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Life Skills Life Skills

Creating Your Dream Job

Lee Rogers, DPM

**** This lecture is not available for CME **** Lee C Rogers, DPM discusses how to create your dream job. Drawing from personal experiences, Dr Rogers talks about the methodology for creating the job you really want including the how, where and why. This is a must see lecture for residents planning their career or anyone thinking about a job change.

  • Author
  • Lee Rogers, DPM

    Medical Director
    Amputation Prevention Centers of America
    White Plains, NY

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  • It is the policy of PRESENT e-Learning Systems and it's accreditors to insure balance, independence, objectivity and scientific rigor in all its individually sponsored or jointly sponsored educational programs. All faculty participating in any PRESENT e-Learning Systems sponsored programs are expected to disclose to the program audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education program. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts.

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    Lee Rogers has disclosed that he is a consultant for and receives financial or material support from KCI

  • Lecture Transcript
  • Male Speaker 1: We have something special for you that’s unique to these resident summits and that’s life skills talks. And who has had more experience in life skill than Dr. Lee Rogers? Dr. Lee Rogers is one of the most renowned wound care specialist in our field in podiatry. He runs a wound care center. He now works for Restorix Health Care and is raising the standards for wound care in their centers around the country. Dr. Rogers has a couple of talks for you about the trials and tribulations of your next step which will be finishing up your residency programs and finding places in the community to use these great skills that you’ve gained. Let’s all welcome, Dr. Rogers.

    [Applause]

    Dr. Lee Rogers: Alright. I’m going to do these few talks back to back. The first one is going to be about how to create the job that you want to have yourself. And the second one is going to be how to value yourself. When you do finally create that job and you are meeting with people, what do you ask for, what kind of salary are you going to look for and how do you make that case and even increase your value when you’re talking to a potential employer? I can tell you that I’ve never applied for a job before. Every job that I’ve ever had I created for myself. Everything from my fellowship, which I created, whether the fellowship with David Armstrong, it didn’t exist before I started. Nick Bevilacqua who you’ve met yesterday, he spoke up here, he was my co-fellow. He and I went to a company and said, “Hey, we want to do a fellowship with David Armstrong. Give us $150,000 and we’ll do this fellowship. We are interested in Charcot foot. We’re going to do a bunch of publications on Charcot.” And that’s what they were interested in and they let us start the fellowship. After that I created a job in Des Moines, Iowa. After that I was interviewed by some people in Los Angeles and offered to come in there and I created that job. You don’t always have to think, “What kind of job am I looking for?” You can also think, “What kind of job do I want and how do I create that job?” These are the essentials, I guess, of being a successful young podiatrist. You’re always worried about how do I find a job. Either how do I find one or what most of this talk is how am I going to create one? And then, once you’re in that position, what do I do for professional development? And that’s board certification, continuing education. How do you get involved in your community and with your county, state and National Podiatry Association? And then if you want, how do you achieve academic excellence in a certain field or interest like mine, the diabetic foot or Charcot, and how do you achieve that academic excellence? So you’re seen as the expert in that field. And then really, the other things which are your life goals because at this point in your careers probably not only concerned with your future job and some of you may be getting married or having children or you’re choosing a new place to live. These are all life goals and things that you’re going to have to be worried about as well. Most of you are probably familiar with looking for jobs in this way and this comes from PMNews you get in your inbox everyday, and at the bottom there’s always these classified ads on what jobs are available in certain areas. The problem with this is if you’re a person who says I really want to go back to Cincinnati. Cincinnati is a wonderful place. I don’t know if anybody says that, if somebody did say that. Cincinnati is a wonderful place. That’s where I want to go work. And you’re just spending all your time calling the Want Ads by whichever publication. You’ll probably never going to find the one that really speaks to you and maybe you’re going to settle for some associate position in Cincinnati just because that’s a geography you want to go back to, your family lives there, et cetera. Instead, you need to think about your different practice options.

