Learning to Run Meetings

Whether you are a college student, medical student, resident, faculty member or physician in practice, you can’t get around the need for meetings. Having watched some masters (and some “masters to be”) I thought it would be worth a little research on what makes a meeting work well. Here’s 12 ideas to help learn the skill of running a great meeting.

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1. Start on time, stay on schedule and end on time. “Set the ground rules – meeting does not equal chillaxin in a room with a big table” from the MIT meeting Primer

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2. Don’t use PowerPoint.

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3. Make meetings as short as possible. Just because Outlook defaults to an hour doesn’t mean a meeting has to be an hour. I’m a fan of 30 minute meetings (max).

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4. Never have a meeting without a clear purpose. If it’s just “getting together” to talk, it’s not a meeting. (Face to face time is important socially, but don’t confuse the two). That being said, a little social interaction at the beginning of the meeting is important to set a collegial tone.

5. Invite the appropriate people. Nothing is worse than sitting through a meeting about a topic that doesn’t apply to you. Limit the number, too – more than 8-10 people limits the ability of the group to interact effectively.

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6. Make an agenda and send it out before the meeting. If you are using Outlook to schedule your meetings, you can include the agenda (or add it later) with the invitation. The best agendas use the DRI approach adopted by Apple. Every item on the agenda should a) have a time limit for the item b) lead to an action item, and c) should list the “Directly Responsible Individual” for that item.  If it’s a smaller meeting, a formal agenda may not be necessary, but setting goals (and letting everyone know in advance) is still crucial.

7. Share documents with the team. Create folders on a shared drive, SharePoint or use Google (or other) apps. Otherwise, make sure these are shared by email.

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8. Include “brainstorming” as an action item at the end of every meeting. When people bring up items that aren’t related to the task being discussed, stop them, write it down and bring their idea up during the brainstorming session.  Reinforce that there is no judgement in brainstorming – this is where the great ideas come from!

9. If you are running the meeting, control the conversation without stifling the creativity of the group. If one person seems to be dominating the conversation, gently (but firmly) steer the conversation to the other people. Go around the table to ask for opinions. If it’s a controversial issue, ask people to write their decision/opinion on a piece of paper and “pass the hat”. You can then read what are essentially “anonymous” responses to the group.

10. No texting, emails or other technology during the meeting. If it’s an hour long meeting, think about a 5-10 minute “bio break” to let people check their phones mid way.

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11. Send an email within 24 hours summarizing the action items, deadlines and DRIs. Alterantively, you can send the  the minutes instead (but do it within a few days, not just before the next meeting so people know their responsibilities)

12. Kindness matters. These are your friends and colleagues who are all trying to do a good job and help.

 

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Seven Steps to Running the Most Effective Meeting Possible

How To Run Your Meetings Like Apple and Google

University of Wisconsin-Madison guide to running good meetings

MIT Meeting Primer

Fast and Easy Recipes – Protein Bars

The senior class ends their formal education at Baylor with a capstone course called “APEX”. In addition to reviewing critical medical information, communication skills and other important aspects of becoming an intern, there are also wonderful lectures from faculty on “how to be an intern”.

One of the APEX speakers this year was Dr. Sally Raty, who stressed how important it was to take time to care for yourself.. but that you had to look for efficient ways to do it! She promised to share recipes that are easy and take very little time to cook. I’ll share the rest of the recipes on future posts… but here is the first one (which she adapted from this recipe).

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These bars have a ton of ingredients, but they are easy to find, and this bar is way better for you than those processed, chemical blobs you’re spending $2+ on. I keep all of the dry ingredients for these bars in a basket in my pantry. I just pull the basket out and make the bars. The crumbs are amazing on vanilla ice cream….not that I would ever do that, but I’ve heard it is good.

