Month: August 2020

What is it about the last weekend of vacation?

What is it about the bittersweet last weekend of vacation? I find that it seems to drive most of us crazy. Instead of soaking it up and metaphorically holding on with both hands, we begin to think forward about all the things we put on the back burner, fretting about what’s ahead. Insidiously conversations get more tense and work creeps back in before the deadline. That last bit of precious time becomes wasted. The cellphones turn back on, the computers get fired up? Why? How can we avoid it? This phenomenon is so common that even the Today Show has done segments on the end-of-vacation-blues and the Sunday Scaries.

So again I ask, how can we avoid the blues? There are some tips out there. For example, travel psychologist Scott Haas says that we need to step back and consider ourselves lucky that we got to take a vacation in the first place. Did you know that half of Americams don’t even use all their vacation days, if they even get some in the first place?

In the Personal and Social Psychology Bulletin, University of Chicago psychology fellow Amit Kumar and Cornell professor Thomas Gilovich recommend that you focus on experiential purchases rather than souvenirs while on vacation. By purchase they don’t necessarily mean spend physical money but rather the investment of time in doing something unique that gives you something with interesting details to share. You will probably have a lot more to talk about after a hiking trip in the mountains as opposed to a pendant or t shirt that you bought.

Another tip is to start planning your next trip. That doesn’t mean discount everything that you just did on vacation. It just means start making a straight forward list for your next trip to help it become a reality and something else to look forward to. There is something called the Zeigarnik Effect that refers to our tendency to remember incomplete tasks more clearly than ones we have finished. Translate that to trip planning and if you have thoroughly planned your next trip it may free your mind from the intrusive “what’s left undone” thoughts that can plague you toward the end of vacation and actually help allow you to enjoy the last few days. That can even apply to tackling your untouched email inbox without guilt while you are on the flight home so you can relax when you get there before work the next day.

USA Today suggests that you nurse that post vacation culture shock. Instead of asking yourself why am I in boring old (insert hometown here) instead of exciting ( insert exotic vacation local here), remind yourself why you moved to your hometown in the first place. Remember why you love it. Reminisce over good memories.

There are a few things you just have to get off your butt and do when you get home: unpack your bags, do your laundry and grocery shop for heaven’s sake. Those suitcases and mountains of dirty laundry will only serve as monkeys on your back and feed your longing to be somewhere else. Grocery shop for healthy food to detox your body from vacation food. It will thank you for it and leave you with more energy to face your new old schedule.

Currently I find myself facing the end of a vacation. I am following my own advice by writing of this blog as an example of finishing a to do list to free my mind to enjoy my last bit of time. I am also reminding myself how much I love my family, my animals and my memories. So far, it’s working. I hope these tips help you too. Have a fantastic day.

Dr. Katz

I have a hard time turning it off

Word Writing Text Private Practice. Business Concept For Work ...

So, I am sitting here right now, trying to relax. I am supposed to be on vacation and yet my mind is spinning with thoughts about my business. Are my patients going to be okay? Will my colleagues care for them like I would? Are any bills going to be late? Did we tie up all the loose ends before we left? Will there be any money in the bank when we come back? Is there anything I forgot? Will all my followers move on when I don’t post for a week? Will I miss any job applications? Will I miss a deadline I didn’t know I had while I am gone? It just goes on and on.

I guess that that is the life I signed up for. You are never truly “off” …..at least, not if you are really in it to win it. It is the compromise that you strike the second you sign on the dotted line to commit to a private practice sans safety net type of scenario. I have no set hours or guaranteed salary. However, I am at least philosophically the master of my own destiny. In reality, my success also depends on a number of third parties like insurances, reimbursements, billing companies, vendors, and employee work ethics. So, I am kidding myself if I think that I alone can guarantee or swamp my career.

