Shirley M. Mueller, M.D.

Before I retired from medicine, I was showing signs of burnout and did not know it. All I knew was that I was miserable. 

The morning started out fine. By one or two, however, I was ready to flee. My thought was always the same—get in my car and drive West. What I imagined was that seeing the open countryside would make me feel free of all responsibility. At that moment, and, that time in my life, it was a welcome thought.

Well, that drive into the sunset never happened. After trying to scale down my practice, I was still in pain. As every practitioner knows, it is difficult to support staff while deliberately seeing fewer patients to save one’s own soul. I retired.

What might have spared me was not available then. But, fortunately for the medical profession, it is now. Enter Dr. Jed Brewer M.D, Ph.D., a neuroscientist, and psychiatrist, who transforms recent research findings into programs to treat addictions and burnout. Since Dr. Brewer is a physician himself, he is particularly sensitive to the plight of the medical profession, who now are not only under the usual pressures, but those of COVID as well. 

Dr. Brewer calls himself Dr. Jud, I assume to make himself more accessible. And, that he is, with his exceedingly calm demeaner and easy to understand instruction. 

His main message is that we humans are responsive to triggers which lead to an action that, in turn, precedes a reward. In its simplest terms, this is hunger (trigger), eat food (action), satisfaction and pleasure (reward). 

Of course, a nurse or physician’s response to a patient who is suffering is more complicated. When the medical caregiver identifies with the suffering herself (empathy), she hurts as well. This leads to burnout. Dr. Brewer refers to this as learned helplessness on the part of the medical caregivers.

On the other hand, he says that a different response to the same patient’s suffering can benefit both the medical professional and the patient. Instead of focusing on empathy, she places her energy into compassion. Then, even if the suffering on the part of the patient continues, she can feel as though she is contributing in the most effective way she can without a side effect of burnout or learned helplessness. She is not living the suffering, but a partner in obviating it.

Now, for a word about the difference between empathy and compassion, two words with similar but different meanings that can easily be confused. 

Empathy suggests that the caregiver relates to another person’s pain vicariously, as though she is experiencing that pain herself. Compassion, on the other hand, refers to both an understanding of another’s pain and the desire to somehow mitigate it—a broader definition.

Dr. Brewer tells this story in his elegant way in videos which, at the present, can be accessed free of charge by the medical profession. The advantage is that watching them takes little time and there really is nothing to lose except an hour or so. Please see them for a deeper understanding which Dr. Jud explains far better than me. 

Module 4: How mindfulness decreases clinician burnout and builds resilience

Module 5: How to move from empathy fatigue to compassionate action (and build resilience)

Putting Dr. Jud’s Program in Perspective

In the past, I recommended making art and appreciating art as a relief from the intensity of the medical profession, i.e. combating burnout. That series, 

, chronicled four M.D.s who found relief and joy outside of their practices through collecting art, taking photographs, making sculptures, and painting. 

Dr. Brewer’s approach, to me, is different. He wants to nip stress-related burnout in the bud by teaching those who are vulnerable to understand it better so that their response to it is healthier right from the get-go. In this way, there may be fewer cases to begin with—a victory not only for those in medicine, but their patients as well.

The views expressed in this piece are those of the author, not necessarily those of the publication.

Inside the Head of a Collector: Neuropsychological Forces at Play

Articles

As every practitioner knows, it is difficult to support staff while deliberately seeing fewer patients to save one’s own soul. 

Stress and Burnout:  A New Approach

A few months ago, an investment banker in New York City told me he believed the U.S. was in a state of stagflation. “There is less choice now than before,” he said. Though his explanation sounded strange, it got me thinking.  

The traditional definition of stagflation is slow economic growth, accompanied by high unemployment and rising prices -- definitely consistent with our current economic situation. The U.S. economic-growth rate was recently cut to 2.6% from 3.3%. The unemployment rate remains at a relatively high 9.6%. Rising gas and food prices can be seen everywhere. Yet no one is talking about the big “S” (stagflation).

