Male Speaker 1: We have something special for you thatâs unique to these resident summits and thatâs 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 youâve gained. Letâs all welcome, Dr. Rogers.
[Applause]
Dr. Lee Rogers: Alright. Iâm 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 youâre talking to a potential employer? I can tell you that Iâve never applied for a job before. Every job that Iâve ever had I created for myself. Everything from my fellowship, which I created, whether the fellowship with David Armstrong, it didnât exist before I started. Nick Bevilacqua who youâve met yesterday, he spoke up here, he was my co-fellow. He and I went to a company and said, âHey, we want to do a fellowship with David Armstrong. Give us $150,000 and weâll do this fellowship. We are interested in Charcot foot. Weâre going to do a bunch of publications on Charcot.â And thatâs 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 donât always have to think, âWhat kind of job am I looking for?â You can also think, âWhat kind of job do I want and how do I create that job?â These are the essentials, I guess, of being a successful young podiatrist. Youâre 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 youâre in that position, what do I do for professional development? And thatâs 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 youâre 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 youâre choosing a new place to live. These are all life goals and things that youâre 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 thereâs always these classified ads on what jobs are available in certain areas. The problem with this is if youâre a person who says I really want to go back to Cincinnati. Cincinnati is a wonderful place. I donât know if anybody says that, if somebody did say that. Cincinnati is a wonderful place. Thatâs where I want to go work. And youâre just spending all your time calling the Want Ads by whichever publication. Youâll probably never going to find the one that really speaks to you and maybe youâre going to settle for some associate position in Cincinnati just because thatâs 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. Thereâs either entrepreneurial practice or employed practice. And you can create jobs in both of these. So itâs easier to do it in the entrepreneurial side to create it because youâre 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. Itâs kind of a mistake if youâre thinking about building your wealth and your equity. Itâs kind of a mistake to think that, âIâm going to spend 40 years working in my own practice and at the end of that 40 years Iâm 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.â They arenât 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. Itâs really hard to find somebody thatâs willing to pay for a practice. If you go out and look to buy a practice, the doctor thatâs been there for 40 years thinks that practice is really, really valuable. Theyâre 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 thatâs 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 youâll 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 wonât buy a practice when youâre going to retire. Theyâll 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 itâs not valuable to buy your practice and you not working there anymore. So, theyâll 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 thereâs 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 theyâre 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 youâre coming out of your residency and you really have a lot of expertise in this or that. And youâve noticed that thereâs a community need and youâre going to answer that community need and then that hospital they donât 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 thatâs $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 youâre working youâre probably going to collect zero because that takes insurances that long to pay you but youâre 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 youâre starting to collect from your first month so then youâre picking it up. And then once you get over the 20 you donât have to pay that money to the hospital. The income guarantee is usually paid off of time. So you say, âIâll agree to stay here for three years past the income guarantee.â And so itâs seen as a loan thatâs paid off of time. Those are actually very nice ways for you to start an entrepreneurial practice because you donât have to put a lot of money into it. And especially if you start a hospital-based practice where your podiatric hospital is, you donât ever have to pay any expenses really. Youâre working in the hospital, youâre working in the wound center, youâre taking call in the ER, youâre rounding on patients. And thatâs not as common in podiatry. Thatâs all Iâve done. Iâve been a podiatric hospitalist so Iâve not had my own office. Itâs 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 youâre working inside of a hospital so you have to mark that in your billing that youâre being paid out of youâre 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, Iâm taking an 18% reduction with no expenses and somebody in their private office is getting 100% but then theyâre 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 youâre going to be thinking about whether Iâm 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 donât feel like theyâre entrepreneurial or donât want to take the risk of being in your own practice. Even when youâre in a hospital-based practice you can still be in private practice and a hospital-based practice but youâre working in a hospital all the time, it kind of looks like youâre employed at the hospital but youâre not. But you could have an employed arrangement and that could be with another podiatrist where you have an associate arrangement. Iâm sure youâve all heard the adage, âPodiatry eats their young.â Itâs 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 thatâs bringing you in and really know what your worth and what youâre bringing in and you want everything to be transparent about how much money youâre 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 itâs probably less so because theyâre benchmarking you according to everybody elseâs other guidelines for the other specialties that are there and itâs 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 thereâs lots of universities that hire podiatrist to run their departments. Employed practice, youâre going to make less than you would if youâre in entrepreneurial practice but thereâs also less risk and all of your expenses are covered when youâre in employed practice. You donât have to worry about things. Youâre not worried about making payments on your malpractice insurance or this or that. Youâre not in charge anymore but you have less worry. For the first part is how do you find a job? Now, itâs not that easy, actually, because thereâs not one place where thereâs repository of jobs for podiatrist. And you spend a lot of time looking. And you could never find the job that youâre looking for. But the first is just word of mouth. People are, âHey, Iâm looking for somebody to come into my office or thereâs a hospital looking for somebody.â And thatâs 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 thereâs something that appeals to you. You could look at podiatry management, the PMNews that comes out and just scroll through that. And if youâre 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 theyâre 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 âLife isnât about finding yourself. Itâs about creating yourself.â And thatâs what you can do with the career like podiatry. You can create the job that you want to have. And itâs not that difficult. Most people just donât 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 itâs 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 youâre 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, âI want to have goals. I have life goals. I know what I want to do in life.â But if you donât write them down itâs harder to stick to them. And so they find that if you actually have your goals and you write them down that youâre more likely to achieve those goals.
