John D. Kelly IV, MD

One of the most effective ways to create meaning in our lives is to serve as a mentor to others. Advising, counseling and showing the way to a younger colleague helps us to get out of ourselves and focus outwardly on the wellbeing of another.

We recently buried my mother-in-law, Helen S. Sakosky, in a cemetery located in her childhood home of greater Wilkes Barre, Pennsylvania. Helen possessed a formidable spirit and the life she lived conveyed many useful lessons, quite applicable to our vocation of orthopedic surgery.

Attendees at the recent Arthroscopy Association of North America Annual Meeting in Orlando were treated to presidential guest speaker Kevin Reilly’s testament on the power of belief in overcoming adversity. He shared that a focused and positive expectancy can overcome any obstacle; even the loss of an arm to cancer.

Times are tough, and there is no sign that orthopedic practice will become easier. Many imposing forces are converging on the practicing orthopedist including declining reimbursement, increasing insurance intrusions and the omnipresent demands of the electronic medical record. It is no surprise that recent data suggest burnout has reached meteoric proportions.

This week, I visited the grave of the nun who changed my life. Sister Viola Hespelein was a Franciscan nun, assigned to my home parish school, St. Ann’s, the epicenter of a predominantly Irish Catholic lower middle-class neighborhood named Forty Acres in West Wilmington, Delaware.

Psychiatrist Judith Orloff, MD, is considered a true pioneer in the nascent area of energy medicine. Practitioners of this discipline recognize that one’s daily decisions can either connect us to renewable sources of inspiration, passion and creativity or render us depleted.

In his treatise on human motivation, Drive: The Surprising Truth about What Motivates Us, Daniel Pink delves into the research on what truly propels humans toward achievement. Pink’s research reveals some startling conclusions: Namely, external motivators (money, fame, notoriety, etc.) do not lead to lasting motivation. Rather, external rewards lead to burnout and unfulfilled lives. Pink cites several studies on the discovery that the well-known reward/punishment model of motivation (carrot-and-stick approach) leads to diminished creativity and productivity. Pink references a study noting that art work commissioned by a patron is uniformly less creative and of lesser quality than work produced by artists for the mere fun of it. External pressures to perform not only stifle creativity, but also lead to compromised ambition and energy. Enjoyment-based and intrinsic-based motivation – namely, how creative one feels when engaged in a project, is the chief driver to achievement.

I continue to write on the burnout epidemic in medicine because it continues to rage on, with no apparent end in sight. Declining reimbursement, insurance demands and the growing demands of the electronic medical record model have taken their toll.

In their masterful treatise, “Extreme Ownership: How U.S. Navy Seals Lead and Win,” former Navy Seal Officers Jocko Willink and Leif Babin artfully convey key leadership principles learned during SEAL training and months of battle experience in war-torn Ar Ramadi, Iraq. The authors delineate several battle-tested principles of leadership ranging from minimizing ego to respecting chain of command. However, the singular most important leadership trait illustrated in their handbook is the practice of extreme ownership. That is, exemplary combat leaders own the outcome of every aspect of their mission. They assume responsibility and do not look to others for success. If failure manifests, true leaders take the heat and do not blame subordinates – they are responsible for all the dimensions and consequences of a mission. The authors are emphatic in the importance of leadership. They flatly state: “There are no bad teams, only bad leaders.”

The burnout epidemic rages on and it is endemic in the entire medical universe, explaining the increasing rate of absenteeism and turnover among physicians.