I am not a 9 to 5 type of physician and I never wanted to be. I look all around me and see the significant disincentive to starting private practice. Medical school graduates now seemed to be groomed to think that private practice is impossible and that they NEED the backing of a large conglomerate, set hours, employed practice in order to even entertain the possibility of being a physician. It’s a shame really. What these new docs have traded for this implied security is stamina, work ethic, commitment, and dedication. To be 100% transparent, this is only my opinion based upon what I have observed all around me with the newest generation of doctors. I am not trying to be some hard core, stone age dinosaur, but I have literally seen resident physicians turn away mid conversation about a patient if that conversation was occurring when their shift was over. That is just not what I want, nor do I feel that that is appropriate. That is going too far in the 9 to 5 direction. We are not office workers. We are responsible for lives.

The private physician is slowly but surely going the way of the dodo and being replaced by shift workers with set hours and volume driven goals at the expense of quality. For me, the world does not stop the second that the office phones get turned off. My responsibilities are not just handed off to the next guy. That is not my reality and that is OK. I am not saying that I never need a break because, in fact, I do. I really do sometimes. It’s just that I am not going to spend time whining about the inconvenience when I chose to have it this way. It would be kind of ridiculous. Now, having said that, I am sure that my family would not agree that I should always be on. It definitely goes against that eternal quest for balance that I am always talking about. Yes, yes, I do actually listen to myself when I am attempting to espouse wisdom to the masses. I guess what I really saying is that I still just need to work on it.

Dr. Katz

Once a manipulator, always a manipulator

There are manipulators everywhere. I am pretty sure all of us have fallen victim to their wiles at one point or another. Depending on the skill of the manipulator, the process may be so sly and so subtle that you don’t even realize that it is happening until it is too late. I personally have been on the receiving end of countless manipulations over the years. After doing a lot of research and reading, plus a side dose of life experience, I have realized a few things about manipulators that are the key to foiling their efforts and getting your life back.

First, you have to recognize a manipulator. A manipulator is a person who uses other people to seize power, influence outcomes, create scapegoats, gain control in relationships and reap the benefits of the work of others. These individuals use a lot of different tricks to accomplish these goals: deceit, guilt, false hope and last but not least, lies.

Second, master manipulators can twist any situation in their favor. They are very skilled at making you talk more about you than themselves. This is a how they gain information about you and use it to exploit potential weaknesses. They feign supreme interest in order to gain your confidence and learn all your inner most secrets. They may be genuinely interested in you, but not for the reasons you think. Their interest and your information reveals may ultimately be your undoing. Turn those questions around and ask them probing questions instead. This is like putting a deflector shield up and may result in the manipulator backing down.

Third, a manipulator is always two-faced. He or she acts differently to different people in different situations. Beware of the person that is smiling and chatting with a person one second and then talking about them to another person the next.

Fourth, a manipulator will always try to make you feel guilty for standing up for yourself and what you believe in. Anyone that tries to make you feel bad for expressing your opinion or maintaining your ground is trouble. It is said that belief can be manipulated while knowledge is truly dangerous. Knowing yourself and your boundaries and your beliefs makes you less vulnerable to someone’s efforts to put you down and undermind you.

Fifth, a manipulator’s actions never meet their words. They may tell you what you want to hear but their actions spell out something completely different. They promise to support you but fail on the follow through. They compliment you and tell you how amazing it is to be with you, but then turn around and act like it’s the biggest cross to bear in the world. This is just one more way that they attempt to mold your perception of reality of the world around you to one that works in their favor.

Sixth, a manipulator will always play the victim in every situation. They are experts at pointing the finger in every other direction but toward them. They blame everyone else for everything. They take no accountability. Nothing is their fault.

Last, they are all about intensity. Everything is too much too soon. They pretend to reveal everything right away and expect you to do the same. They pretend to be vulnerable so that you will be flattered because they “let you in.” It is all part of the plot though to make you feel sorry for them and to make you completely responsible for their feelings, regardless of what they are actually based on.

All of these attributes are important to spot, but once you do, now what? Use this awareness to maintain emotional distance from the manipulator. Refuse to participate in their guilt traps. Control the chaos. Don’t get sucked into it. Delay your responses to situations rather than offering instant gratification to the manipulator.

In the most serious cases, these manipulative relationships can progress into violence. This is a situation in which outside intervention is often needed because the victim has been so conditioned to think the interactions are normal that they cannot see their way out of it. This is where national hotlines come in.

