Bosses don't get bad days (Proceedings)

Lots of leadership books and experts detail steps you can take to become a better leader. Trouble is, many times they omit the single most important trait of exceptional leaders – a positive attitude. Fact is, your attitude and emotions determine how effectively you lead others. How we deal with bad attitudes around us and how we confront our own sour feelings directly influence our abilities to inspire and lead our teams. Fortunately, there are tips and techniques to help keep us centered and focused on being the best leader possible.

No Bad Days?

Bad days lead to burnout. Many veterinarians lead an existence of "getting through the day" and never reaching their maximum potential. How do we optimize our abilities while maintaining enthusiasm for our profession? The short answer is by preparing ourselves intellectually, being as physically fit and healthy as possible and including diversity in our lives. Research conducted during the past twenty years has shown that our physical state has tremendous impact on our ability to think, process and retain information and regulate our moods. In other words, how healthy and fit you are tremendously affects how well you perform mentally and emotionally while still enjoying it. To enjoy more "good days" takes work. By staying physically fit and healthy, you can maximize your potential as a veterinarian and avoid "bad" days. The more productive you are, the better you'll be and ultimately the more successful you'll be – and avoid burning out.

Step 1 – Avoiding Bad Days and Burn-out: Exercise and your Mood

In 1999, Duke University conducted the SMILE Study (Standard Medical Intervention and Long-term Exercise) to determine the effect exercise had on patients suffering from depression. They compared subjects treated with the popular psychoactive agent Zoloft (sertraline). The researchers found that exercise was as effective as medication in treating depression. Moreover, when the test subjects were evaluated six months after the study's conclusion, they found that 52 percent of the patients receiving Zoloft were still suffering from depression compared to only 30 percent of the exercise group. Perhaps even more interesting, the more exercise a patient did the less likely they were to be depressed. The Duke study found that every fifty minutes of weekly exercise correlated to a 50 percent drop in the odds of being depressed. The more patients exercised, the better they felt and the more stable they became.

Aerobic exercise increases the neurotransmitters dopamine, serotonin and norepinephrine. These compounds play a vital role in the regulation of our moods and feelings. Exercise is our body's natural means of keeping the brain chemistry stable and enhancing our chances of survival. Our estimated energy expenditure is less than 38 percent of our Stone Age ancestors. To make matters worse, we take in far more calories than our caveman relatives ever dreamed. Even if you follow the government recommendations of thirty minutes of aerobic intensity exercise each day, you'd still only burn about half of what our genes are encoded for. Overweight and obese individuals now vastly outnumber normal and thin people in the United States and Canada, and the number of patients diagnosed with mental and physical disorders linked to excess weight continues to escalate. We were designed to move and when we don't, bad things happen, both physically and mentally.

Cold Coals: Life in the Shadows

A bigger concern for many people is what psychologists term the "shadow syndrome" of sub-clinical depression. These individuals experience common mood swings, are quick to anger, have trouble remaining focused and experience sadness and negative thoughts more frequently. While not technically depressed, these people are functioning sub-optimally. These individuals benefit tremendously from exercise. A recent doctor I worked with commented that "she had forgotten how much fun veterinary medicine was" after four weeks on a five times a week exercise program. She was sleeping better, feeling more energized and found that "life was going her way." While exercise is certainly no panacea, many people have lost sight of how good their life truly is due to the veil of sub-clinical depression brought on by abnormal brain physiology that a sedentary lifestyle creates. When the neurotransmitters released with aerobic exercise flood the brain and reset the normal neurochemistry, people feel better and experience optimism and happiness, something everyone could use more of in their life.

Train for your Brain

If you were told there was a once-a-day pill that would make you smarter, more creative and slow the effects of aging on the brain, you'd be foolish not to take it. Exercise is such a pill. According to recent research, exercise can make you smarter and more creative and slow cognitive decline. Numerous studies have shown that aerobic exercise can improve memory and creativity, reduce cognitive decline in aging individuals, and boost cognitive flexibility. Cognitive flexibility is particularly important in intellectually demanding professions such as medicine. This skill reflects our ability to shift thinking and produce a steady flow of creative thoughts and answers as opposed to reciting memorized information. Until a magic brain pill is discovered, exercise is the best option for optimal brain function.

These findings have been put into widespread use in several school districts across the United States. Students have been shown to perform better on reading and math tests and learn new concepts more rapidly after exercise. The conclusion of these emerging studies is clear: exercise can make you smarter. If we are to optimize our intellectual abilities as veterinarians, we owe it to our patients to take better care of ourselves so we can be the best we can be.

