7. DON’T WASTE SUFFERING

We all make mistakes. You will inevitably miss something. When you do, learn from it. Don’t allow yourself to waste that suffering. Learn and move on. You can become a better physician and person from handling failure with grace and a growth mindset.

When I see higher volumes or staff many APP patients, I am more prone to missing small details. My personal practice is that when I find myself seeing higher volumes, I purposely spend a few extra seconds re-reviewing the CBC, BMP, and vitals one last time before discharging.

8. IT’S OKAY TO SAY NO

Early on, it is easy get seduced by the dollar amount of an extra shift and pick up so many shifts that you are working more than you were in residency. Instead of thinking of the extra pay, I now look at extra shifts in terms of what I am trading away my time for. Is it worth it to me to miss dinner with my spouse or not spend time on hobbies that rejuvenate me?

One of the hardest lessons I have had to learn is to say no. Consider your bandwidth before agreeing to a new QI project or committee. Will it bring you joy?

9. FIND YOUR PRACTICE STYLE

I did not staff patients with physician assistants and nurses practitioners during residency, so this was a learning curve for me as a new attending. Working with nurses and physician assistants comes in many flavors. Sometimes you staff all their patients. Sometimes you staff none. Other times you sign all their charts whether you saw the patient or not. I can write an entire paper about the lessons I have learned from staffing NPs and PAs patients and signing their charts. My main lesson is: pay attention to the attestation you are using when signing the physician assistants and nurses practitioners. charts. If something doesn’t feel right, be more thorough, see the patient, ask for more information. Your medical license is undersigning the care. But remember, both you and the NPs and PAs both want the best care for the patient.

10. HAVE FUN, BECAUSE IT IS AN HONOR FOR PEOPLE TO INSTILL THEIR TRUST IN YOU

Remember to have fun! Emergency medicine is what you make of it. Take ownership of your professional identity and who you become over the next 10 years. You have worked hard to enter an honorable career that will challenge you, bring you perspective, and allow you time off and the opportunities to pursue different interests in and outside of medicine. I have never had a boring ED shift or the same shift twice. Stay positive. Enjoy being an attending and physician. Most importantly, be proud of yourself.