The bottom line is, when it comes to manipulators, you need to trust your instincts. If your gut is telling you that something is off about the relationship, reassess and break away. Don’t let the worry and self doubt that they have carefully implanted in your mind take over. You have nothing to gain and everything to lose by staying in the relationship. Extricate yourself while you can.

Dr. Katz

Self Care is Tricky

Woman Doing Yoga Inside A Room

Self care has many definitions. In health care, self care most closely aligns with preventative medicine, the care of one’s own body and adherence to medical advice. It is also considered a primary form of care for patients with chronic medical conditions who have to make many day-to-day decisions or self-manage their illnesses. In terms of philosophy, self-care refers to the care and cultivation of self in the most comprehensive sense in terms of one’s soul and self-awareness. Instead of taking care of one’s body, it focuses more on caring for one’s mental health, soul, and emotions.

Okay, so both of those sound good don’t they? Take care of your physical and mental health. Sign me up. So then, I ask you, why is it so difficult to see to fruition? Somehow, the concept of self-care in our day and age has acquired a negative connotation. Somehow the idea of self-care has become synonymous with selfishness and therefore imbued with a sense of guilt that we have difficulty shaking off. Why? They are absolutely not the same thing.

Kenya Foy outlines 6 important differences between self care and selfishness. I am going to focus on four of them. 1) Self care has far reaching benefits for yourself and everyone in your life. If you have taken the time to care for yourself, you reap the emotional and physical benefits and so does everyone around you as they benefit from your energy, your positivity and your productivity. 2) Self care is not done with an intent to harm others. To be selfish is to behave in a self-serving manner with an underlying malicious intent. There is a desire to actually take from others which may result in harm. Self care is all about replenishing your own resources without taking anything from anyone else. 3) Being selfish prevents you from giving of yourself while self care makes it possible. If you go around with a “me first only” attitude then you have absolutely no room for consideration of others. If you practice self care, you end up setting boundaries for yourself that actually leave some room and some energy left to focus on others if necessary. 4) Self care builds strength. Once you give yourself permission to shower yourself with love, you gain security which allows you to make better decisions for the world around you. Selfishness has an inherent insecurity that weighs down everything that you think and do.

Are you convinced yet that self care is the way to go? I think I am. As a matter of fact, I think I hear my bubble bath waiting before I head off to my meeting. Have a fantastic day everyone.

Dr. Katz

What are the real costs of no show appointments?

There is nothing a doctor’s office hates more than no shows. Let’s define a no show. A no show, like it sounds, happens when a client or patient misses an appointment without calling and notifying the office at least 24 hours ahead of time.

Doesn’t sound like much of a big deal right? One missed appointment…life goes on….no one gets hurt and it costs nothing…..Wrong! That is the wrong way to look at it. There are actually multiple costs associated with this undesirable scenario. The first and most important cost is to the patient. The patient misses out on getting the treatment that they need and the attention that they deserve. The second cost is to the office. Every appointment slot costs money in salaries, staff time, and supplies. When a patient does not show up, all those resources go to waste if we don’t have the opportunity to re-book that slot. This brings me to the third cost. This cost goes to the patient that didn’t have the opportunity to get an appointment because the slots were already filled, or so we thought. So, in one small and fairly inconsiderate swoop, multiple people are affected.

Sadly, I think that most patients do not even stop to consider any of these costs, until they get notified that they will be charged a small no show fee of 25 dollars, which doesn’t even come close to what the office has already spent. We aren’t even allowed to charge it to all insurances. Then it’s all hands on deck. The tables are turned quickly. The no show patient becomes an instant victim in their own mind. They become irate and refuse to pay it. Righteous indignation rears it’s ugly head. They yell and scream at the staff regarding the unfairness of the situation. Sometimes they even threaten to never come back, as if that will really teach us a lesson and discourage us from ever holding them accountable for anything. I regret to say, it won’t work. We are just going to keep on charging no show fees and attempting to hold patients accountable. We are still going to try to make ourselves available to as many patients as we can and plan ahead to make each visit as fruitful as possible, as if every patient is just as invested in their health as we are. Have a great day everyone.

Dr. Katz