The ‘more or less’ model of not-New-Year’s resolutions for busy MDs

We've heard it before:Lose 50 lbs (minimum) in 6 months maximum Dry January then 2 drinks maximum on weekend days only for rest of yearExercise 1 hour a day – 8 days a week to start, relax to 7 days a week when goal 1. listed above is reachedNo desserts, no junk food, no pop (diet included) ever again!No meals after 8 pm Get 8 or more hours of sleep every night (no exceptions) Limit social media screen time to less than 30 minutes a day Every year our patients do it and probably many of us also. The New Year’s Resolution. The ultimatum for the upcoming year, chiselled out in stone. Serious. Monumental. Always life changing!Usually by the end of January, if we even last that long, we have all but given up these big goals and settled for something much less illustrious, if anything at all. Just like the Maple Leafs—we end up muttering to ourselves, “there is always next year.” Patients ask us for advice. They demand “medical clearance” to embark on elaborate plans of self-flagellation. They tell us what they are going to do, whether we agree or not. You might have heard variations of these themes: “Can I have a stress test to ensure my heart is OK to start training for two iron-man triathlons this year?”“Do you think losing 10 lbs a week is too much?”“Will you monitor my 16/8 fasting plan? – That’s 16 days fasting alternating with 8 days of food.” “Have you heard of the raw-food-Keto-Caveman diet? I’ve just bought the plan and want my doctor to know that I am ALL IN!” Why do our patients do this? Why do we secretly also buy into this madness in our own lives? What is wrong with all of us??The truth is, we’re human and easily enticed by the glamour of absolutes, easily manipulated by social media and advertising and suckers for believing we can change our lives if we just set a lofty goal and put in a solid effort. The problem is that the goals are generally unattainable and the effort needed is unsustainable. And more so, the plan can be dangerous to our overall wellbeing. Not only does it back-fire but sometimes the “rebound” is worse than where we started. The one step forward, two steps back is manifest in an unmaintainable 10 kilo loss bouncing into a 20 kilo easily kept gain. So if the ill-fated New Year’s resolution is a recipe for disaster, what is the solution? What is the key for busy physicians? Is it making SMART goals? Here’s my version . . . The pragmatist’s MORE or LESS model of “Not-New-Year’s” Resolutions for busy MDs.There are 5 simple rulesThis model can only start after the 2nd week of January (trust me on this one)ABSOLUTELY NO ABSOLUTES (oops) Must revisit the list at least once a month—preferably mid-month You get unlimited mulligans (for all the non-golfers, you get to start again as if no one saw you miss the shot i.e. slip, fall off the wagon, miss the mark, F-UP)You cannot eliminate anything on the list for a full year; if it was important in January, it will still be important in DecemberWhat would this look like in the real world? Here’s a sample list. This year I will try to have LESS Food (especially carbs)Fast Food/Junk food especiallyAlcoholHours in the clinic/hospitalStressScreen time (work and leisure)Sitting on my assAnd/or This year I will try to have MORESleep ExerciseFamily timeTime off workVacations Time for me – doing anything I love doingGrocery shopping/home-made meals/whole foods/fruits and vegetables / fiber (sure you can use a SMART goal of three servings of XYZ a day) That’s it, relatively speaking. Can it be accomplished? For sure. There is a commitment, but a misstep doesn’t mean you throw it all away. You have to persist with the premise, dust yourself off if need be and just do more/less moving forward. Incremental, small adjustments. But the naysayers will chirp that nothing will ever be accomplished with this slacker’s lackadaisical approach. Well . . . maybe they are right. But busy MDs will be a lot happier and will feel that they have succeeded if only modestly. There is joy in accomplishment. Setting hard goals means being disappointed a lot of times. Soften it up and everyone is a winner! Think chronic disease management, not a lot of big wins, but hopefully several small ones. We celebrate when our patient/s HBA1C drops 0.1%. So why can’t we be elated when we sleep an extra hour or take an additional day on our vacation. Sometimes this is as good as it gets!! May 2024 be a better year, more or less. Sometimes not so SMART is clever enough to succeed! Dr. Ted Jablonski is a performing artist and writer who has retired his family practice to focus on sexual medicine and transgender health in Southern Alberta with two feet still on the front-line trenches of acute primary care.

The ‘more or less’ model of not-New-Year’s resolutions for busy MDs

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Ted Jablonski

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