity

Motivate MD – 9 Gift Ideas for Medical Students

One More Special Story That Reminds Me of Christmas

Here is  a wonderful story – not about Christmas per se, but about the spirit of Christmas…

Little Girl Befriends 82 Year Old Widower

Final Thoughts

Most readers seeing this will already have made it through Christmas, and possibly the New Year. I hope this holiday season was a joyous one, and that each year gets better and better.

Thanks for listening.

For more of my thoughts on healthcare and leadership Subscribe here.

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And feel free to email me directly at john.jurica.md@gmail.com with any questions about anything.

See you in the next post!

The post Christmas Morning Thoughts and Stories appeared first on NonClinical Physicians.

In actual fact, I had about 70% of a post ready to go two days ago. But I decided that it just sucked, so I sent it to the WordPress trash bin.

Since then, I have been vacillating over what to write about. At the same time, I have been thinking to myself “Why bother?” It is Thanksgiving day. Nobody is at home. And if they are home, they're cooking or eating dinner. Or they're already in a turkey- (tryptophan-) induced coma.

(Please, don't argue this point – I know that eating turkey does NOT cause increases in tryptophan, or melatonin. As a vegetarian that doesn't eat turkey, I can attest to the fact that I still get very sleepy after Thanksgiving dinner.)

Oh – one other admission…

If I was a good blogger, I would not be fretting over this, because I would have several posts already written and in the queue. That's more evidence of my failure as a blogger.

Maybe I'm being too hard on myself. After all, I ‘m not a professional blogger.

But I am trying to instill good habits in my blogging. And two of the rules are:

1. Be consistent and post on a regular basis, and
2. Write posts ahead of schedule so that little “hiccups” do not interfere with following rule #1.

Unforgettable Patients

So, I decided to write about the types of patients I have seen over the years that gently, or not so gently, reinforced my goal to stop doing any clinical work whatsoever. I had already begun working as vice president for medical affairs full-time. But I was still seeing patients 2 or 3 half days each week.

Keep this in mind: when you transition from clinician to administrator in your home hospital (as opposed to taking a job in a new city), it is easy to end up working one full-time and one part-time job. But I digress…

My primary reason for stopping the clinical work was to focus 100% on my administrative duties. I was getting very busy with administrative responsibility for six clinical areas within my hospital:

• Quality Improvement
• Risk Management/Patient Safety
• Pharmacy
• Physician Services
• Laboratory
• Imaging

Needless to say, the clinical work sometimes interfered with some of that work. Juggling both could get challenging. I clearly remember, however, some of the patient types that made me dread certain days in the office. I certainly did not miss the following types of patients when I left practice:

• The chronically ill and addicted. I had several Type 2 diabetic patients who were just NEVER able to get their glucose levels under control. I tried every kind of cajoling and combination of the  medications available. But they continued to drink alcohol, would not follow a diet, and refused to lift a finger to exercise. They were always surprised when they developed a foot ulcer or a scrotal abscess that would not heal.
• The 30- or 40-year old with one day of cold symptoms. They were often planning to travel and wanted to make sure they would not be ill while on their trip.
• The hypochondriacal patient with no confirmable medical illness. They came in weekly for whatever new hint of a symptom they had. According to my board prep CDs the treatment for this is to proactively schedule visits every week or so. What these patients really needed was reassurance and some face time with a physician. I get that, but it's hard to do when you're trying to care for several thousand patients with the help of a nurse practitioner and only 2 half days in the office.
• The overly familiar patient. He thinks that he's in the office to shoot the breeze for 20 minutes. My least favorite one of these had such severe obesity and sleep apnea that he had a tracheostomy and was on a home ventilator. His respiratory tree was chronically colonized with MRSA. He'd come in the office coughing through his trach and the staff would scatter.

Working in urgent care now, I don't usually see many of those kinds of patients. But I see many trivial illnesses that could be cared for via telemedicine or simple home remedies. It makes me wonder about the future of medicine.

It being Thanksgiving Day, however, I am reminded to be thankful. And I am. For my wife and family; my career; and even my patients. And my opportunity to try to serve my audience here on the Vital Physician Executive.

I hope you had a great week.

Thanks for listening.

John

The post Regrets and Nostalgia on Thanksgiving Day appeared first on NonClinical Physicians.