by Patrick Pevoto, MD, MBA

My time as your CMS president is ending during the upcoming Annual Meeting in Vail. It has been an honor to serve you this past year and quite a learning experience! Our medical society has been in the midst of many changes, a sort of microcosm of our society today. Our politics continue to be quite divisive, and as servant leaders of Colorado physicians we don’t always represent the individual viewpoints and beliefs of each physician. Many decisions and actions I took could be construed as “right” or “wrong,” but I assure you I always made these decisions with the intention of improving the practice of medicine for physicians and our patients.

I received a letter from a Colorado physician leader that CMS – and particularly me – seemed to insinuate that physicians are their own worst enemies…sort of “victim shaming.” That has never been my intent, especially since things that I have espoused have been directed at me first. As I quoted Dr. Viktor Frankl in my presidential address last September:

“Forces beyond your control can take away everything you possess except for one thing...your freedom to choose how you will respond to the situation. You cannot control what happens to you in life, but you can always control what you will feel and do about what happens to you.”

My goal was to try and provide some tools that might be useful during the weathering of storms and tempests that come our way. We have all suffered from “moral injury” in the practice of medicine; it is hard, painful and at times there seems to be no end in sight. It does follow that finding ways to control our response to moral injury is time well spent, no matter what you use or who you work with in that endeavor.

Many of you have read "The Four Agreements: A Practical Guide to Personal Freedom" (A Toltec Wisdom Book), by Don Miguel Ruiz, MD, a neurosurgeon from Mexico. If you haven’t, I recommend that you do so. The premise of the book is that everything a person does in their lifetime is based on “agreements” they have made with themselves, with others, with God, with society and with life itself (from the source listed above). He outlines four such agreements:

  1. Your speech should be impeccable.
  2. Don’t take things personally.
  3. Don’t make assumptions.
  4. Always do your best.

I do not want to rewrite the book in this column. First, I would not do it justice. Second, it is not a long book (less than 170 pages) and can be read in one sitting. I wanted to relate the Four Agreements to my experiences the past year.

During my presidency, I have done my best to make sure my speech has been impeccable. Whether right or wrong, I strived to be transparent and honest. It has always been hard for me not to take things personally. I am a “people-pleaser” and I experience great discomfort when others interpret my speech or actions as offensive. I am the world’s worst at making assumptions as well. An action or decision made by someone, or some group, was being directed at me for nefarious reasons, when that conclusion was far from reality and/or the truth.

The Fourth Agreement is one that I guarantee I worked hard to execute...always do my best! What a realization it was that “my best” does not have to be perfect, does not have to please everyone, does not have to lead to a perfect outcome. I hope that my fellow Colorado physicians know that I was doing my best to represent them, and I will continue to do so when I turn the reins over to Omar Mubarak, MD, MBA, in September.

Thank you so much for giving me the opportunity to serve all of you!!

Categories: Communications, Colorado Medicine, President's Letter