The five mantras I live by.

Throughout my life, I have collected sayings, ideals, or mantras that have resonated with me and served as a template for my path. Some of these themes I picked up in childhood or adolescence, some more recently in my adulthood. Regardless of their age, these beliefs are important for shaping who I am and who I plan to become. Let me share them with you now.

1. You have not because you ask not.

My grandmother always said this to me when I was a kid. She was usually trying to get me to eat more but I have adapted her saying to be the catapult this timid introvert needs to go after her dreams and desires. When I was trying to start my practice (during third year of residency), I needed to borrow some money. You know, just a little bit to build an office — like physically build one from the ground up — and get the practice going until it was self-sufficient. A million dollars would do just fine, I figured.

So on my precious days off and after nights on call, I visited bank executives and laid out my plans. I was going to start a pediatric practice in my hometown. We needed another pediatrician. The business case was straightforward. Our community was growing but we still had the same number of pediatric practices as when I was a newborn (one).

I had 5-year projections from my accountant and technical plans from my architect. I knew where I wanted to build and how I wanted to doctor my patients. But I didn’t have any patients yet and I wasn’t even board certified (hello, still in residency!). To most franchise bankers, I was a textbook, “Come back when you have business under your belt.”

I wasn’t going to accept that answer, though, so I kept asking. And you know what? Eventually someone said “yes” to my question. But I think you probably knew that. What if I had never asked the question in the first place? I hate to think that I wouldn’t have been able to buy my little 1/2 acre plot or build my lovely 5000 square foot office to welcome my sweet patients into those short six weeks after I finished residency.

2. Every year you should do more of what you love and less of what you don’t.

I hadn’t been in practice long — solo practice in a small town — when I started to feel exhausted and overwhelmed. I was seeing all my own patients in the hospital, taking all my own call during the week (sharing on the weekends, thankfully). Managing a growing practice, adding employees, and trying to squeeze in time for family and self-care had me stretched thin.

I knew I needed help but I also knew that didn’t want to give away what I had worked so hard to build. Some of you may disagree with this mentality but others of you will understand where I’m coming from. I just could not image having a partner. I had invested so many sleepless nights, so much heartburn, so many hours building my practice, there was no way for me to put a price tag on that to allow a partner to buy in.

On top of that, I knew my personality couldn’t share the responsibility of calling the shots. Control freak? Maybe. I just knew that practice was my baby and I wanted to be the only mother.

So I called a pediatric colleague across the country who happened to be the sole owner of a large practice with dozens of employed pediatricians. I figured if anyone knew how to manage my problems, it would be him.

We chatted about various practice management quandaries, but the thing that stuck with me was his mantra that, every year you should do more of what you love and less of what you don’t.

Ever since that conversation, I’ve made that advice a priority. Not long after he shared his wisdom, I hired a part-time pediatrician so I could take a day off and get some help with nursery rounds. Eventully, I hired a full-time associate to help share the load. We started using an after hours nurse triage service to screen our mommy calls. Then we dropped in-patient privileges and then newborn nursery responsibilities.

For each of those deletions, I’ve made it a point to add something “good.” Traveling more, learning to sew, knit, and quilt. Taking the time to serve on non-profit boards and committees. Developing my communication skills so I can share my knowledge and passion with others. (That last one has been a particular challenge considering I am a classic introvert.)

3. The pediatrician should only do what only the pediatrician can do.

This lesson has been a difficult one to learn over the years. As a professed type-A control freak, it’s hard to let other people do things for me. You know how it is. You want something done right, so you do it yourself. We’ve worked to hard to get to where we are to let someone else screw it up for us. Or sometimes we think it’s just easier to do it ourselves than to try to explain it to someone else.

Well, let me share something with you. Your time is extremely valuable. You are highly skilled to do very specific work. In fact, your time is worth at least $600 per hour if you are an outpatient pediatrician. Take a look at my free Scribes Quick-Start Guide for the details on this math. I think it’s safe to say there’s no one else on your payroll making $600/hr?

I want you to read the Scribes Guide section about the value of your time, even if you’re not considering a scribe, because there’s some good stuff in there. How often do you actually consider that you are the only person in your office (other than the other physicians), who is specifically trained to take a history, do an exam, and devise a treatment and plan for your pediatric patients?

