In Sonia's final article on the top skills for general practice, we learn how to handle inevitable change.

GPs are often bombarded with both overt and subliminal messages to carry on, keep on achieving, keep on working (often well beyond what is sustainable for the individual longer term) and generally not give up. The mortgage and other living costs reinforce this of course.

There is, unfortunately, a culture in medicine where it seems to be regarded as some sort of failure to let go. Yet there must be a balance between carrying on and letting go, and this is applicable to life as a whole.

Hopefully this ‘hang on/let go’ issue is acknowledged fully at end of life palliative care, and a balance achieved. This is between making a person comfortable and being proactive (the latter of which may be damaging to difficult family interactions). This is never an easy canyon to straddle, but an important one to be aware of.

So as part of reaching a good work-life balance for your own unique situation, this hang on/let go balancing act is an important, nay vital, skill at which to become adept.
Yet in our own careers, GPs often do not know when to let go of something. The sort of personal or work-related things which might need to be “let go”, and where doing so can facilitate a more in-balance working life, include letting go of:

  • a career dream
  • a post or partnership
  • general practice completely for another clinical route
  • general practice for another career altogether
  • assumptions about what work could be
  • the shoulds we all harbour regarding “work” ( and conversely look more at wants)
  • colleague conflict
  • worry and or guilt about patients
  • guilt about work overpowering family life
  • fear of failure
  • excuses

I could go on!

However, if one is never taught “how” to let go - and the pervasive and indoctrinating culture is one of “hanging on in there” - how on earth does one let go, or judge when letting go, is appropriate? This can be incredibly difficult to A) identify and B) actually do the letting go when every fibre in one's being and training says “mustn’t do that”.
One way that we have tackled this almost straitjacket Catch 22 at Medical Forum is to point out that letting go does not have to be done at the outset in order to “explore” options or to define more of what one does want from life and work. The process of starting to explore options in itself immediately removes that horrible (and in reality, rather overly dramatic and often incorrect) either/or thinking. Without this pressure, and with encouragement to explore not only the options but also deeper aspects of the ‘self’, solutions are more likely to arise, leading to an appropriate and timely letting-go of something, which happens organically rather than in a forced way.

Another technique I have used personally, and which I often recommend, is that of Sedona Method. I started using it 25 years ago on and off and found it to be useful. Then around 17 years ago, my Mum became very ill and I realised I was going to need to let go of her and that this was likely to be incredibly traumatic. The enormity of this really hit me, but I returned to the Sedona Method and I am certain that this enabled me to be calm at the final moments. It doesn’t stop bereavement, but it certainly enabled much better functioning at a difficult moment in life.

So if there is anything lurking in your life that needs to be let go (it can be applied to any sphere of life, not just career or bereavement), this method might really help. It does however need learning and practice and so doesn’t work instantly. A parallel to this is learning breathing techniques to calm oneself before exams; it's not much help if one only learns it the night before the viva.

I think there are so many things that, when reevaluating a career, might need to be let go; just look back at the list above. How many things might you tick?

To start with (and without this list to offer the challenge), one might not even know they are there, causing a problem, nor that it would be cathartic, liberating or catalytic to let them go. However, as part of a structured career guidance program, these issues generally very quickly get flagged up as important or worthy of some attention. This does not mean one instantly leaps to a solution, but the generation of solutions is more likely to happen within a reasonable time frame if one is not “holding on to stuff one really needs to let go”.

I suppose another way to tackle all this is to start psychotherapy (not studying it - seeking it!) but I know which option I’d prefer if I were trying to get my professional life under control and in balance with the rest of life.

This article first appeared in The Sessional GP magazine.

Sonia Hutton-Taylor

Dr Sonia Hutton-Taylor is the founder of Medical Forum Career Management and the author of an ebook Easy career change - good career choice.

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