One reason might be that concept of stagflation is so upsetting that few want to acknowledge it. Those who lived through the 1970s can likely attest. Back then, unemployment was high and inflation raged, climbing to 13.3% by 1979. Gold and oil prices soared, while the dollar weakened against foreign currencies. The stock market was flat. 

If we are indeed seeing a return to 1970s-style stagflation, what can an investor do about it? Here are five ways to shore up your finances:

 Pay off any creditors that aren’t charging a fixed low interest rate. Interest rates on credit lines of the flexible variety may skyrocket in the near future, so it’s better to pay down your debt while rates are still relatively low.  

 (TIPS). The value of TIPS rise with inflation and decline with deflation, as measured by the 

. When a TIPS bond matures, the investor is paid the adjusted principal or original principal, whichever is greater. The bonds generate interest twice a year at a fixed rate, which is determined at auction.

 It is essential to stay in the stock market, since stocks historically have outperformed bonds. Dividend-generating stocks, or exchange-traded funds, or mutual funds are a plus in an atmosphere of stagflation, since you get an income while waiting for prices to rise. (Of course, it’s most important to ensure your stock portfolio is properly diversified.)

 Now is not the time to be loading up on “alternative” investments, such as minerals (gold, silver and platinum) and real estate. The latter includes physical property or real estate investment trusts (REITs). While real estate and REITs historically perform well over time, short-term performance can be dicey and real estate’s carrying cost may turn out to be exorbitant over the number of years it will take the flooded housing market to work itself out. As for gold, which is breaking records every day, some are 

 Having a sufficient amount of emergency savings in cash investments, such as CDs, high-yield savings accounts and money-market accounts, is critical in a stagflation economy. Stick with shorter-term CDs — you don’t want to get locked into today’s rock-bottom yields when interest rates start climbing.

Slowing economic growth, high unemployment, rising gas and food prices -- are we seeing a return to 1970s-style "stagflation"? If so, the next few years could be bumpy. Here what investors can do to protect themselves.

Five Ways to Protect Your Assets from "Stagflation"

It may not be as philosophical aquestion as Hamlet posed, butthe "to hire or not to hire a financialadvisor" question still requiresthe same prompt attentionâ€”especiallyif you're in need of financial help.Like other interested physician-investors,you're probably plagued bythe same doubt: Will a financial advisorreally help me or will they just bea waste of good money?

Unfortunately, the articles that arewritten about this subject tend to beboth dry and unhelpful. In addition,authors generally insist that anyonewith a credential (eg, CFP&#174;) will produceresults, which is not necessarilythe case. So then, just what shouldyou look for once you've decided tohire a financial planner? There are 2essential criteria your potential advisorshould meet.

First, your advisor's practiceshould offer full servicesâ€”beyondmoney management. Your advisorshould also instruct you on investmentplanning, trust and estate planning,charitable giving strategies, andwealth transfer strategies. If you'reconsidering an advisor in a largerfirm, check to see whether they offerbanking and family services.

When your advisor's practiceoffers full services, you benefit in 2ways. You won't have to shoparound for other financial services.All of your financial needs will betaken care of by your advisor. Inaddition, these needs will be takencare of by 1 practice, which willlikely make your total cost less.

Second, the practice that youradvisor belongs to should be large.Practice size is important because alarge practice ensures continuity inthe unfortunate case that somethinghappens to your advisor. For example,if your advisor leaves the firm ordies, you won't have to find areplacementâ€”saving both yourtime and your sanity.

If your chosen advisor meets thesecriteria, most likely you'll be workingwith Certified Financial Planner™practitioners, lawyers, trained investmentplanning specialists, and a hostof other professionals. Choosing theright firm means you won't have toworry about degrees, because thefirm already did the footwork for you.

Additionally, you'll be treated as awhole person. Your advisor won't payattention to only a portion of yourfinancial needsâ€”they'll keep all ofyour financial needs in mind.Therefore, your money managementwill be done in unison with otherfinancial factors in your life.

