If this is not overall anxiety and ONLY anxiety about your profession...all you can do is stick with what you're comfortable with. Don't be afraid to ask a colleague or someone you did residency with for help. Send patients out for a 2nd opinion if you're not comfortable with the treatment plan...
Yes, you have to stick with what you're comfortable with. Overall and especially in the workplace. I would assume this is mainly about OR cases since that's what the OP references a few times, but if it's overall anxiety with daily and personal stuff also, that is counselor/doc visit stuff 100%. It is sleep well and protect sleep (#1), nutrition, exercise, maybe yoga/meditation, LIMIT stress, limit stimulants, limit screen time, all that good stuff. Basically, simplify, simplify... you get what you allow. Guidance of a counselor helps, but just drop stressors like some external stresses (news, politics, etc), some family members, some goals that are too taxing, etc. Simplify. Overall anxiety's obviously beyond scope of a forum, though.
With regard to pod surg being stressful, "knowledge is the antidote to fear." That goes for anything, especially OR.
You either got enough reps, enough confidence, enough in residency... or you didn't. No big deal. There is not really a way to go back and fix it. If you are like 99% of people, you got enough of some stuff but not enough of other stuff. As to what "enough" is, that's different for everyone. I will say that I still watch a LOT of surgery textbook DVD and internet videos the evening before (esp when I'd train residents... wanted to review the step-by-step). Sure, I watch less and more just segments of the vids for stuff I've done a lot now, but I still watch or read . Knowledge is the antidote to fear.
I always maintained that the 4 pillars of good surgery are:
-education, prep, mentorship, training, exp
-personal interest and motivation (reading, planning, etc)
-natural motor skill and hand skills
-confidence
...Luckily, it is faaar from essential to do surgery or all surgery that comes in the door. The average DPM does less than one whole day of OR per week... I probably do 0.75 days/wk average, and I'm higher end. Some hospital-employ or ortho group or academic docs do more, most do a lot less. We have a large DPM group, MANY offices... and a lot of guys in the group do minimal or no surgery. Some aren't qual/certified for it, some just don't enjoy it or didn't have much surgery training, a few had problems with it before, some just know they make more collections/money with office stuff, etc. The ones who are non-op do wound care and primary care office podiatry, DME, etc.... and they make a fine living. They send surgery to others, like me, who do basically every surgery a DPM can do when it's indicated (trauma, recon, RRA, etc). The majority are actually somewhere in-between and do basic surgery (normal bunions, wounds, plantar fascia, etc) and might send out the bigger things. The funny thing is: we probably all make similar money at the end of the day... it's actually more based on who does high margin stuff, which is not happening on surgery day.
You will never hurt anyone by NOT doing surgery (as long as it is referred out appropriate). I honestly believe we'd be better with some DPMs doing 5 or 10 cases per week instead of nearly all DPMs trying to do 1 or 2... works for ortho F&A, and it works for dentists to funnel wisdom teeth and cosmetic and OMFS and to specialists with higher volume.
The problem children in podiatry are the ones who keep putting square peg into a round hole and think they can do stuff and crash off the guardrails with bad outcomes, long OR times, overly aggressive procedure selection, trying to talk ppl into surgery for fractures that'd heal fine in a CAM boot or deformity that's not painful, etc. Those are the dangerous ones who will embarrass us all, and they typically end up losing privileges or getting malpractice suits, etc...
High skill , high surgery = ok
Low skill, low/no surgery = ok
Low skill, high surgery = reckless