    [05:00]

    There are two main categories. There’s either entrepreneurial practice or employed practice. And you can create jobs in both of these. So it’s easier to do it in the entrepreneurial side to create it because you’re basically becoming your own boss in just doing it. But you could do something from buying a practice. And the practices are not really that valuable anymore. It’s kind of a mistake if you’re thinking about building your wealth and your equity. It’s kind of a mistake to think that, “I’m going to spend 40 years working in my own practice and at the end of that 40 years I’m going to be able to sell it to some young podiatrist with a lot of money because I put all my sweat and my blood equity into this practice.” They aren’t really worth anything anymore, these practices. They used to pay a certain amount of money per chart whenever you would take a practice and up to a third of the patients would leave anyway after a new doctor came in. It’s really hard to find somebody that’s willing to pay for a practice. If you go out and look to buy a practice, the doctor that’s been there for 40 years thinks that practice is really, really valuable. They’re going to ask you for $1 million or something like that and you can pay it off over a course of a number of years. And that’s just ridiculous because you can just open up a practice right next door to them. And when they do retire, like I said, 30% of their patients are going to leave anyway even if somebody else comes over there, and then you’ll be able to do a better job by just opening fresh right next to somebody. The only thing that your practice might be worth is the real estate or the equipment in those type of things in the practice. The one exception to that is that hospitals are buying practices for strategic reasons. So a hospital may buy a practice. But the hospital won’t buy a practice when you’re going to retire. They’ll buy a practice about 10 years before you retire because they want to bring you into the fold and bring all your patients in and they want you to work there for a while because your practice is you. So it’s not valuable to buy your practice and you not working there anymore. So, they’ll buy it about 10 years before. That kind of gives you some money for retirement and then you can retire after that period time. But there’s usually a period of time that they request that you stay. Another option is to get an income guarantee. These are very common in California and Nevada. They occur in other states but they’re really common in California and Nevada. But this is where you go to a hospital and when you create your job you convince the hospital that they need you there for whatever reason whether you’re coming out of your residency and you really have a lot of expertise in this or that. And you’ve noticed that there’s a community need and you’re going to answer that community need and then that hospital they don’t really have any podiatrist that are fulltime working there. You can ask them for an income guarantee. An income guarantee is something like they would guarantee that you make $240,000 a year for the first two years. And so you divide that up by the months and that’s $20,000 a month. At the end of your month you would turn over all of your receipts to them, whatever you collected not what was built. So, you know your first month when you’re working you’re probably going to collect zero because that takes insurances that long to pay you but you’re going to get zero on your first month. So your first month you turn in your receipts, you got nothing, hospital writes you a check for 20,000. And then next month you got maybe 5,000, hospital writes you a check for 15,000. The next month you’re starting to collect from your first month so then you’re picking it up. And then once you get over the 20 you don’t have to pay that money to the hospital. The income guarantee is usually paid off of time. So you say, “I’ll agree to stay here for three years past the income guarantee.” And so it’s seen as a loan that’s paid off of time. Those are actually very nice ways for you to start an entrepreneurial practice because you don’t have to put a lot of money into it. And especially if you start a hospital-based practice where your podiatric hospital is, you don’t ever have to pay any expenses really. You’re working in the hospital, you’re working in the wound center, you’re taking call in the ER, you’re rounding on patients. And that’s not as common in podiatry. That’s all I’ve done. I’ve been a podiatric hospitalist so I’ve not had my own office. It’s a lucrative way to do business because you do take a little bit of a reduction from Medicare and from private insurances because they say that you’re working inside of a hospital so you have to mark that in your billing that you’re being paid out of you’re working the hospital. So they pay you about 82% of what they would pay somebody in their office. But if you think about your expenses in your office your overhead is about 50%. So, I’m taking an 18% reduction with no expenses and somebody in their private office is getting 100% but then they’re paying 50% of that in expenses. Income guarantee, especially with hospital-based practices is very good then you could just start a practice on your own and that could either be office-based or hospital-based. And if you start an office-based practice you’re going to be thinking about whether I’m going to have affiliation with a surgery center or a hospital, how the referral is going to work.

    [10:04]