[15:00]
And then to step even further is if you tell other people about those goals. Youâre even more likely to achieve those goals and itâs because youâre almost embarrassed not to achieve them. Itâs just like if youâre going to compete in a marathon and you posted it on Facebook, âIâm training for this marathon.â Well, now you told everybody that youâre doing it. And if it comes along and you donât do it, itâs going to be a little embarrassing. Psychologists recommend writing down these goals and then telling people about what are your goals. And thatâs going to help you stick to your goals. So, who do you want to be? And thatâs 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 youâre 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 youâd have a goal and then the different requirements to achieve that goal. And then you prepare for obstacles because youâre always going to bump into obstacles on your way to achieving what it is that youâre looking to do. Then youâre always working consistently towards your goal so itâs 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. Iâm in the road about 25 days a month. I take a couple of days on the end of a trip somewhere thereâs nice to stay. I just shut up my phone, I sit around, I redo all of the goals that Iâve had in life and I decide where I need to restrategize and do some other things. But itâs kind of like a reassessment of where I am and where my career is and then move forward from there. If youâre 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 youâre going to be in five years, just create where youâre going to be in five years. The other thing is you have to make a decision. Thereâs so many people who are, âI donât know.â Theyâre indecisive. âI could do this or I could do that. Iâm just putting off the decision until somebody forces me to make the decision.â But, they say that âThe road of life is paved with flat squirrels who couldnât make a decision.â And thatâs 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 didnât 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 thatâs important too. When youâre doing surgery you donât have a lot of time to try to ruminate over things. Youâve got a bleeding artery you have to make a decision and then you have to move on. You canât spend all day in surgery. Donât 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 Iâve done. You canât 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 donât 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 didnât work, and you move on to the next idea. I saw this other quote the other day that said, âIf you ever are scared about voicing your idea, just remember that a bunch of people sat in the room once and said, âHey, letâs make a movie about sharks inside of a tornado.ââ 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. Thatâs where youâre going to be getting a lot of your referrals. Even if youâre in an office-based practice, a lot of your patients are going to be sick, theyâre going to have to go to the hospital, youâre going to have to communicate with other doctors in the hospitals. So a lot of this is focused around hospitals. And thatâs why people when they open up their offices, when you look at hospitals, what surrounding a hospital for the next several blocks? Doctorsâ offices, pharmacies, physical therapy, those are all surrounding these like medical community. Itâs like a medical community or a campus of all these health care services because thatâs 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 thereâs hardly anybody that really specializes totally in the diabetic foot, so really youâre going into a field that is pretty empty and that thereâs tremendous amount of need for it. Youâre seeing an increase in the prevalence of diabetes. So youâre never going to have run out of business if youâre looking at the diabetic foot. Two, if you go into a hospital and you say, âI am a great podiatric traumatologist. I do ankle fractures, calcaneal fractures. I want to take call on the ER.â The first thing youâre 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, âI do diabetic foot work. Iâll come in and do incision and drainage. I do TMAs for a forefoot gangrene. I work closely with vascular people,â and usually the hospital will be like, âGreat. When can you start?â And orthopedics is like, âWe donât want to deal with that. Have them come in.â But when you get your privileges in the hospital, your privilege is, you say thatâs what I want to do but then your privilege is donât 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 youâre 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 Iâd recommend focusing on that, on whatever you say youâre 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 youâve been there for a while. Youâre going to cause less commotion if you do it that way. So understanding who your competition is, whether itâs orthopedist or other podiatrists or if youâre doing in a wound center, saying, âWho is working on the wound center?â 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. Theyâre looking to bring in doctors that are going to bring patients to the hospital. Thatâs 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 theyâre 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 theyâll 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 youâve ever heard that your resume should be no more than two pages, well thatâs true but thatâs not a CV. Your CV is your curriculum vitae. Thatâs everything youâve ever done in your life. So my CV is 60 pages long and itâs got every lecture Iâve ever given. Itâs got every article Iâve written, every committee Iâve served on. All of that on my CV. David Armstrong CV is almost a hundred pages long. Your CV is your lifeâs work, curriculum vitae. You need to create one and put it in the right format with the right headings so thatâs easy for people to get to. You visit the hospital, you got to make a case for yourself, what makes me different, how youâre going to work with people at the hospital, how youâre going to be a team player and thatâs 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 donât 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 youâre offering. Thatâs 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 