The Optimized Doctor

Grind it out


“And five more, four more, three more, two more, one more, and done!” Just when you thought you could not stand the searing pain any longer, it ends. Your spin instructor is not only helping you be fit, she is also teaching you an important lesson for life: Sometimes you just need to grind it out.

“Grind it out” is a phrase I’ve heard a lot lately. You might associate this with push-ups and burpees, but grinding it out applies to much more. College basketball teams need to simply grind it out to advance in the NCAA championship tournament. How might Tiger Woods recover from a disastrous few holes at the Masters? “He’ll just have to grind it out on the back nine.” How will you finally finish your PhD thesis? You’ll have to grind it out this month. It’s how I’m writing this column, how I got my taxes in on time, and, sometimes, how I get through clinic.

on exercise bikes UberImages/iStock/Getty Images

The phrase is used to describe something which needs to be done that is tedious, laborious, or joyless. Although the outcome of grinding it out is always pleasant, the task is often considered arduous.

In my dermatology practice, patient demand came in like a lion this March, and to meet our awesome access goals, we needed to add clinics on Saturdays, early mornings, and even a few nights. We met our goal, with supply to spare, and felt proud of our accomplishments. Physician wellness gurus (this author not included) say that, to avoid burnout from such excess work, you must find meaning in your work. Be grateful to help that 24-year-old with acne at 8:15 p.m. Think about how lucky you are to serve that lawyer with hand dermatitis at 8:45 p.m. Celebrate the mom’s cancer-free skin screening at 9:00 p.m. By finding meaning in our work, we’re told, we can achieve clinic nirvana. Except it doesn’t always work, and sometimes it serves us badly.

Dr. Jeffrey Benabio, director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego.

Dr. Jeffrey Benabio

No matter how concerning the alopecia areata is to this 20-year-old man, it’s just another hair loss case for me. Third one today. Draw up Kenalog injection. Push play on alopecia areata spiel. Type note. Repeat. Being grateful to see him is a lovely idea, but I’m just not feeling it. Not only is this feeling acceptable, it’s normal. Always trying to find meaning in our work can be exhausting and often disappointing. This is true of any work. Rory McIlroy might love playing golf, but sometimes he just has to grind out the back nine. You may love being a doctor, but sometimes you just have to grind out the prior authorizations, paperwork, and patient messages. You’d no more seek meaning from these tasks than you would from abdominal crunches. And it’s not just about the money. As you, and rapper 50 Cent know, you could be making “a mil on the deal” and be “still on the grind.”


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