    Then the next step would be if you want to have an employed practice. Now this is a safer option for people who don’t feel like they’re entrepreneurial or don’t want to take the risk of being in your own practice. Even when you’re in a hospital-based practice you can still be in private practice and a hospital-based practice but you’re working in a hospital all the time, it kind of looks like you’re employed at the hospital but you’re not. But you could have an employed arrangement and that could be with another podiatrist where you have an associate arrangement. I’m sure you’ve all heard the adage, “Podiatry eats their young.” It’s sad how much younger people get taken advantage of by older podiatrist who are looking to bring somebody in their office and make a bunch of money on you. You have to trust the person that’s bringing you in and really know what your worth and what you’re bringing in and you want everything to be transparent about how much money you’re bringing in the practice. Then you could do a group practice and that could be podiatry group, or a multi-specialty group or a hospital group. In a podiatry group you could still get the same problems with the associate arrangement. In the multi-specialty group and a hospital group it’s probably less so because they’re benchmarking you according to everybody else’s other guidelines for the other specialties that are there and it’s a little bit more transparent. You could just be a hospital employee and the hospitals will employ podiatrist in many cases because they have podiatry departments that would take call and do surgery, work in their wound centers, do the inpatient rounds. You could be a government employee. You could work at the VA or in health services for the military or you could work for the county hospital that would also be a government employee. Or, you could be a university employee and there’s lots of universities that hire podiatrist to run their departments. Employed practice, you’re going to make less than you would if you’re in entrepreneurial practice but there’s also less risk and all of your expenses are covered when you’re in employed practice. You don’t have to worry about things. You’re not worried about making payments on your malpractice insurance or this or that. You’re not in charge anymore but you have less worry. For the first part is how do you find a job? Now, it’s not that easy, actually, because there’s not one place where there’s repository of jobs for podiatrist. And you spend a lot of time looking. And you could never find the job that you’re looking for. But the first is just word of mouth. People are, “Hey, I’m looking for somebody to come into my office or there’s a hospital looking for somebody.” And that’s usually done through residency directors and friends. Another place you can go is to APMA. They have a career center where people are posting jobs on the career center and you can scroll through that and see if there’s something that appeals to you. You could look at podiatry management, the PMNews that comes out and just scroll through that. And if you’re looking for a government job, all government jobs in every branch and part of the federal government are all posted on usajobs.gov and that includes podiatrist. So if you go to usajobs.gov, you can just search podiatrist. But you could set up a search alert where every week they’re emailing you all the job openings for podiatrist for all government, not only the VA but IHS and the military, anything that pops up. You can just have that come as an email alert to you and you can see where it is. This is one of my favorite quotes and this is George Bernard Shaw. He says that “Life isn’t about finding yourself. It’s about creating yourself.” And that’s what you can do with the career like podiatry. You can create the job that you want to have. And it’s not that difficult. Most people just don’t think about it. You ask yourself, what is your ideal job? And if you think of a Want Ad and what would that Want Ad say for your ideal job? And I would even recommend you write it out because it’s very important how these things done on paper. But think about what your ideal job is, where the location is, what you want to be doing, even what your salary would be and write it out in the Want Ad so you know exactly what it is that you’re looking for. How do you create yourself? You can see over there a little quote. One of the most common characteristics of really successful people is that they have written goals. And you can say, “I want to have goals. I have life goals. I know what I want to do in life.” But if you don’t write them down it’s harder to stick to them. And so they find that if you actually have your goals and you write them down that you’re more likely to achieve those goals.

    [15:00]

    And then to step even further is if you tell other people about those goals. You’re even more likely to achieve those goals and it’s because you’re almost embarrassed not to achieve them. It’s just like if you’re going to compete in a marathon and you posted it on Facebook, “I’m training for this marathon.” Well, now you told everybody that you’re doing it. And if it comes along and you don’t do it, it’s going to be a little embarrassing. Psychologists recommend writing down these goals and then telling people about what are your goals. And that’s going to help you stick to your goals. So, who do you want to be? And that’s where you do this thing of visualizing your future self. It is just like an athlete. Before they shoot a basket in the Olympics, if any of you are watching it, before they do a dive or a routine in gymnastics, a lot of the athletes stop and they visualize the routine. And then they go through with it or they visualize them practicing shooting baskets. And that type of mental repetition has been shown to increase the likelihood of achieving the outcome. You should also visualize where you want to be in life and what kind of person you want to be and what kind of doctor you want to be. And then write a vision statement for that. A vision statement is usually two sentences of what your goals are and where you’re going to be in 5 or 10 years. So you create these written goals. You set priorities of which goals are most important. You consider the requirements for each goal so you’d have a goal and then the different requirements to achieve that goal. And then you prepare for obstacles because you’re always going to bump into obstacles on your way to achieving what it is that you’re looking to do. Then you’re always working consistently towards your goal so it’s important to stay motivated. You need to change your strategies every once in a while and then you do self-reassessment periodically. This may sound stupid but about once a year I take a little retreat by myself somewhere. I do a lot of traveling anyway for Restorix. I’m in the road about 25 days a month. I take a couple of days on the end of a trip somewhere there’s nice to stay. I just shut up my phone, I sit around, I redo all of the goals that I’ve had in life and I decide where I need to restrategize and do some other things. But it’s kind of like a reassessment of where I am and where my career is and then move forward from there. If you’re looking to predict the future, the best way to predict the future is to just create it. If you want to know where you want to be in five years predict where you’re going to be in five years, just create where you’re going to be in five years. The other thing is you have to make a decision. There’s so many people who are, “I don’t know.” They’re indecisive. “I could do this or I could do that. I’m just putting off the decision until somebody forces me to make the decision.” But, they say that “The road of life is paved with flat squirrels who couldn’t make a decision.” And that’s true. Think about where you want to be and make a decision and move on to the next decision you have to make. I went to school at Des Moines University and I was always the fastest test taker. I was out of there in 18 minutes or 20 minutes for every single test that I took. I didn’t get every question right. I was a solid B student. But everybody thought I was the smartest person because I was out of there so quick. But I was out of there quick because I looked at a question, I made a decision, and I moved on to the next question. I never went back unless the later question sometimes would answer an earlier question. That will be the only time I would ever go back. I never circle to think about it later and come back and just ruminate over it. Make a decision and move on. And in surgery that’s important too. When you’re doing surgery you don’t have a lot of time to try to ruminate over things. You’ve got a bleeding artery you have to make a decision and then you have to move on. You can’t spend all day in surgery. Don’t be afraid to fail either because the number of times you succeed is proportional to the number of times you fail. I failed numerous times at things that I’ve done. You can’t let that get in your way. They talk about business in America and how one of the reasons why America is a better business environment for entrepreneurs and startups is because we have bankruptcy laws, which they don’t have in many other countries.

