When I think back to my first years of practice, I remember a stark contrast between what I knew was possible as a physician, in caring for patients, and the reality I was facing each day.
In medical training, for almost a decade, every step of my training came with preceptors, examiners, and attendings; people whose job it was to scrutinize my decisions and my knowledge. Their approval became the barometer of whether I deserved to be a doctor. I, like many medical trainees, internalized that harsh inner critic.
After that blur of intense training that at times felt unendurably long and arduous and at the same time “too short”, you pass your residency and licensing and board exams and that external accountability is gone. With that, you leave the neat, other-defined thresholds of what counted as “good” or “bad.”
I found myself isolated in my clinic with no guidance for the vision of care that was mine to create. And very quickly, the weight of the responsibility of care quality becomes staggering. Within months, I had close to 2,000 patients depending on me. Every request, every crisis feels urgent, and, as you can imagine, in medicine, it often is. I couldn’t say no when someone told me their father had cancer and needed a family doctor. You don’t turn away 11 year olds in mental distress. When an emancipated youth tells you that they do not feel safe with their partner, you can’t just abruptly end an appointment to go pick up your own kids. You don’t shrink your humanity to protect your schedule.
As you fumble all the balls, perpetually attempting to put out other people’s fires, an anxiety builds up and you begin to worry what your practice data might say about the care you give your patients. So, you resist looking at your practice data – not because you don’t care, but because you care so much and you’re terrified of what has been missed. You rush between exam rooms with the quiet fear that today might be the day that a lapse in attention, in documentation, or an overlooked detail impacts your patient’s life. You start making compromises to keep moving; not because you’re careless, but because the math of one heart and one brain juggling the needs of 2000 lives sometimes just does not add up.
It’s not uncommon between the occasional snarky remark from a colleague you’ve never met and the rare moments that you finally find the courage to look at your own data, that your “misses” can feel like confirmation of your worst fear: I’m failing at the very thing I sacrificed my youth to do well.
If you’ve ever felt something similar to the above, you’re not alone. In fact, it’s one of the most common, unspoken experiences in family medicine. It is normal to be scared to deep dive into numbers that tell an imperfect story about patient journeys and outcomes.
I used to interpret my overwhelm as a personal flaw rather than what it really is: the predictable outcome of stepping into a system that was never designed to support the complexity of the work we do.
Everything changed for me when I stopped treating my practice data as a threat to my ego and started treating it as a guide to my growth and my clinic’s wellness while recognizing that I am working in a cultural system that expects one human to bear an unsustainable cognitive load. With this awareness, I then began to build infrastructure around that insight: bringing on a team, working on my compassionate leadership skills, delegating, and using tools like HDC Discover to make the invisible visible. I decided to dive straight into the deep end, tackling my fear of losing my perfect persona head-on.
Stepping into small group learning and leadership roles forced me to confront the areas I was afraid of. In small group learning, clinicians come together in peer-to-peer dialogue around a shared goal of improving care. Recently, for me, that meant meeting with peers to focus on supporting patients with heart failure. We pulled our EMR reports, reviewed patient charts, and asked concrete questions about care. Were patients on guideline-based medications? Were we collecting and documenting the right vital signs that would help the patient’s care? Using HDC Discover helped us see patterns and answer those questions more clearly. Sharing my own data in those spaces was at times uncomfortable, but it was grounding and orienting. It quickly became clear that everyone has gaps, and that improvement happens faster when those gaps are named openly.
The same lesson was carried into leadership. Serving as Department Head of Family Medicine at Surrey Memorial Hospital and facilitating quality improvement work at a provincial level removed the option of saying, “I will look at this later.” Leadership required visibility. It meant showing my own data, showing my shortcomings, naming what was not working, and modeling that credibility comes from authenticity & proximity rather than perfection. Each time I stepped into that discomfort, the fear lost its hold. Data stopped being something to avoid for fear of what it would reveal but something to lean into as an opportunity to shape my practice infrastructure.
If you are apprehensive to look at your data with others, I understand that completely. But I also want you to know that no one has the right to judge you, they have not walked in your shoes. Your data is there to give you an orienting awareness of direction in a job that asks you to hold so much alone – in fact, your data will likely give you a business case for calling in some kind helping hands. If you want to connect directly, peer to peer, I can be reached at lawrence.yang@hdcbc.ca
To work with a free consultant to guide you through HDC and our measures, contact HDC at info@hdcbc.ca