Acceptance, as I discussed last time, allows you to make a reality-based assessment and then plan your response, rather than reacting to “how things should be”. It is the recognition of what is actually happening, the facts without judgment or emotional attachment. 

As physicians, we are used to being on the other side of acceptance. We deliver the diagnosis, the treatment plan, the surgical option, and the bad news. We assist the patient and family to reach that place of acceptance. 

We also get to see what happens when patients fight with reality. When they don’t take medication or follow through on recommendations. Maybe they seek multiple second opinions in search of another reality. Their health can suffer and they certainly suffer emotionally. 

In our own lives as practitioners, partners, employees, and employers, we can face similar dilemmas.

I’ve previously written about my own struggles to accept those middle-of-the-night calls to the ER. As long as I am focused on how I don’t want to go in and how adversely it’s going to affect my next day, I’m just causing myself unnecessary suffering. Because the fact is that there is a patient who needs my help and I will be going in to help them. Once I accept the reality of the situation, I am able to approach the situation without anger.

Sometimes at night, the nurses might page the wrong doctor about a patient, thinking I am covering on or on call when I’m not.  Again, I can fume all night about how they shouldn’t mistakenly call me or call me, but the angrier I get the less I will sleep that night. The key to getting back to sleep easily is to accept that the phone call happened and let it go. That’s the reality. 

A client of mine faces a dilemma. He has a great partner. They work well together and have similar clinical and ethical approaches. But, the partner owns the practice while my client has been an associate for a couple of years. The time has come to either buy into the practice. Or they also have an opportunity for a hospital system to take over the practice and become employees. 

This client likes the independence of staying in private practice. But his partner’s wife is interfering in the practice. She doesn’t work in the office per se. Still, she often pops by and makes demands on the staff, tells them how to do their jobs,  and also has opinions about how much employees should be paid, so the practice can never hire anyone with experience because she thinks that salary is just too high. She made them reuse supplies that shouldn’t be reused to save pennies, although the staff doing so costs money because they have to clean the old supplies, even though new ones cost pennies. 

My client can complain about how what the wife is doing is wrong, and he may be objectively in the right, but continually hashing this out isn’t getting him any closer to finding a solution, because he is stuck in how wrong it is. 

Another client is upset about negotiations her group is having with the hospital, which supplements her group substantially to cover the uninsured care they provide. She doesn’t like how her group is approaching the administration nor how the administration is squeezing them to provide more care for less money. She is angry at her group for not heeding her advice and also at the hospital admin for the demands they are making. She feels very strongly that this is wrong. But while she is stuck in how wrong they are and how unfair the situation is, that is not helping her make any progress personally or with her group.

All surgeons have faced the dreaded “your case needs to be bumped” scenario. There is an emergency case or some cases are running long. You can get angry that the operating room doesn’t have more capacity, complain about how they should, or find some way to improve the situation. How urgent is your case? What could you be doing instead to make use of the time? It may not improve your situation, but it improves your experience of the situation and allows you to get something constructive done in the meantime. 

In each of these situations, lack of acceptance leads to being stuck fighting reality rather than dealing with problems and making progress.  Acceptance is the point where you stop wishing reality was different. And the point where choose what to do with that reality.

Fighting reality is like swimming against an overpowering current. You’re not likely to reach the far shore, and you may be injured or perish in the attempt. Acceptance is the point where you decide to let the current take you since you’re already in it. The opportunity to not be in the current in the first place has passed. To avoid unnecessary struggle or defeat, it’s time to go with the flow until your next opportunity.

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