Rx for the Business of Medicine

We all know that the beginning and ending chapters of a book are pivotal. What if we thought about our day in the same way?

Each day is a book. The morning is its opening chapter. The hours that follow become the middle chapters, while the evening gives us an opportunity to close the book, examine what we have written, and learn what we want to carry into the next one.

You do not control every character who appears in your story. You do not control every event, interruption, or plot twist. You can choose, based on your values and your intention, how you respond to what happens.

Intentionality is not control of reality. It is agency within reality.

Setting your intention is not about deciding how the day will unfold. It is about consciously deciding who you want to be within whatever reality the day brings.

Chapter One: Set Your Intention

The world is going to try to begin writing your day as soon as you wake up. Before you hand it the pen, take the opportunity to write the opening chapter yourself. Before the inbox, text messages, appointments, social media, or the demands of other people begin competing for your attention, give yourself a moment to focus on your values and goals.

What matters to me today?

Who do I want to be?

How do I want to show up?

These questions may seem simple, but they represent a meaningful act of choice. Instead of beginning the day by immediately responding to whatever demands your attention, you begin by deciding how you want to meet those demands.

You cannot know what the day will bring. What you can do is decide, before the story begins, who you want to be within it. If you know you are likely to encounter stress, perhaps your intention is patience. If you are carrying something difficult in your personal life, perhaps your intention is compassion, for yourself as well as for others.

The specific intention may change from day to day. What matters is that it is chosen consciously and grounded in your values. Then the real work begins. An intention has little value if it remains only a thought you had when you woke up. Your intention is meant to travel with you into the day.

Middle Chapters: Throughout the Day, Live Your Intention

The morning is only the beginning. You have chosen your intention and now the story begins to unfold. The schedule changes. Someone frustrates you. You become tired, distracted, rushed, or overwhelmed. These moments are not failures of your intention. They are where your intention becomes practice.

As the story unfolds, are you still holding the pen?

Your intention acts as your lodestone as you move through the day. It becomes something you return to when circumstances begin pulling you in different directions. This requires awareness.

Notice Before You React

One of the central ideas in Buddhist practice is mindfulness, the cultivation of awareness of what is happening in the present moment. Thoughts and emotions surface. Frustration, fear, anger, and anxiety may emerge before we have consciously decided what to do with them.

The first step is to notice. Before we can choose our response, we have to recognize what is happening within us.

Am I becoming frustrated?

Am I reacting to what was actually said, or to the story I am telling myself about what was said?

Am I allowing my emotions to determine my next action?

Awareness creates space between what happens and what we do next. That space gives us an opportunity to remember the intention we set at the beginning of the day and ask whether the response we are about to choose is consistent with the person we want to be.

The goal is not to eliminate emotion or become detached from the experiences of the day. It is to become conscious enough of our inner experience that we are not automatically governed by it.

Returning to the Intention

We will inevitably lose our way. There will be moments when we forget our intention, react poorly, speak impatiently, become distracted, or allow circumstances to dictate our behavior. That is part of being human.

The practice is not to never lose your intention. The practice is remembering to return to it. The day does not have to be perfect for it to be intentional. Every page is an opportunity to return to the story you want to write.

The Plot Will Change

The story does not always unfold the way we expect it to. Plans fail. People disappoint us. Circumstances change. There will be chapters we would not have chosen to write, and some may be chapters we would gladly erase if we could; but we cannot.

The world does not promise to conform to our intentions. Setting an intention should never be confused with positive thinking or an attempt to manufacture a particular outcome.

The world will make demands of you. Your intention determines how you meet them.

The intention is not: Today will go exactly as I want.

It is: Whatever today brings, this is how I intend to meet it.

The distinction matters.

Understanding the Absurd

It is human nature to want our lives to make sense. We look for order, meaning, and predictability. We make plans and build expectations about how things should unfold. Yet the world does not promise to cooperate with those expectations.

Albert Camus called the tension between our desire for meaning and the world’s refusal to provide certainty the absurd. The absurd is not simply the claim that life is meaningless. It is the confrontation between our longing for meaning and a reality that does not guarantee that meaning will be provided for us.

For Camus, the answer is not to deny this tension or pretend that difficult circumstances are somehow good. It is to face reality as it is.

We can acknowledge that something is painful without deciding that it should not have happened. We can recognize that a situation is unfair without allowing that unfairness to determine who we become. We can accept that we cannot change what has already happened without becoming passive about what happens next.

Acceptance is not surrender. It is seeing the page clearly enough to decide what you will write next.

