Life lessons I’ve learned

I once asked a wise mentor of mine who was on the verge of retirement how he would change his life if he were to live it again. “I would balance my life and see my children grow” he replied.

I never forgot that conversation, which took place around the time that I arrived in Philadelphia to start my new job as a “clinician scientist.” I was facing the same challenges before even starting my career. I had to develop a social network in the new city, be a productive researcher, and establish a clinical practice to support my expanding family.

The challenges that my mentor outlined felt real. I decided that I needed a “strategy” to ensure that I could accomplish my career goals without sacrificing my family. Recently, I summarized my strategy during the Orthopaedic Leadership Institute; at the request of AAOS Now editor-in-chief S. Terry Canale, MD, I am sharing it here as well.

Love your family and show it
We all love our families. We need to express this love in both words and action. Participating in important events (birthdays, graduations, sporting events) is an expression of that love in action. I have “black-out” dates in my calendar so that I can be at home or with family on important days.

Being with family for important occasions does not necessarily mean being physically at home. My wife’s birthday frequently coincides with an important annual meeting. I make sure that my wife travels with me to that meeting, which is held at a ski resort, as a birthday treat! I take my family on trips whenever I can. I always take the opportunity to purchase discounted air miles and use them to buy tickets for my family.

I know how frustrated I feel when the person I’m talking to gets distracted by a phone call or email; I can imagine how much more frustrating it is for my spouse and children when they want my attention and the mobile phone beeps. I try to not bring my phone to the dinner table, graduation ceremonies, and soccer matches. I make sure that when I am with them, I am truly with them.

Prioritize
This may be the toughest challenge of all. I have realized that tasks fall into one of four categories—essential and enjoyable, essential but not enjoyable, not essential but enjoyable, and not essential or enjoyable (Table 1). When asked to do something, I decide which quarter the request falls into and prioritize accordingly. Although it is tempting and, some would argue, essential to accept most requests early in one’s career, many requests will shift from essential/enjoyable to nonessential/not enjoyable over the years.

Be a planner
I like to have plans for each day, each meeting, and every assignment. I also live my life in 1-year and 5-year sections, with supportive plans. I advise my students to decide what they want to accomplish for each section of their lives—whether it be learning a language while traveling, preparing a National Institutes of Health grant request in the first quarter of the year, or writing a book during the summer.

I also point out that the family must be in synch with these plans—even children can learn to be planners. Every weekend over breakfast, each member of my family discusses his or her plans and we try to merge activities as much as possible.

Be efficient and organized
This recognizes that there is not enough time in a day to do everything. Multitasking enables me to do as much as I can. I run two operating rooms and perform as many surgeries as possible when I am in town. I even operate on Saturdays if need be. I start my clinics early and run them late.

I also take advantage of small things that can add to my efficiency. For example, I will take a fellow or my nurse on my walk to the car, coffee shop, or store to discuss issues at hand.

Because I have a 30-minute commute from home to work and vice versa, I use this time to contact my patients, return calls, and catch up with distant friends and family. To save time, I don’t fly to meetings if I can take a train or drive there in less than 3 hours. Long drives enable me to catch up with my reading by using audio books.

Electronic media helps keep me organized, as well as saving time. I synchronize my calendar with my personal assistant. I color code tasks, label and arrange folders, and keep everything neat. As silly as it sounds, I even arrange my ties and suits according to style and color so that I do not spend time in the morning finding the right clothes. I can tell how organized a person is by looking at his or her computer and office desktop.

Communicate
I have regular early breakfast meetings with my employees and fellows in a local coffee shop. I have realized that sitting in a relaxed environment encourages them to speak freely. I am more likely to hear about a problem in the coffee shop than in my office.

I advise clinician scientists to have regular meetings, talk to staff, and give feedback. It helps efficiency, improves quality, and makes the person feel important. I also recommend regular communications with a professional circle. If in-person meetings aren’t possible, email or phone calls will suffice. I always answer emails and return calls, because ignoring them is an insult to the sender or caller.

Be honest
Honesty and integrity breed respect among peers, family, and colleagues. It also enables one to sleep well at night, without worrying about the IRS, the ire of a chairman, or the necessity of a journal retraction. I believe that people should mean what they say and deliver on their promises.

Be kind
People will do so much more when they are asked kindly. Being a kind and pleasant person helps to retain employees, attract people to the group, and engender forgiveness. I try to be kind to everyone, regardless of social or financial status. To me, the janitor who cleans my office has the same human value as the senior manager who pays my salary.

Strive to improve
Complacency is the worst enemy of progress. Although accomplishments should be celebrated, they should not be used as an excuse not to do better. I try to identify my areas of weakness, which are ample. Regular communications with others is helpful in identifying these areas. When asked, I offer my evaluations and highlight areas that need improvement. I host a quarterly research “retreat” and expect all attendees to outline issues that need attention or improvement as well as strategies for addressing them. I try to encourage everyone to identify problems and think of solutions.

I do the same with my family. Every Wednesday evening, my wife and I set aside time to be together. I make sure she has time to talk to me about anything she wants. Fortunately (or unfortunately), I occasionally hear about ways I can improve.

Live below your means
When it comes to finances, I try to follow the rule of thirds. At the end of the month, I put a third of my income toward paying my debts or obligations, a third into savings or investments, and a third for discretionary spending. I will expand my financial commitments only if my income expands.

People have different interests and hobbies—hopefully not too many expensive hobbies. My own hobbies include buying antiques, collecting art, traveling, and driving a nice car. However, I never stretch myself financially to enjoy these hobbies. I would never take a loan to “sponsor” my hobbies. I have found that living below my means minimizes financial pressure and jealousy, while giving me more time to enjoy life.

Stay healthy
I recently read that regular exercise (20 minutes per day) is one of the strongest predictors of longevity. Exercise not only keeps one healthy, it allows for reflection and “self-time” I enjoy biking and when I bike by myself, I can get a lot of thinking done. I watch what I eat and do not overdo alcohol. I try to live life to the fullest.

I hope these tips will help others. Orthopaedics is a discipline that provides so much gratification and joy. I believe that those who practice it are indeed fortunate.

Javad Parvizi MD, FRCS, is vice chairman of research and professor of orthopaedics at The Rothman Institute of Orthopedics, Thomas Jefferson University, in Philadelphia.