The question of how much and how to exercise is the topic of much discussion. In general terms, aerobic exercise is defined as physical activity performed at 60 to 80 percent of your maximum heart rate (MHR). A good starting point to determine your MHR is to subtract your age from 220. In the SMILE study, the individuals that benefited the most burned about 1,400 calories or eight calories per pound (3.6 to 4 calories per kilogram) per week. Start by taking your weight multiplied by eight (or 3.6 to 4) and get on your favorite exercise machine such as a treadmill or elliptical trainer. If you weigh 150 pounds (70 kilograms) and burn 200 calories in thirty minutes on the elliptical trainer, you'll want to do at least six sessions a week.

Step 2 – Physical Health

When it comes to disease recognition, we're the experts. The majority of our veterinary education focused on diagnosis and treatment of diseases. Too bad we didn't spend more time learning how to avoid illness. Today's clients are interested in the preservation of wellness, and so should you. The transition from disease experts to experts in disease prevention is well underway in the human profession. Research demonstrates that our lifestyle: diet, exercise and stress management contribute about 70 percent of how long and well you'll live. Genetics have been shown to influence only about 30 percent of a person's life expectancy and quality of life. It's time to take a hard look at your lifestyle to see if you're reaching your full potential and what message you're sending to clients and staff about health.

The first step is to schedule a thorough physical examination with your physician. Complete blood and urine tests and age-appropriate testing such as mammography, prostate exam and electrocardiography should be performed. If we're going to recommend these tests and services to our patients, shouldn't we have them done on ourselves? Next, based on a good check-up, select a personal trainer to teach you to properly exercise and enlist a registered dietician to help you eat healthier. These professionals are well worth the small price you'll pay. The investment in your health will allow you to be a better doctor and the better you are, the more productive (and profitable) you'll be. Finally, learn how to best manage your daily stress through meditation, yoga or other relaxation techniques. The time you spend refocusing and de-stressing will allow you to be more engaged with your loved ones, co-workers and clients as well as leaving you refreshed and energized.

Finding the Time to Exercise

While training for Ironman events, I often feel that I have pushed beyond my comfort zone. Being a husband and father of two, owner of two businesses, practicing full-time and training twenty-plus hours a week is a bit of a stretch for anyone. The value of this extreme time management that I put myself through repeatedly is that I have a difficult time looking at other people's schedules and accepting that they "don't have thirty minutes a day to exercise." It simply boils down to priorities. When your health is your priority, thirty minutes is nothing in the scheme of a busy day. When there is no commitment and true belief in the power of exercise, thirty minutes can seem like an eternity.

Studies have shown that people who exercise in the mornings are more likely to 1) do it and 2) continue to do it for long periods of time. For me and the individuals I train or coach, I find that early morning workouts are the best fit for our lifestyle and schedules. In addition, you start the day energized that sure beats a bedraggled and bleary-eyed morning greeting.

If you put off exercising until the end of your day, life is likely to interfere and cause you to miss your workout. From late emergencies to later soccer practice, evenings rarely work for most busy people. Of course, the only way to make early morning training happen is to get to bed earlier. Is it really important to find out what happened on a 10 pm drama each week? Try recording your favorite shows and viewing them at an earlier hour or on weekends. What about the modern time stealer – the internet? Are you mindlessly surfing and wasting valuable time you could spent interacting with family or sleeping? People need an average of seven to nine hours of sleep per night. If you have to awaken to an alarm clock, you're probably getting inadequate sleep. If you need a cup of coffee to get going in the morning, you're probably not getting enough sleep.

For most people, walking or jogging on a treadmill or outdoors is simply the most effective and time efficient means of exercise. Take five minutes to stretch, five minutes to warm up and reach your aerobic heart rate and then sustain aerobic intensity for twenty to thirty minutes. Warm-down over a five minute period until your heart rate has dropped twenty to thirty beats. Perform a couple of minutes of light stretching and you're done. The entire process should take forty-five minutes or so. The key is to reach your aerobic heart rate zone and maintain it. You'll need an inexpensive heart rate monitor. Regardless of the activity you pursue, with the exception of swimming, maintaining aerobic intensity is the best way to ensure you're getting the most out of the effort you're investing in exercise. Walking and running are natural actions and I encourage everyone to spend at least some time hitting their stride to maximize their fitness.

Strength training is another essential ingredient to fitness, especially as we grow older. I prefer compound exercise or motions that target natural movements and engage multiple muscle groups in one exercise. Before you pick up a dumbbell, I strongly advise you work with a certified personal trainer to make sure you don't inadvertently injure yourself. Gyms are full of newbies who either did some weightlifting in high school or watched it on television who get injured within a few days. Injury will not only cause you pain, it will also turn you off to exercise and you'll see your fitness fade fast. Work with someone to learn how to not only properly perform the movements but to also guide you ion the exercise that work best for your body and goals. It's hard for me to watch some people in the gym slinging weights without a clue that what they're doing could hurt them – sometimes seriously. Don't be "that guy or girl" trying to do something you shouldn't. It looks easy to perform a biceps curl, but I can tell you from experience that most people can't even perform a curl properly. They move lots of weight and then wonder why they don't achieve the results they desire.

