Physicians, Learn to ‘Self-Round’

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I always think of the beginning of July as the New Year in medicine. It’s when medical students become interns, interns become residents, and residents become newly minted attendings. With each change is an increase in responsibility.

I remember paying even more attention to the history and physical each time I crossed that threshold, with an increased sense of purpose and responsibility. This was true in the office, during admissions to the hospital, and during rounding.

Back when I was in training, we always rounded a minimum of twice a day — usually in the morning to find out about the night and to discuss the plan for the day, and then at night, to check in to see what happened during the day and set up the next day. How did medications or treatments affect my patients? What test results were there to review? In practice, I more commonly rounded once a day, but some patients still needed twice daily or more, depending on their medical condition, personality, and family.

Now with the start of the new medical year, I’d like to suggest that you add a new type of rounding to your routines. You already know about multiple types of rounding. There are patient rounds, resident rounds, and attending rounds. Some services require pre-rounds, others allow GI rounds, and some just do list rounds at the end of the day.

The new type of rounding is called “self-rounding.” Or, as Joey Tribbiani would say, “How you doin’?”

One of the very first steps in coaching is generating awareness. You can’t change what you don’t know. You can’t change unless you know why a change is necessary and desirable.

Most of us in medicine (and elsewhere) have spent a lifetime putting the needs of others ahead of our own. And we put our self-worth into how well we address the needs of others. Before we can address our own needs, we need to become aware of what they are because we’ve also spent a lifetime unaware of them. We’ve been focused on our tasks of tending to others, while ignoring our own needs as irrelevant or something that just has to wait.

Self-rounding is how you build awareness. A chance to check in. How did you sleep? What are your vital signs? How is your day starting off or going? How do you feel mentally, emotionally, and physically? Are you cognizant of your goals for today and how your values inform them? What about the long term? Are you getting enough social interaction? How do your usual environments affect you?

And now that you’ve asked the questions, you know what’s next — the assessment and plan. Assess where you are. Make a plan for what is well supported in your work and life, and what needs to change. Write yourself some orders on how to change your day, a prescription to see friends, to go outside, or to just be.

Victoria Silas, MD, is an orthopedic surgeon and physician coach. She can be reached at Medical Minds Consulting.

This post appeared on KevinMD.

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