    [20:03]

    Where if you start a company, and you divorce yourself financially from that company because you remove the company as the corporate structure in America allows the company to be separate from your personal finances and if you try something with a new invention or a new way of doing something and you fail, you declare a bankruptcy, your personal assets are fine. You move on to the next company, you start another company and you go at it again. You also have to think about that in your career, not necessarily hopefully, not declaring bankruptcy but at least declaring bankruptcy on this idea. If you have an idea and it didn’t work, and you move on to the next idea. I saw this other quote the other day that said, “If you ever are scared about voicing your idea, just remember that a bunch of people sat in the room once and said, ‘Hey, let’s make a movie about sharks inside of a tornado.’” So there are no idea is a bad idea. How do you create your own job? Most of what we do is related to hospital work. That’s where you’re going to be getting a lot of your referrals. Even if you’re in an office-based practice, a lot of your patients are going to be sick, they’re going to have to go to the hospital, you’re going to have to communicate with other doctors in the hospitals. So a lot of this is focused around hospitals. And that’s why people when they open up their offices, when you look at hospitals, what surrounding a hospital for the next several blocks? Doctors’ offices, pharmacies, physical therapy, those are all surrounding these like medical community. It’s like a medical community or a campus of all these health care services because that’s where patients go to get health care. They go to the hospital and then they know where everything is. The first thing is do plenty of research. Find out what the community need is in that area so you could do something. I specialized in the diabetic foot, so that I knew I wanted to do that ever since I was in school. The diabetic foot in many cases is easier to get into than trauma orthopedics. One, because there’s hardly anybody that really specializes totally in the diabetic foot, so really you’re going into a field that is pretty empty and that there’s tremendous amount of need for it. You’re seeing an increase in the prevalence of diabetes. So you’re never going to have run out of business if you’re looking at the diabetic foot. Two, if you go into a hospital and you say, “I am a great podiatric traumatologist. I do ankle fractures, calcaneal fractures. I want to take call on the ER.” The first thing you’re going to do is get arguments with all the orthopedics surgeons in there. That may not be a battle that you want to take at the beginning. So instead, if you walk in and you say, “I do diabetic foot work. I’ll come in and do incision and drainage. I do TMAs for a forefoot gangrene. I work closely with vascular people,” and usually the hospital will be like, “Great. When can you start?” And orthopedics is like, “We don’t want to deal with that. Have them come in.” But when you get your privileges in the hospital, your privilege is, you say that’s what I want to do but then your privilege is don’t say Dr. Smith is limited to diabetic footwork, your privileges say, you can do surgery on the foot and ankle, including all the procedures that you applied for your privileges. And so you’re going to be able to do all these other surgeries. You just got your foot in the door because you wanted to focus on the diabetic foot. And I’d recommend focusing on that, on whatever you say you’re going to focused on to begin with. And then slowly introduce the other stuff in your practice once people are more comfortable with you and you’ve been there for a while. You’re going to cause less commotion if you do it that way. So understanding who your competition is, whether it’s orthopedist or other podiatrists or if you’re doing in a wound center, saying, “Who is working on the wound center?” You got to contact the physician recruiter. Every hospital has a physician recruiter. And hospitals, some of them are not for profit but most of them are for profit. They’re looking to bring in doctors that are going to bring patients to the hospital. That’s what they want. They want you to do surgery in the hospital and they want more patients to be admitted to the hospital. I always would joke around. Remember that TV commercial of people walking around and above their head is their credit score? Do you remember that TV commercial? People are walking around. Some of them have 695 and others have 780 or whatever. Well I think that when you walk around the hospital, and the hospital administrator walks in the cafeteria, they know, because they do know, they know how much money should the doctors are bringing into the hospital. They can see above your head how much worth you are and then see where they sit, which group of doctors they sit with in the cafeteria.