I want you to take that information and look critically at all the things you do throughout your day, especially at the office. How many people in your office have the skillset to be able to do a throat swab, give a shot, or enter a referral? Are you doing menial clerical or administrative tasks that could be outsourced or delegated? Of course you are. I still am and I’ve been attentive to this problem for years.

Closely evaluate all the jobs you perform, and start to let go of the ones that aren’t specific to your skills.

4. Just because you can do something doesn’t mean you should.

Building on Mantra #3, just like you should only do the things that only you can do, I would also remind you that just because you can do something, doesn’t mean you should. You may be super expedient and skilled at doing a throat swab or giving a shot but not $600/hr good (see #3 above).

Use your know-how to empower someone else to become just as good, if not better, at those tasks that don’t fall within your zone of genius. In fact, I believe when you can empower someone else to take ownership of those things that you’ve been controlling and allow them to make them their own, they can breathe new energy into the process.

Along these same lines, if you find that you are constantly pulled from your zone of genius (doing your $600/hr duties) to do other tasks that should be delegated or outsourced, it may be time to embrace Mantra #5.

5. Hire all the help you can afford.

At what point in our training or our upbringing do we have the lesson that we are able to do it all? Because I’d like to go back and find that teacher and give her a piece of my mind. Hopefully you’ve figured it out by now but in case you haven’t, we can’t do it all! No one can and no one does! Anyone who appears to be doing it all is creating an illusion, plain and simple.

I think we also ignore the fact that we all have different strengths and weakness, different commitments and interests, which we then translate into someone else “doing more” than we do. For example, I have taken a different path to motherhood than many of my friends and peers. I was blessed with my stepson when he was three and I was 22. As a result, I was an empty-nester before the age of 40. Most of my friends still have kids in grade school and many colleagues have even younger kids because they waited until after training to get started with having a family.

So I find myself in my early 40s, with a stable and fairly successfully practice, and a lot of time on my hands. Not one to sit around, I have busied myself with crafts, travel, and AAP involvement. I’m at a different place in my life than my friend who is just starting a practice and a family. It wouldn’t be fair for either of us to compare our successes or failures to one another or to set our standards by those of the other (not that we should EVER be doing this anyway!).

That was a long-winded way of me saying that each of us has a different skillset and a different set of challenges and responsibilities. But absolutely no one — AND I MEAN NO ONE — has it all figured out or put together. And considering that we are all busy professional women with homes and partners and families and practices and commitments, we all need as much help as possible.

I would say that every other mantra builds up to this last one. You have to be willing to ASK for help (#1). Unless you enjoy grocery shopping or cleaning the house, don’t keep doing it (#2), and chances are someone else can actually do it better than you if you let them so that you can focus on your zone of genius (#3 and #4). I think you know what I’m about to say next…

You need to be willing to delegate and outsource tasks as often as possible. Both at work and at home. Continue to ask yourself the question, “What is my time worth?” We’ve already established your earning potential, but what is your time worth to you? What is the value of an hour with your kids? Or a date night with your partner? Or a free afternoon to spend anyway you want?

Letting go of control isn’t easy. But it’s necessary. No one can do all. the. things. We all know better because we’ve all tried it and failed too. Instead of continuing to live with the disappointment of never feeling adequate, never checking all the boxes, give yourself the gift of focusing on the things you’re great at — being a pediatrician, partner, mom, friend, etc. Leave the other jobs up to the people who are really good at them.

So what can you delegate or outsource first? Can you hire a housekeeper, a scribe, and after-hours nurse triage service? Teach the kids to empty the dishwasher or fold the towels? Maybe you’ll let the bed make itself every morning (yes!)? On a smaller scale, what things can you automate? Can you enroll in autopay for your monthly bills or signup for a grocery delivery service?

I know you can find at least one things to mark off your list of responsibilities. Can you find even more?

About Katrina Skinner, MD
I’m a knitting-obsessed, independent pediatrician, entrepreneur, and advocate. I built my practice from the ground up right out of residency. I’m on a mission to live the most fulfilled life, doing more of what I love everyday. I want to help you do the same!