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After the Match

Three Simple Skills Now for 10,000 Future Days

Cook, Thomas MD

doi: 10.1097/01.EEM.0000464080.20744.10
After the Match

Dr. Cookis the program director of the emergency medicine residency at Palmetto Health Richland in Columbia, SC. He is also the founder of 3rd Rock Ultrasound (http://emergencyultrasound.com). Friend him atwww.facebook.com/3rdRockUltrasound, follow him @3rdRockUS, and read his past columns athttp://bit.ly/CookCollection.

PART 2 IN A TWO-PART SERIES

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Residency is a 1,000-day process that prepares you for the next 10,000 days of your life. Real-life issues, from legal to financial to interpersonal, take on an entirely different light once you enter independent practice. But residents can — and should — develop three skills to prepare for these future challenges.

First, learn about malpractice. Roughly two-thirds of you will go through this, and male physicians are twice as likely to be sued as women. Truth be told, however, the risk of ending up in court with someone pointing a finger at you is very small. The vast majority of cases never go to trial. About one-quarter settle, and of the five percent that go to trial, 90 percent end in favorable decisions for the physicians. Still, malpractice ends up being feared like shark attacks. They are not common, but they have a lot of teeth.

An effective way to learn about the medicolegal system is to get involved in mock trials that are often conducted by teaching hospitals using attorneys from a local malpractice carrier. You will see how trials are conducted and how attorneys behave in the courtroom. We put on mock trials regularly at our program, and this is one conference in which you do not see anyone fall asleep. Also find out which of your faculty members are expert witnesses in malpractice litigation. What are the key issues in cases they have reviewed? Learning from others' mistakes allows you to focus on what not to miss in your patient care.

Residents must also acquire basic information about personal finance. You will read lots of articles that provide a list of things to do to secure your financial future. But you are a resident; you do not have the time. But doing just two things will make a difference. First, find a financial advisor. Most financial advisors will fall over themselves to get you as a client. Not because you have any money, but because you will make a lot in the future. Good financial advisors will guide you through all the anxiety. They will calm you down when you panic about your crazy student loan debt. They will hold your hand and tell you about the other successful physician clients they have that went through the exact same process you are going through now. Finding a good one is easy; just ask your attendings. They all want to retire someday, and they have been investing money for years to do so.

Secondly, learn how to use Quicken or some other personal finance software. Doing this will teach you the most important lesson about your future finances and how money flows into and out of your life. You will really be able to see how you spend your money.

Try to complete both of these tasks before you are halfway through residency. It will make life easier when potential employers start throwing big numbers at you to join their practice.

The last skill to acquire is the most important. Learn how to conduct a “crucial conversation.” Interpersonal relationships create the most happiness but also the most chaos in your life. It is ironic that the most intense arguments you will ever have will be with the people you profess to care about the most. This includes your spouse, your children, your peers, and eventually your partners. You need to be able to identify which conversations are tricky and how to create a safe environment in which to negotiate. Learning how to have a civil conversation with your spouse about money or where to spend the holidays is just as important as a tough conversation with a demanding patient and his family.

If you are interested in learning more about how to do this, I suggest the book Crucial Conversations: Tools for Talking When Stakes are High by Kerry Patterson, et al. It is a quick read, and you will immediately learn strategies for solving problems that you encounter every day.

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