Integrating a goal other than a target weight is another critical step in achieving fitness. For many people, the thought of even running a 5k is daunting. For that reason, I refocus our efforts not on a number on the scale, but on an event. If a person trains for a 5k, they'll not only improve their fitness but they'll lose weight in the process. As you complete a 5k, try a 10k in several months. Keep a goal in front of you and fitness, increased energy and stamina and improved intellectual abilities will follow.

If you smoke – stop. If you drink (more than two or three glasses of wine per week) – don't.

Step 3 – Nutrition

You can't be physically and mentally healthy if your fuel source is polluted. You need to focus on providing your body with pure nutrients to not only provide energy but to build and repair tissues, maintain a healthy immune system and stabilize your mood. We are what we eat; is your diet the best it can be?

Some simple steps include avoiding simple sugars, caffeine and alcohol. Drink water instead of soda; decaffeinated green tea to replace coffee. When you're feeling the urge to snack, reach for fruit or a handful of nuts and turn down the candy. Try eating three meals and two high-protein snacks each day. Calculate the number of calories you need to maintain your weight and learn what it looks and feels like each day.

Don't turn to alcohol in the evenings to "relax." Instead, talk to your family, read a book or meditate. Meditation can be as simple as sitting in a chair and thinking of – nothing. It is vital that you take some time and clear your thoughts and anxieties associated with work, even if just for five minutes.

Whenever possible, eat real, whole foods. Reduce the amount of processed foods you're eating. If it's in a box, it's probably processed.

Drink a vegetable and fruit smoothie every morning. My favorite consists of blueberries, strawberries, bananas, spinach (lots!) and hemp milk. Fruits contain significant calories so remember to calculate the number of calories in your concoction.

Supplements can also help. Adults such consume at least 2.5-grams of the omega-3 fatty acids DHA and EPA each day. DHEA may also help high-stress individuals. Other supplements you should consider include a good multi-vitamin, B-vitamin complex, resveratrol, l-carnitine, co-enzyme Q10, a probiotic, St. John's wort, etc.

Step 4 – Incorporating Diversity

What are your hobbies? This question has puzzled more than one veterinarian I know. Some veterinarians can list a hobby but can't substantiate any participation. To avoid burn out, you need to participate in activities outside veterinary medicine. The best hobbies engage your mind as well as your body. Strive to do something, anything, twice a week. Free your mind on an activity that really excites you. If you don't have a hobby – start searching for one. If there's something you always wanted to try, go for it. Forget the costs, if you burn out on your profession it will cost you more than any diversion.

Step 5 – Remember Why

Everyone has bad days. When you start feeling like the world is against you, recall the good times. I keep a drawer full of thank-you notes I've received over the years. Whenever I've felt like giving up, quitting or just plain feeling sorry for myself, I open this drawer and begin to read. I soon forget my troubles and focus on the positive influence I've been able to have with my patients. I feel truly fortunate to be a veterinarian; it's been my lifelong dream – and probably yours, too. Remember the "why" when you're feeling bad – then go out for a run!

What about Bad Staff Members?

One of the key secrets of successful leaders is picking the right team. If you're surrounded by staff members with bad attitudes, negative energy and downright downer lives, ask yourself why? No one is forcing to remain employed there or keep those individuals employed. One of the secrets to my personal success is letting people go that were holding me or my team back. This is never easy and has been painful on many occasions. Firing a staff member that's been with you for 12 years is never an easy task. However, each cut has allowed my practice to reach new levels.

But She Said It First!

Whenever I'm confronted with gossip, negative or snide comments about clients or just plain old mean talk, I speak up – and out. I don't tolerate this type of culture in my workplace. If you remain silent, you're condoning and supporting these harmful conversations. As a leader, you must not engage in negative discourse and set a solid example that such comments or attitudes are unacceptable. If you remain passive about this issue, you can't expect your staff to behave differently.

Change is never easy, but the facts should make you seriously consider whether your health is affecting your ability to burn as brightly as you should. Whether you suffer from mood swings, diminished energy, difficulty sleeping or decreased enthusiasm, you'll certainly feel better after breaking a sweat. If you've lost the excitement of waking every morning and facing the day's challenges, try starting your day with a brisk walk. Almost whatever ails you will be made better by routine aerobic exercise. Getting into the "flow" of everyday medicine is immensely fulfilling and will allow you to sustain long term success. By improving your lifestyle, you'll improve your health and you're sure to see an enhancement in your professional abilities and personal life. You owe it not only to yourself but to your loved ones, co-workers, clients and the patients we serve.