John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania. He focuses his blog on helping surgeons reduce stress while achieving balance in their practices and families.

BLOG: Reformat your vocation for positive energy balance

Psychiatrist Judith Orloff, MD, is considered a true pioneer in the nascent area of energy medicine. Practitioners of this discipline recognize that one’s daily decisions can either connect us to renewable sources of inspiration, passion and creativity or render us depleted.

Orloff has long recognized that energy imbalance is the root cause of burnout, the emotional exhaustion which has reached epidemic proportions in physicians.

In her epic best seller Positive Energy, she elegantly delineates ten ‘prescriptions’ necessary to transform fatigue and fear into vibrance and love. Her sixth prescription, “open yourself to the flow of inspiration and creativity” addresses how we can all modify our work situation so that positive energy balance may be restored. In particular, Orloff recommends the following:

Heal difficult relationships at work

The commonly experienced “bad energy” between you and a coworker is, in Orloff’s words, a true “energy vampire” and drain us of precious stamina needed to care for others. Such negative relationships are best reconciled with kindness. Charitable acts toward another melts hostility and penetrates other’s insecurities. Orloff continues by declaring that the nastiness you perceive in others is often a mask for insecurity. Heal the rift with a colleague with compassionate kindness.

Application: Consider a thoughtful holiday gift for the “annoying” OR charge nurse.

Don’t expect your chair or chief to be a mind reader

Orloff is emphatic in the need to express one’s needs. Resist the temptation to stew in frustration or dissatisfaction. The key is to risk by merely communicating better your needs and your passion. If you have an idea to improve your practice, express it. You will never know the outcome until you try. Your boss does not know what is troubling you. You may be surprised at how fruitful a heartfelt conversation with your superior may be.

Application: If you are tired of seeing everyone else’s “problem patients” say so!

Micro-analyze your day

Orloff suggests we take a hard look at our day and take note of any aspect that generates sparks of energy. Get in tune with what initially attracted you to medicine and recognize what relieves apathy or fatigue. Do you connect better with older or younger patients? Is shoulder surgery or knee surgery your bliss? Do you love the challenge of revision surgery? Is fracture surgery your real calling?

Application: Keep a journal and document the signs of “life force” in your day. Commit to spending more time in these areas.

Spend time with colleagues who inspire and energize you

Some coworkers simply are energy scavengers and can rob of our precious life force. Others are repositories of positivity and joy. A good friend of mine used to jog every morning with a colleague who used to habitually complain about the sad state of medicine and the hopelessness of the fate of a physician. After hearing the continual litany of complaints, my friend would find himself emotionally depleted after his workouts – the opposite expected effect of exercise.

He ultimately recognized that he was absorbing all the negative energy his friend expended and found a new, more positive running mate. His mood soared.

Find energy “hot spots” at the office or OR and spend as much time as you can there. You will be heading closer to an inspired life.

Application: Ask for certain scrub techs or OR nurses who exude positivity. If the OR lounge buoys you up, spend more time there. If solitude recharges you, do not be afraid to spend time alone between cases.

Look for the real service and meaning in your work

When we inject meaning into what we do, we are tapping into a huge energy reserve because humans are hardwired to serve others. When we truly consider how an orthopedic vocation makes a cataclysmic difference in the lives of so many, we will experience a monumental spiritual uplift. Service to others also helps us to get out of ourselves and rids us of preoccupation with our own personal worries and issues. Reframing our work into service to humankind will ignite inspiration and provide a windfall of motivation. True and lasting drive is predicated not on RVUs and fancy race cars, but in finding purpose and significance in the lives of others.

Application: Keep a journal for 1 week and reflect on how your surgery and diagnoses have enriched the lives of many.

Orloff’s Positive Energy is, in my humble opinion, required reading for those navigating the stressors of contemporary medicine. It will awaken you to the truth that we are all responsible for our energy bank accounts. We are all obliged to make choices which increase flow, inspiration and creativity. Conversely, we are all wise to protect ourselves from “energy vampires.”

Is your energy bank account overdrawn? It is never too late to make deposits.



Orloff J. Positive energy: 10 extraordinary prescriptions for transforming fatigue, stress, and fear into vibrance, strength, and love. Harmony, 2005.

Shanafelt TD, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385.