Re-Earning Your Rad Work Ethic and Reputation

We recently had a little blizzard in my neck of the woods. If you pay attention to the media at all, you surely heard about it. There is no such thing as regular weather anymore. Every system gets a name to go with the dire predictions of doom from forecasters. They try outdoing one another with scary-sounding terms like “bomb cyclone,” etc.

My long, sloping driveway got buried under an abundance of snow. While I had a call into my landscaper/plow guy just in case, I was able to indulge my preference: clearing the stuff with my own two hands and a couple of tools. I do this partially out of pragmatism as it saves me a few hundred bucks and there is no telling when (or sometimes if) the plows will show up. Also, even though I do have a functioning treadmill, I prefer to get my exercise outside.

Another motivation, however, is a sense of “earning” my driveway by clearing it myself. Directly maintaining the driveway feels like I’m applying a fresh coat of spiritual paint to my ownership of it.

It’s not just the driveway. Every spring, I re-earn my backyard with various tasks to ready it for warm weather. The grill is a particularly messy affair but disassembling and cleaning each part by hand brings a satisfying sense of renewed ownership. It is the same deal when I have company coming and prep by taking out and hand-washing the fine china.

How and when I developed this attitude is a mystery to me. Perhaps it was an adaptive response to otherwise joyless chores that I had to do anyway. It casts them in a positive light to the point where I may approach them less grudgingly, if not eagerly.

It also occurred to me that there’s another adaptive value to periodically, if not routinely, re-earning what I own. It keeps me mindful of the impermanent nature of ownership: There was a time that I didn’t have X, and there may come a time when I no longer do. The less I take my ownership for granted and consider X a part of myself, the less its loss will feel like an amputation.

Instead, if X mattered to me, I’ll be more apt to earn it again (or a suitable replacement, perhaps even an upgrade). Eschewing the mindset of a has-been champion who has gone to seed and is resting on his laurels, I can still contend. I believe this contender mindset is not only good for retaining or regaining my current holdings, it keeps me capable of achieving new heights.

The repair/replacement value of a grill or a set of dishes pales in comparison to what most radiologists can re-earn professionally. Probably the most common example I can think of is a rad who has gotten a little too comfortable in his or her job. When someone spends a few too many years in a safe, cushy gig with guaranteed salary and little incentive for productivity, he or she might start thinking of those paychecks as a given, an entitlement.

Next thing you know, there’s a contraction in the job market, a harsh cut in reimbursements, or some other major tightening of belts across the field. A rad who has fallen out of the habit of re-earning his keep, of demonstrating just as much value today as he or she did years ago when the rad first landed the gig, might be first in line for a compensation haircut. Worse, the rad might lose the job entirely, and have to rediscover his or her work ethic at the same time he or she is scrambling for a new job.

This isn’t limited to employees. A rad who owns his or her own operation (or multiple rads sharing ownership) risks similar misfortune by getting a little too comfortable with already acquired coverage contracts and/or referral network. Stop re-earning the business and they might unpleasantly surprise you by turning to other rads. Further, if you and your people aren’t demonstrating that you’re hungry for the business you already receive, you’re less likely to bring new stuff in the door.

I think physicians, radiologists included, are particularly at risk for such complacency. It takes a lot of time and effort to get into our field. Many of us make a fair amount of sacrifices in our third decade on the planet while we watch our friends living their lives with greater enjoyment of their twenties. Even once we have “arrived,” we often work tougher, more stressful hours.

All of this may result in a grim, determined “I’ve earned what I have, and it’s perpetually mine by right” attitude, resistant to the idea of yet more earning to be done. Further, the health-care system often throws mandatory re-earning at us via CME requirements, maintenance of certification programs, etc. It’s easy to feel like doing all that stuff, plus showing up for work and going through the motions should be enough.

A status quo of insufficient re-earning can develop stealthily. The absence of something is often harder to detect than its presence. Rads accustomed to scrutinizing complex imaging to “rule out” this and that are probably more aware of this than most.

I have found it helpful to periodically check myself for excessively flying on autopilot, particularly in my professional life. I like to know that I have more than occasional moments when I am 100 percent consciously invested in what I’m doing as opposed to diffusing my efforts with multitasking, or even daydreaming.

That goes for everything I do as a rad, whether it is screening lung nodules, interacting with other members of my rad group (in meetings or curbside consults) or troubleshooting with techs. If I’m giving total focus to my work with a robust consistency, I can be confident that I’m earning my place there.