    [25:06]

    But you can become like that. Our programs have been some of the most successful programs inside of the hospital. And bringing in millions of dollars into the hospital because they’re based on surgery. So you contact the physician recruiter. You find out what the needs are at the hospital. You introduce yourself. They bring you in and they’ll talk to the administrator. You have to know what it is that you do and you have to know how much money that stuff brings into the hospital so you can talk to them about it in their language. You want to create a good CV. If you’ve ever heard that your resume should be no more than two pages, well that’s true but that’s not a CV. Your CV is your curriculum vitae. That’s everything you’ve ever done in your life. So my CV is 60 pages long and it’s got every lecture I’ve ever given. It’s got every article I’ve written, every committee I’ve served on. All of that on my CV. David Armstrong CV is almost a hundred pages long. Your CV is your life’s work, curriculum vitae. You need to create one and put it in the right format with the right headings so that’s easy for people to get to. You visit the hospital, you got to make a case for yourself, what makes me different, how you’re going to work with people at the hospital, how you’re going to be a team player and that’s going to ultimately resort in bringing in more money into the hospital for them. You need to produce a light version of a business plan. They don’t expect you have a huge 40-page business plan but they want to see something like five pages to seven pages of what the community need is for the services that you’re offering. That’s pretty simple research to do. What type of procedures you do, how much of those procedures bill, all of that, and you put that together in a plan, a business plan for the hospital so that they know what your worth. And then put together a presentation of the cases. If you’re talking about the diabetic foot, put together a presentation of cases at the diabetic foot. About trauma, put together presentation with those cases. Offer to give grand rounds so that when you’re doing the grand rounds and you’re presenting these cases, they see you as the expert in that. And then the other thing is to know the MGMA data and that’s Medical Group Management Association. In the next lecture, I’m going to show you the MGMA data and how to get it and you’re going to be amazed that you never heard of this before. If you have, I’m impressed but if you haven’t I understand. But this is how all hospital administrators value what you do. If you know the data going in, you’re going to be at an advantage because they know the data already. They know that they’re going to try to get you. Just like buying a car. They’re going to try buy you for less than what you’re going to make. They want you to bring in more money than that. But if you know what you’re bringing in, you’re never going to get exactly that number. But you can negotiate up higher. What is your browser say about you? Everybody know these browsers? I’m sure you do, right? What do you think in studies people that use which browser are the best employees? I’ll wait for an answer because I want somebody to say something.

    Male Speaker 2: Chrome.

    Lee Rogers: Chrome? Now think about why would you think that? There is a study that showed that people who use Firefox or Chrome are better employees. And the reason why is because Internet Explorer and Safari are pre-installed on your machine. It’s the crappy browser that’s pre-installed on your machine. When you buy new PC or new Apple, that’s what you get. You have to go to the internet and download these other ones and put them on your machines. It has nothing to do with the actual functionality of the browser but it has everything to do with the type of person that is looking for something that’s better than what’s already pre-installed. These people that use Internet Explorer and Safari, they’re satisfied with the status quo and that’s fine. But people that are looking for something else and having other functionality, those are people that are better employees because they’re going out and they’re looking for things and bringing it in. So it’s interesting. The mentality behind it is interesting. That doesn’t mean that if you’re one of those people right now that uses Safari or Internet Explore that if you just download the other one, you’ll be a better employee because I told you the secret. I love this quote as well. “To achieve great things, two things are needed. A plan and not quite enough time.” And that true. That’s how we get to the moon. We had a plan of how we’re going to get to the moon. We had a deadline of by the end of the decade and it wasn’t quite enough time to do it.

