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Optimizing Your Mindset in Medicine, Step 6 - Crucial Caveats

We are closing out the details of optimizing your mindset as physicians over the next two weeks. This week we will unpack 2 critical caveats to up-level to quality thoughts and enhance your experience. 



A couple of weeks ago, I shared with you how to move into an intentional thought model. Remember, it was a way to leave a thought behind that was adding unnecessary suffering and replace it with something that both A. was believable and B. that served you better.


When physicians start utilizing this tool, there are a couple of things to watch out for –


  1. This is NOT toxic positivity or thought swapping. This is a tool, first and foremost of awareness of how your thoughts greatly influence your experience. If you decide you want to move to a view that improves how you experience the situation, you can’t just replace the original automatic idea with something positive and happy. This isn’t about rainbows, unicorns, and pixie dust. This is about your lived experience. Sometimes, finding a less toxic perspective than your automatic one drastically reduces your unnecessary suffering. 



C: The patient showed up 15 minutes after the appointment started. Your staff rooms them.

T: They are so disrespectful

F: Annoyed

A: You think about how this messes up your day, your lunch, and your time after work; you walk in rapidly, skip the niceties, and rush the patient along in their history; you mention to your staff how they should have rescheduled the patient, you stew about how the clinic doesn’t run the way it should

R: Now you are disrespectful to the patient, your staff, and even yourself by not showing up the way you like.


Toxic Positivity:

C: The patient showed up 15 minutes after the appointment started. Your staff rooms them.

T: Oh, it’s so fantastic that they came late.

F: Happy.

A: Nothing happens good here – it’s fake! It’s not real. Abandon effort.


Improved Intentional Model:

C: The patient showed up 15 minutes after the appointment started. Your staff rooms them

T: I will do the best I can in the time I feel is best

A: Neutral or Accepting

F: You are kind to the patient; you explain your time is shortened, you give them the option of rescheduling or paring down the focus,  you address their most pressing issue, and you kindly remind your staff if someone is more than 10 minutes late they should check with you.

R: You do the best you can. You don’t add extra suffering and disrespect to the situation.



  1. There are NO “shoulds” There is no “right” way to view the situation. You want to be aware of your own perspective and then allow yourself to choose the thought you wish to intentionally rather than automatically accepting the one your brain gives you. 


This is about agency. This means you can keep the original thought if you want!



C: Pedatric abuse case

T: That parent is an awful human being!

F: Disgusted

A: You think about how terrible they are, you make sure all other children are in a safe situation, you are not kind to them, you call the police, report to OCS. You shake your head repeatedly. You vent to those you can. You type with extra vigor.

R: You experience the natural human emotions around abuse.


Evaluate fact vs. story – Fact: a child with a head injury and liver laceration. Mom says, “His dad did XYZ” – Story: “he’s an awful human being.”  Pause. Reflect on perspective: How do you want to view this? How is your automatic thought affecting you? What do you want to think?


Be intentional with your thoughts. “Yep, that’s the thought I want to keep.” Great. This is where you don’t accept the automatic thought, look as the observer of your mind, and endorse the original thought on purpose. 


Okay, keep your eye on the awareness piece of your thoughts. Take back your agency when you can’t control the situation so you don’t have to ride the emotional roller coaster that other people and situations seem to put you on. Do so without toxic positivity and on your own terms. 


Next week, we will wrap up the series with what to do if you get stuck.


Until then, Have a joy-filled week!


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