3 cups raw oats
(nothing fancy. Quaker 3 minute (not instant) oats are fine)

1/2 cup whole sesame seeds, or shelled sunflower seeds

1/2 cup shredded coconut (unsweetened is best, but sweetened is easier to find)

1 teaspoon ground cinnamon

1 teaspoon salt

1/4 cup brown sugar

1 cup vanilla Greek yogurt

1/4 cup + 2 tablespoons pure maple syrup or honey

1 cup peanut or almond butter

1 teaspoon vanilla extract

1/4 cup coconut oil, liquefied if solid (or just use canola oil)

1/2 cup chopped chocolate chips (> or = 70% cacao is best)

1/2 cup chopped nuts (almonds, walnuts or pecans)

1/2 cup chopped dates, raisins, figs or other dried fruit–optional (I don’t typically add these)

1 cup vanilla or chocolate whey protein powder– Garden of Life Raw Protein is a good one and is available at Whole Foods Market

2 eggs

½ cup egg whites (or add a 3rd egg)

Heat oven to 350F. Spray an 11 X 7 inch glass baking dish with nonstick stuff. Throw everything in a big bowl. Mix well with your hands. Place in the baking dish, press into the pan to eliminate bubbles and try to get it level. Cook for about 20-25 minutes. Let cool completely to room temp. Refrigerate for a few hours before cutting into bars. Cut into about 48 bars. Refrigerate the cut bars.

 

Top 10 ways to survive (and maybe even enjoy) being on call

Like our residents (but not nearly as frequently), my group has started taking “in house” call.   For every one who is currently or has been a resident, this is an experience we all know…. and one that’s hard to describe to those that haven’t experienced it.   Spending 24 hours on call in the hospital can be emotionally and physically draining, but it has moments that make it a special experience, too.

There are ways to make the experience easier.  Here are my top 10 ways to survive (and maybe even enjoy) being on call:

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1. Drink water. Put a water bottle in the lounge refrigerator, drink from every water fountain, put your water bottle next to your computer, or come up with other ways to stay hydrated. If you want more flavor, bring a zip-lock with cut up lemons or limes to put in your water or add a splash of fruit juice.

2. Be kind. No matter how stressed or busy you are, knock on every patient’s door and enter their room with the intention to help. Sit down or put a hand on their arm when you are talking to them. Smile.

3. Take breaks. On purpose. No one really expects you to work non-stop for 24 hours and it’s not good for your patients. Deliberately stop to do something else every few hours, even if it’s just for 5 minutes. Go outside for a few minutes for a short walk to catch some natural light and breathe some fresh air. Get a good cup of coffee or tea, listen to some music or just sit. If you want something more active, climb a few flights of stairs, stretch, or even do a light workout.

4. Eat well and eat often. Do not rely on fast food or the hospital cafeteria. By far the best plan is to bring really good food from home. You need to have “comfort” food on call. If you don’t cook, buy really good prepared food that you can look forward to. Make sure you have “plan B” ready if your call day gets completely out of control by having an energy bar (my favorite is Kind bars), peanut butter sandwich or other “quick” food in your white coat pocket.

5. Be part of the team. Notice and encourage the unique camaraderie you share with everyone else who is on call. It’s a small “band of brothers” who find themselves in the hospital at 3am. Be kind to each other, help each other, and use this unique opportunity to get to know someone you might otherwise not get to know.

6. Wear good shoes. If you are in house for 24 hours, bring a second pair that’s completely different (clogs and running shoes for example). Ditto socks. Buy really good socks and change them after 12 hours if you can.

7. Use caffeine wisely. It’s practically essential for many of us at the beginning of the day, but beware trying to “wake up” with caffeine after 2pm.   Not to mention that if you “caffeinate” all night, you’ll have that sickly post-call-too-much-caffeine feeling in the morning.

8. Take naps. Any sleep is good sleep on call. If it’s possible, 20 minutes will make you more alert and effective in your work.

9. Make your beeper a “Zen bell”. Use your pager or phone as a tool for mindfulness. When it goes off, take a deep breath, relax the muscles in your face and shoulders and be present.  This is a proven practice to decrease stress – try it, it works!

10. Learn. Take advantage of the unique educational opportunity of being on call. The fact that there are fewer people around at night and on the weekends has a real impact on how and what you learn on call.   If you are a student or junior resident, you are more likely to be the first person evaluating new consults and admissions. You are also more likely to have one on one time with your senior resident or faculty as you care for patients together.  If you are further along in your training,  the “down time” on call (if there is any!) is a great time to catch up on reading.

 

 

Healthy Recipes: 101 Cookbooks

It’s been a while since I posted about cooking and the pizza rule”. If you are trying to eat well as a medical student or resident, the key to success is planning, finding simple healthy recipes, and cooking for yourself.

101 Cookbooks has recipes that are healthy and many that are fast… but a few minutes on this beautiful blog will also feel like a “mini-vacation”. Heidi Swanson’s beautiful writing about food and travel, her award winning images plus the wonderful recipes make this time well spent.

