After 35 years practicing medicine, I believe the following disciplines have been essential.

Verbal Discipline
The more successful a physician becomes he or she must learn to monitor what is spoken. Verbal discipline includes; keeping information confidential, thinking before speaking, sensitivity to the feelings of others, circumstances and environment, avoiding gossip, and criticism. Use pleasant voice tone in hospital wards, or in the presence of patients. Avoid noisy or boisterous laughter which can be disruptive and in some circumstance disrespectful. Foul language or vulgar joking in the hospital or office setting is unacceptable. Learn to ask good questions, when giving medical opinions support them with evidence based information. Do not dominate conversations, be a person of few words. Be sensitive to anything you might say that could be perceived as arrogant or self aggrandizing. The old adage; "is it true, is it kind, is it necessary", is an excellent guideline for all conversation.

Substance Discipline
Substance discipline means you know your limits. The abuse of alcohol can ruin a physician's career. If you can't say "no", don't say "yes". Beware of the personal use of drugs and/or medications. Always have a physician colleague prescribe medication for your personal use. Avoid prescribing for family members or friends outside the context of the doctor/patient relationship.

Sexual Discipline
Sexual appetites do not disappear when one arrives at work. Working in challenging circumstances with the opposite sex with the differences in power and status may increase sexual appetites; it takes personal discipline to not act on your impulses and attractions. This is particularly important for the physician in the hospital or office setting. Touching, flirting, suggestive comments are unacceptable behaviors. Despite the changing cultural mores the physician behavior must be above reproach.

Emotional Discipline
Physicians can experience a wide range of feelings from anger, sadness, anxiety, and/or discouragement throughout the working day. Being aware of your feelings can be useful, the appropriate expression can encourage empathy, comfort and security to patients in a state of anxiety or discouragement. Communicating without awareness of your emotional status can be harmful. It is not always possible to eliminate your emotions, but it is possible to control their expression. It is certainly useful to acknowledge them to yourself and perhaps to others who you may trust. Remember, whatever your emotional status, don't take yourself too seriously. Be "others" oriented and somehow that is a great antidote to disruptive emotional conflicts.

Ethical Discipline
Temptations abound in the medical world for several reasons; money, status and power. Conflict of interest is constantly in tension with what is in the patient's best interest. The handling of information, timely recording of data, interplay between colleagues, intellectual bias, pharmaceutical perks, all need to be closely scrutinized. Aggressive self promotion and/or advertising are inappropriate. Many physicians have found that ethical compromise is a slippery slope and have caused public distrust of the medical profession.

Decision-making Discipline
Making good decisions is the essence of good medical practice. Analyzing and weighing options, diligently reading the literature and frequent dialog with colleagues is the appropriate pathway to making good decisions. Impulsive decisions will create negative consequences not only in the doctor/patient relationship but will provoke peer criticism. Stress, fatigue, pressure and burnout all can lead to poor decision making. We must monitor ourselves closely. We must welcome peer review.

Summary
Many physicians work at a hectic pace; fatigue can fog thinking and interfere with achieving performance goals. Stress can increase impulsivity and diminish patience. The aforementioned disciplines create boundaries that promote consistency and effectiveness. When we fail to think through the consequences of our behavior we can fail at our task. The practice of medicine is a calling, the burden and responsibility is enormous. Enhanced by medical science, tempered with discipline, virtue and humility we will fulfill our mission.