    [30:04]

    And that’s how we achieve great things. I feel like that in my life and I’m sure you feel like that in yours as well. You have a plan but there’s never enough time to get something done. When you’re under the gun that’s how it works. Talking about board certification, you heard from Marc Bernard or Steve Goldman talking about ABPM. I’m a board member for ABPM as well. Board certification, so when you’re looking at how does a hospital evaluate your competence. Board certification only one thing that they check off. The same thing of like, “Do you have a license?” You have a license, “Okay, we check that box.” They look for board certification. They check that box whether or not you’re board certified and neither one of the boards that are recognized by the profession. And so that’s part of your credentialing. There’s two parts of getting on staff at a hospital. There’s credentialing and there’s privileging. So your credentialing part is, “Do you have the credentials to be on staff at the hospital?” Your privileging part is, “What privileges are you going to be given so that you can do these things inside of the hospitals?” You have to do through credentialing first before you go to privileging. So they look at board certification just as a box for this. But the problem is, they have to read the hospital bylaws and the surgery department policies and procedures because in many cases, they say that you have to be board certified within five years or you get thrown off staff. The problem is that, we have a board in podiatry, ABFAS that says that you have seven years to get board certified. So you can go to the hospital medical staff office and you can say, “Oh, yeah, I’m a podiatrist and my board says that I have seven years.” And they say, “We don’t care. It’s a hospital policy, a five years, all the hospitals, because everything in the MD world is five years.” So I said, “Ours says five years or you’re off staff.” And so that’s why we’ve done a lot to change ABPM to make it more user friendly for younger people getting out so that you can get board certified within one year. Within the first year that you get out, you can board certified by ABPM. Then you don’t have to worry about a work towards ABFAS. That’s fine. Now you’re board certified. You don’t have to worry about being thrown off staff or not getting credential by an insurance company. One of my pet peeves is parts of our profession that want to get away from the P word, podiatry. So we have a lot of things. You may not have been exposed to this other line of thinking but this is David Armstrong, who I’m sure you all know. His dad was a podiatrist. He would pontificate all the time when I did my fellowship with him and he just sit down and just ramble on about things in the profession. This is something that I gained from him, was that, you’re never going to get away from the word podiatry. You are a DPM. You’re not ADFM. So those in our profession that feel embarrassed by the word podiatry and try to get away from that word, you’re just playing mental games with yourself. If you’re not happy with what the perception is of podiatry, then just be a better podiatrist so that you help to increase the perception and improve the perception of what a podiatrist really is. Anytime I walk into a hospital, I don’t walk into a hospital and think, “Oh, I’m just a podiatrist. I got to keep my head down and I can’t talk to anybody.” I do really valuable work for that hospital and for my patients and I’m the best one that can work on a diabetic foot in the whole hospital. Nobody else can do what I can do in the hospital. And I have surgical privileges and if something happens in the OR, I’m treated just like anybody else in the hospital. If you carry yourself with that stature, you’re never going to be looked down upon and you’ll never have to feel that way about where you are in the profession. Some of our organizations are moving away from using podiatry like ABPS changed to ABFAS, and ACFAS is ACFAS. For us, it was important to maintain the word podiatry in there because again we’re DPMs and we’re never going to get away from that. Winston Churchill said that, “Success is going from failure to failure without losing enthusiasm.” That’s kind of like an earlier quote that I used which is that, “Don’t be afraid to fail.”

    [35:04]

    The way you’re going to be successful is by failing over and over again until you finally get that one chance to succeed and you’re going to learn from all these failures. The last part before I move on to the next lecture is just the life goals. So everything is not about work. Work makes you happy, gets you money, so you can have a better life. You can take care of your kids but it’s also about living because one day you’re going die. What are the top five regrets of the dying? And I think these are important to look at every once in a while. If somebody is dying, a lot of these are patients with cancer. But if somebody is dying and they say, “I really regret this or that.” And now they’re at the end of their life and they can’t change any of that. We can learn a lot from that now by saying, “What were the things that they regretted and so I can do some of these things before I get to that point and I don’t have to regret the same things.” But they say, “I wish I had more courage to live a life true to myself and not what others expected of me. I wish I hadn’t worked so hard. I wish I had the courage to express my true feelings. I wish I had stayed in touch more with my friends.” They obviously didn’t have Facebook. “I wish I let myself be happier.” So I think that’s important too to look at at where you want in life and how you’re going to be happy. Because ultimately, all these things come together to make you happy and you have to concentrate in all of that. And then Hunter Thompson said that “Life should not be a journey to the grave with the intention of arriving safely in a pretty and well-preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming, ‘Wow, what ride.’” And then the last part is just, “Kill them with success and bury them with a smile.” The best thing that you can do to anybody who’s giving you grief or your enemies is to be successful.