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Summer Vegetable Curry

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Kale Market Salad

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Best School Lunch: Sicilian Broccoli and Cauliflower Pasta

 

* The “pizza rule”: Find recipes that let you cook dinner in less time than it takes to order a pizza.

Celebrating Match Day!

Yesterday was Match Day.  At noon EST, just over 17,000 4th year medical students simultaneously found out where they will go for their residency training this July.

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Medical training is punctuated by ceremonies like convocation, the White Coat ceremony, the donor ceremony (to acknowledge the “silent professors” in anatomy) and graduation.  But of all the ceremonies, the one that is pure joy is Match Day.

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I truly believe that any physician disillusioned with their work, or even suffering from burnout should be “prescribed” attending a White Coat ceremony, donor ceremony and/or Match Day.  I’m serious!  These moments of ceremony allow us to remember the reasons we choose the profession of medicine and the joy of practice. If you are part of a medical school faculty, make a point to attend one or all of these ceremonies next year.  I promise, it won’t feel like an obligation, it will feel like a gift.  If you are not in a medical school, contact the Dean of Student Affairs at your alma mater or a school close to you – we’ll help make it happen.

During the five long days of waiting between Monday, when they find out that they matched and Friday, when they open the envelope to find out where they are actually going, many fourth year students often wish this process would be replaced with an email notification…. until they experience the celebration of Match Day…

 

Congratulations to all medical students graduating this year –  and to your families, friends, and professors!

 

Photos and video from Baylor College of Medicine

 

 

 

 

Why You Should Take a Sabbatical

With all the concerns about “burnout” in physicians, allowing a colleague time to rediscover the excitement of his or her career may just be “just what the doctor ordered.”

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I’m ending up a month long “sabbatical” to work on a writing project.  I’ve become convinced that this is something most, if not all, physicians should include in their professional life.  I’m also sure that the data about sabbaticals are true – the “return on investment” for a practice or university is well worth developing a policy to encourage and support sabbaticals.

The concept of a sabbatical is traced to the Old Testament, but in recent times it has come to mean “any extended absence in the career of an individual in order to achieve something.” The corporate world has learned the benefit of these planned breaks and an impressive number of companies not only support the concept, but pay their employees to take sabbaticals.

Here are some concrete suggestions for taking a sabbatical, based on what I did (and some things I learned to do… and not to do).

Have a Mission.  A sabbatical isn’t a vacation.  It’s supposed to push you to learn something new, but it should be related to your work.  Think carefully about where/what/why you want to do, but don’t be afraid to choose something challenging.  Ideally this should be something that takes you out of your comfort zone into a new way of thinking.   It may be concrete, like learning a new skill in the laboratory, or a new procedure… but take advantage of the time to explore other fields and other ways of thinking.

Advance Planning is Key.  I picked a month that was the closest to “off peak” for my clinical and administrative responsibilities as possible.  I went to my associates six months before the sabbatical to make sure they were ok with the idea, and to give them time to work out any coverage plans that needed to be put into place.

Let People Know.  It’s not a good idea to just “disappear.”  It’s really ok to talk about what you are going to do and why.  I put an out of office message on my email 2 weeks before I left, explaining that I would be “out” for the month in order to avoid surprises for other people who were trying to find me.

Be prepared for pushback, but don’t be surprised if there is none.  Not only was everyone supportive of my plan, numerous people congratulated me on being a good role model for my colleagues.

Decide how to pay for the time away.  Many universities pay for some or all of your time away, so if you are in an academic setting, the first place to start is to learn about your institution’s sabbatical policy. Some non-academic practices also have policies to provide a part of your salary if you are on sabbatical.  If there is no policy, you may have to finance this another way.  You may have accrued enough vacation to cover the time away from work.  Another strategy is to put aside money specifically to support you for the time you are away.  A word of caution, if you take an unpaid leave, make sure your benefits are still in place. Finally, unlike other occupations, physicians have the option of locum tenens work to finance a sabbatical.

If at all possible, disconnect completely.  This is the one thing I would do differently next time.  My initial out of office message told everyone I would only read emails on Fridays, but was otherwise unavailable.  There were, however, a few events that happened during the month that I (and others) thought I needed to handle, and I let them take over some of my time away.  It didn’t detract from the overall goal of the month, but I think the experience would have been even more rejuvenating if I had been able to really leave work behind.

