Field Notes:
Performance Medicine Physician Coach’s notes on the evidence of human optimization.
Field Notes is the clinical record of what actually works in human performance optimization…And what the wellness industry gets wrong about it.
Every post here is written by Will King-Lewis MD FAAFP, a board-certified Family Medicine Physician, Fellow of the American Academy of Family Physicians, and US Navy Senior Medical Officer responsible for the health and performance of 3,500 sailors.
I am a Sustainable Performance Coach creating a new fiduciary standard in personal performance coaching to ensure that your performance is grounded in evidence and designed to help you for the life. The standard applied to every recommendation here is the same one applied in his clinical practice, the Fiduciary Standard.
I read the study, check the sample size, find the conflict of interest, and ask who funded it. If the evidence is strong, you will hear that. If it is limited, you will hear that too. If something is overhyped, you will hear exactly why. Even if that means going against the grain and not recommending the newest hotness, or other popular, profitable, and aggressively marketed wellness junk.
That is what the MD means. That is what Field Notes is.
I Saw the Pan and Made a Flash
I am tired from three deployments in four years. But I learned something the hard way that you can learn the easy way.
Leadership Malpractice: The Reassessment Loop
Leadership Malpractice: If a physician made a treatment plan and the new treatment did not seem to work and the physician did not change the treatment they would be guild of Malpractice.
The standard should not drop when the patient is an organization.
Best DRAINS Framework for Identifying Performance Problems
The best tool for finding your performance leak is the SPMD Leak Assessment tool which is free. You get your primary leak identified, your DRAINS. Also you will get your primary method to remove it, your CLEARS. You also get your primary intervention to execute that removal, your MOVES.
What a Physician Exodus Will Cost
Physicians are leaving medicine because expectations do not match reality and responsibility does not match capability. This is the third and final piece in a series on why, and what it costs everyone.
An Executive Performance Program with Physician Oversight
Most executive performance programs have no physician involved. Here is what physician oversight adds to a performance program and why it changes the clinical outcome.
Precision Coaching Is Not More Coaching. It Is Targeted Coaching.
Precision coaching for leaders is not a more intensive version of standard coaching. It is coaching calibrated to a specific individual's performance architecture after a clinical diagnostic.
They Stopped Trusting Us to Do It: The Second Reason Physicians Are Leaving
The shortage is not a mystery. It is a mechanism. A physician explains the trust-to-expectation ratio, the prior authorization apparatus, and why efficiency became a trap.
They Codified Everything Except the Part That Makes Us Physicians
There is no CPT code for the moment a patient grabs your hand and says they are scared. A physician on why the unbillable parts of medicine are the parts keeping people alive, and why we are leaving.
Ready to Work with a Performance Coach? This is Where You Start
If you're ready to work with a performance coach but not sure where to start, identifying performance leaks is the first step when the process is physician-led and evidence-based and held to a fiduciary standard.
Ready to Improve Your Leadership Performance? Start With What's Limiting It.
If you're ready to improve your leadership performance, the first question is not what to add. It is what is currently limiting the performance you already have.
How to Fix Energy Crashes During the Workday
How to Fix Energy Crashes During the Workday. A Sustainable Performance Physician explains how energy crashes during the workday are not a caffeine problem. They are a physiological signal from a system running below its sustainable threshold. Here is the clinical explanation.
Finally, Executive & Leadership Coaching with Real Medical Credibility and Rigor
Leadership Coaching With Medical Credibility and Rigor. Medical credibility in coaching is not a credential to display. It is a standard of practice that changes how recommendations are made, evaluated, and revised.
Why A Sustainable Performance Physician Holds Coaching to a Fiduciary Standard, and Not a Research Standard
Demanding a perfect study for every coaching intervention sounds rigorous. It is not. A physician explains why best interest, not maximum evidence, is the real standard. and why he holds coaching to a fiduciary standard, not a publishable research or peer review standard.
The Clinical Threshold: When a Performance Problem Is Actually a Health Problem
Performance and health are not separate conversations. The line between them moves, and most coaches are not trained to see it.
Spent: The Performance DRAINS That Makes Refills Longer and Longer
Spent is the performance DRAINS that makes refills take longer and longer. The tank empties. You recover. It empties again faster. That is not tired. That is spent.
Nerve Failure: The Performance DRAIN That Won’t Let You Do When You Know Exactly What to Do
Nerve Failure Performance DRAINS is the Performance Leak that will not let you do when you know exactly what to do
Performance Coaching That Doesn't Push Supplements
Most performance coaching comes with something to sell you. A physician explains why the supplement on the back end is a conflict of interest, and what coaching held to a fiduciary standard looks like instead.
Auto-Denials Are Medical Decisions. Last I Looked, Health Insurance Companies Do Not Have Medical Licenses.
Dark navy square graphic with large white bold text reading "Auto-Denials Are Medical Decisions. Last I Looked, Health Insurance Companies Do Not Have Medical Licenses." Blue subtext reads "The physician who signs a denial is accountable, and so is the system that generated it." SPMD circular logo and text reading "SustainablePerformanceMD.com, Will King-Lewis, MD, FAAFP" in the lower left corner.
DENIED! The Insurance Industry Already Bet You Won’t Appeal their Auto-Denial
Dark navy square graphic with a large red distressed DENIED stamp overlaid diagonally across the center. White bold text reads "The Insurance Industry Already Bet You Won't Appeal their Auto-Denial." Blue subtext reads "Not medically necessary. Four days after his second suicide attempt." SPMD circular logo and text reading "SustainablePerformanceMD.com, Will King-Lewis, MD, FAAFP" in the lower left corner.
Identity Lock: The Performance DRAIN That Does Not Respond to Productivity Systems
Header image for SPMD Field Notes post on Identity Lock. Dark navy background with bold white text reading Identity Lock: The Performance DRAINS That Does Not Respond to Productivity Systems. Center image shows a broken painted mirror with a faint smiley face visible through the cracks. Subheading reads: The role has grown. The identity has not. No protocol fixes that. Footer credits Field Notes at SustainablePerformanceMD.com and Will King-Lewis MD FAAFP.