So, in your search for a qualifiedfinancial advisor, it's a good idea tokeep in mind 3 things: You deserve tobe respected, provided excellent service,and treated as a whole person.When you find someone who meetsthese requirements, you will knowthat you are making the right decisionâ€”and reap the benefits. 

 is boarded inneurology and psychiatry. Shewas a practicing neurologistuntil 1995. Since then, she hasretrained and is active in theinvestment and financial planningarea. Dr. Mueller is a senior wealthadvisor at Star Wealth Management in Indianapolis,Ind. She welcomes questions orcomments at MyMoneyMD@aol.com.

Don't Let Luck Lead Your Advisor Search

A few days ago, I had lunch with a physician-investorinterested in transferring his assets.In our discussion, he brought up someknowledgeable points that seemed to indicate hisgood judgment. However, while discussing his previousinvestment experiences throughout the years,he made a few statements that inspired adifferent opinion. As I finished off thelast of my lunch, I couldn't help butreflect on a common investing qualityassociated with poor judgment or shakethe feeling that I was staring across thetable at one of its victims.

Throughout our conversation, thephysician frequently discussed how wellhe had done in the past. He explainedto me in detail how he had made greatgains in the late '90s and how he hadcashed out of specific investments early.In his mind, this physician-investor hadsuccessfully managed to guide his portfolioto victory. And, obviously, hehad—reaching the top of his game andwinning in the market.

So, what's wrong with sharinginvestor war stories over lunch, especially whenthey're happy? Usually nothing. Most investorsenjoy patting their own backs every now and then,especially when it's well deserved. However, duringthis particular conversation, it wasn't so muchwhat my lunch partner said; it was what he didn'tsay. And that's what inspired my reflection on theterm "cognitive dissonance," which, unfortunately,seemed to have taken my physician-investorcolleague out to lunch.

Cognitive dissonance is a fancy psychologicalterm that means your brain ignores or lessens negativeinformation and fixates on the positive.Evidently, the brain does this to preserve our self-image;it's a protective strategy. To endure the realityof some of our poor decisions would cause toomuch pain. Therefore, we ignore negative evidenceor attenuate it by not recognizing thewhole truth. And although I didn'tknow my lunch partner that well, itseemed obvious to me that he dabbledheavily in cognitive dissonance.

While cognitive dissonance may notlead to eventual financial demise, lack ofrecognition can influence our decisionprocesses adversely. First, we may notmake necessary decisions because it istoo uncomfortable to contemplate facingunfavorable results. For example, wemay not keep accurate documentationof our investment results so that wedon't have to face the possibility of apoor outcome. Unfortunately, this typeof behavior can spell trouble forinvestors. Knowing our results usuallyhelps us invest better in the future.

In addition, we tend to sift through new informationto accommodate our beliefs that our previousdecisions were better than they really were. Inother words, we change our beliefs to suit our self-imageand not the facts. To illustrate this commonconsequence, a group of architects was asked toestimate the return in their pension plans the previousyear. They recalled their investment performanceas 6% higher than the actual return.Furthermore, they estimated that they had beatenthe market by 5% more than they actually had.Other studies have been performed with educatedinvestors, and the results have been similar.

So what does cognitive dissonance have to dowith you? Hopefully nothing. However, beingaware is the key to resistance. And although it ishuman to yield to cognitive dissonance, it is literallydivine to resist it. This means that objective figuresare necessary in terms of your investment performance.Not only do you need to know how wellyour portfolio performed in reference to its appropriatebenchmark, but you also need to know itsrisk-adjusted return. This is because the risk-adjustedreturn tells you if you are being compensatedin terms of return for the risk you're taking.

How do you find this data? Most of the time it'sdifficult, unless your investment advisor keeps trackof it for you and provides you with the informationregularly. This is 1 advantage of a good investmentadvisor. Ask them for this data if you're currentlyworking with one. It's much easier than trying tofind the data yourself. However, if you don't havean advisor and are interested in doing the legworkrequired, there are some useful Web sites you canvisit (see the sidebar for more information). By takingthe time to know objective results about yourinvestment performance, you don't have to accommodateyour beliefs about it. Ultimately, this canonly lead to better investment results for you. 

www.finportfolio.com/education/tutorial/tutorial_risk-adjusted_return.html

Information on the Sharpe ratio, which measures

www.investopedia.com/terms/s/sharperatio.asp

A Web site that offers risk-adjusted return on