Coffeehouses (and tea houses) are great places to write.  I know that many of my students and residents routinely study in coffeehouses, but I never “got it”.  Now I do.  A good coffeehouse has just enough background activity that you have to focus to work… but not so much that it is distracting.  You are also protected from the day to day distractions of your office or home.  One of the great secondary gains of my month was learning about the great coffeehouses and teahouses in Houston!

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From Pre-Med to Med: Making the Transition to Medical School

Making the transition from college to medical school is one of the biggest academic “leaps” a student can make.  I was recently asked to address the Texas Association of Advisors for the Health Professions on how to best advise students getting ready to start medical school.

There are more details in the slides I presented (Here’s a link to the slides:Transition to medical school), but the following are the “top ten” pieces of advice I passed on during my lecture:

1.  Arrive a week early (at least).  It’s important to build in time to move into your new home and make it a space you enjoy.  Make sure your electricity and cable are working.  Meet your neighbors, find a gym, stock your kitchen with healthy food.  It’s tempting to stay with your family (or add to your trip to Europe), but don’t – the time you spend getting ready to start medical is time well invested.

2. Buy a good computer (and the appropriate software).  Check on line to see if your school has specific requirements and make sure you meet them.  You’ll want a laptop, not a desk computer – you’ll be taking notes in class and carrying your computer around to study.  You’ll also be taking National Board exams on your own computer.  Most medical students at Baylor organize their notes with One Note (PC) or Growly (Apple).  You might want to buy the software and get used to it before you start.

3. Set up your study space before the first day of class.  You’ll be studying hard from the first day, so don’t put this off.  Most students buy two monitors and hook their laptop to the monitors to study (usually with a supplemental keyboard and mouse, but this is optional). Buy a really good chair for your desk.  If you listen to music while you study, invest in good speakers for your computer.  Keep your desk organized. Put some reminders on your desk of why you are doing this for the times it’s not so easy.  Consider a standing, walking or biking desk for your primary desk – or as a alternate desk.

4. Learn about active study skills and apply them from day one. Your study style in medical school will be different than what you used in college.  You have to learn all the material, as in really learn it.  It all builds on itself, so you can’t skip parts that aren’t interesting.  You’ll never cram for another test in your life – it’s all about learning, reviewing and repeating.  To get ready, learn about methods like the SQR3 method of studying as well as other systems.

5. Go to class (and be really present).  Unlike college you’ll need to use class time as active learning time.  Review the notes before the lecture and make notes during class.  Ask for clarification during class.  Most medical schools record the lectures as streaming video so you can review them later.  It might be tempting to skip going to class but don’t.  It’s easier to stay actively engaged if you are in class.  You’ll be able to ask questions about the things you don’t understand.  And, most importantly, if you don’t go to class you’ll miss out on the social benefits of being with your classmates.

6. Start with studying 1 hour for every hour of class.  Adjust up if needed.  The amount of material you cover in a semester of medical school is the equivalent of 30+ hours of undergraduate courses.  Medical school as a 60 hour a week job.  Schedule your “work” on a calendar to make sure you make your 60 hours.  When you tackle your hours of studying, use “study reps” – 45-50 minutes of all out studying followed by 10-15 minutes of absolutely no studying.

7. Exercise at least 30 minutes every day.  The real goal should be an hour a day, but the minimum should be 30 minutes.  You can “multitask” by riding your bike or walking to school.  Daily exercise is a great way to decrease stress, help prevent future work related injury and prevent the medical school equivalent of the “freshman 10”.

8. Plan your day so you can sleep 8 hours a night.  No sleep = poor synapse formation.  Poor synapse formation = no learning.  It’s that simple.  Don’t believe yourself or anyone else who says they “don’t need” 8 hours of sleep.  It’s just not true.

9. Eat real food.  Good fuel is necessary for your brain to make the synapses that are necessary for learning.  Eat well and often enough (every 4-6 hours) to keep you blood glucose stable.  Shop on the outside of the store (where they real food is) and learn to cook!  If you don’t cook, at least make conscious choices to buy prepared food that is healthy.

10. Make friends and work to maintain those friendships.  Social connections are one of the strongest antidotes to the stress of medical school.  Make friends among your classmates (because they really understand what you are going through) and maintain your friendships out of medical school (for the perspective they will give you).  Your significant other is your most important friend – so pay special attention to the time and effort you put in to supporting him/her.