youâre 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 youâre doing the grand rounds and youâre presenting these cases, they see you as the expert in that. And then the other thing is to know the MGMA data and thatâs Medical Group Management Association. In the next lecture, Iâm going to show you the MGMA data and how to get it and youâre going to be amazed that you never heard of this before. If you have, Iâm impressed but if you havenât I understand. But this is how all hospital administrators value what you do. If you know the data going in, youâre going to be at an advantage because they know the data already. They know that theyâre going to try to get you. Just like buying a car. Theyâre going to try buy you for less than what youâre going to make. They want you to bring in more money than that. But if you know what youâre bringing in, youâre never going to get exactly that number. But you can negotiate up higher. What is your browser say about you? Everybody know these browsers? Iâm sure you do, right? What do you think in studies people that use which browser are the best employees? Iâll 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. Itâs the crappy browser thatâs pre-installed on your machine. When you buy new PC or new Apple, thatâs 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 thatâs better than whatâs already pre-installed. These people that use Internet Explorer and Safari, theyâre satisfied with the status quo and thatâs fine. But people that are looking for something else and having other functionality, those are people that are better employees because theyâre going out and theyâre looking for things and bringing it in. So itâs interesting. The mentality behind it is interesting. That doesnât mean that if youâre one of those people right now that uses Safari or Internet Explore that if you just download the other one, youâll be a better employee because I told you the secret. I love this quote as well. âTo achieve great things, two things are needed. A plan and not quite enough time.â And that true. Thatâs how we get to the moon. We had a plan of how weâre going to get to the moon. We had a deadline of by the end of the decade and it wasnât quite enough time to do it.
[30:04]
And thatâs how we achieve great things. I feel like that in my life and Iâm sure you feel like that in yours as well. You have a plan but thereâs never enough time to get something done. When youâre under the gun thatâs how it works. Talking about board certification, you heard from Marc Bernard or Steve Goldman talking about ABPM. Iâm a board member for ABPM as well. Board certification, so when youâre looking at how does a hospital evaluate your competence. Board certification only one thing that they check off. The same thing of like, âDo you have a license?â You have a license, âOkay, we check that box.â They look for board certification. They check that box whether or not youâre board certified and neither one of the boards that are recognized by the profession. And so thatâs part of your credentialing. Thereâs two parts of getting on staff at a hospital. Thereâs credentialing and thereâs privileging. So your credentialing part is, âDo you have the credentials to be on staff at the hospital?â Your privileging part is, âWhat privileges are you going to be given so that you can do these things inside of the hospitals?â 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, âOh, yeah, Iâm a podiatrist and my board says that I have seven years.â And they say, âWe donât care. Itâs a hospital policy, a five years, all the hospitals, because everything in the MD world is five years.â So I said, âOurs says five years or youâre off staff.â And so thatâs why weâve 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 donât have to worry about a work towards ABFAS. Thatâs fine. Now youâre board certified. You donât 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 Iâm 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, youâre never going to get away from the word podiatry. You are a DPM. Youâre not ADFM. So those in our profession that feel embarrassed by the word podiatry and try to get away from that word, youâre just playing mental games with yourself. If youâre 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 donât walk into a hospital and think, âOh, Iâm just a podiatrist. I got to keep my head down and I canât talk to anybody.â I do really valuable work for that hospital and for my patients and Iâm 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, Iâm treated just like anybody else in the hospital. If you carry yourself with that stature, youâre never going to be looked down upon and youâll 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 weâre DPMs and weâre never going to get away from that. Winston Churchill said that, âSuccess is going from failure to failure without losing enthusiasm.â Thatâs kind of like an earlier quote that I used which is that, âDonât be afraid to fail.â
[35:04]
The way youâre going to be successful is by failing over and over again until you finally get that one chance to succeed and youâre 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 itâs also about living because one day youâre 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, âI really regret this or that.â And now theyâre at the end of their life and they canât change any of that. We can learn a lot from that now by saying, âWhat were the things that they regretted and so I can do some of these things before I get to that point and I donât have to regret the same things.â But they say, âI wish I had more courage to live a life true to myself and not what others expected of me. I wish I hadnât 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.â They obviously didnât have Facebook. âI wish I let myself be happier.â So I think thatâs important too to look at at where you want in life and how youâre 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 âLife 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, âWow, what ride.ââ And then the last part is just, âKill them with success and bury them with a smile.â The best thing that you can do to anybody whoâs giving you grief or your enemies is to be successful.