Choosing Within Reality

This brings us back to intention. Your intention does not exist to make the world conform to you. It exists to give you a way to meet the world when it does not.

The difficult patient still arrives. The conversation still goes badly. The diagnosis still comes. The thing you worked for may not turn out the way you expected.

The question is not: How do I make this situation become what I want?

The question becomes: Given that this is the page in front of me, who do I choose to be as I write it?

That is the difference between intentionality and control. You do not control the characters or events. You do not control the plot twists. You do choose how you participate in the story. Sometimes, the most intentional thing you can do is accept the page exactly as it is, take a breath, and decide what you will write next.

The Final Chapter: Evening, Examine What You Have Written

The evening is not simply the end of the day. It is an opportunity to close the book by examining what we have written.

Not simply: Did I have a good day?

A better question is: Did I live the day I intended to live?

A day can be difficult and still be meaningful. A day can go completely according to plan and still leave us with something to examine. The purpose of reflection is not to decide whether the day was good or bad. It is to understand how we participated in it.

Did my actions reflect my values?

Did I live according to my intention?

What do I want to carry into tomorrow?

Plato and Socrates: The Examined Life

Plato’s account of Socrates gives us one of the clearest philosophical foundations for this practice. In the Apology, Socrates makes a powerful claim about the importance of examining our lives:

“The unexamined life is not worth living.” —Socrates, in Plato’s Apology, 38a

Reflection allows us to step outside the immediate experience of the day and examine our choices, reactions, and behavior with enough distance to learn from them.

This is not an exercise in self-condemnation. The purpose is not to lie in bed replaying every mistake and judging ourselves for what we should have done differently. Reflection is meant to create understanding.

Intention tells us what we hope to write. Reflection allows us to see what we actually wrote.

Sometimes the two will align beautifully. Sometimes they will not. That is not failure. It is information.

The Next Book: Learn, Carry Forward, Begin Again

The purpose of evening reflection is not to give the day a grade. It is to gather its lessons.

What belongs in tomorrow’s book?

Tomorrow begins with a blank page, but it does not begin without knowledge. We carry forward what we learned about our reactions, our values, our relationships, our strengths, and the places where we still need to grow.

We do not need to carry every mistake from today’s chapter into tomorrow’s book.

Set the intention. Live the intention. Examine the day. Learn from the day. Begin again.

The RxTBOM Framework

The practice of setting an intention is not a single moment in the morning. It is a process that unfolds throughout the day.

RxTBOM gives us a framework for that process:

Notice	Become aware of what is happening within you and around you.
Interpret	Consider what is happening without immediately reacting to it.
Understand	Seek to understand the situation, your response, and what matters.
Control	Recognize what is within your influence and what is not.
Choose	Decide how you want to respond based on your values and intention.
Become	Allow repeated choices to shape the person you are becoming.
Contribute	Bring that person int your relationships, work, and the lives of others.

Decide how you want to respond based on your values and intention. Allow repeated choices to shape the person you are become Bring that person int your relationships, work, and the lives of others

The movement is intentional. We notice what is happening. We interpret and seek to understand it. We recognize what is within our influence. We choose how we want to respond. The goal is not to write a perfect story. It is to become conscious of the story we are writing, to learn from each chapter, and to keep choosing who we want to become.

Tomorrow, we pick up the pen again.

Questions for Reflection

1. What intention do I want to carry into tomorrow, and which of my values does it reflect?

2. Where did my actions today align with my intention, and where did I react rather than choose?

3. What did today teach me that I can carry into the next book?

Further Reading and Reflection

Plato, Apology Reflect on Socrates’ argument for examining one’s life.

Albert Camus, The Myth of Sisyphus Consider the possibility of living consciously in a world that does not always cooperate with our expectations.

Don Miguel Ruiz, The Four Agreements Consider how the four agreements can translate intention into daily behavior.

David Schreiner, Be the Best Part of Their Day Consider how personal intention becomes contribution to patients, colleagues, and others.

References

1. Camus A. The Myth of Sisyphus and Other Essays. O'Brien J, trans. Vintage Books; 1955.

2. Plato. Apology. Jowett B, trans. In: The Dialogues of Plato. Oxford: Clarendon Press; 1920.

3. Ruiz DM. The Four Agreements: A Practical Guide to Personal Freedom. Amber-Allen Publishing; 1997.

4. Schreiner DL. Be the Best Part of Their Day: Supercharging Communication With Values-Driven Leadership. Advantage Books; 2024.

Note on the connections: The companion intentionally places philosophical ideas in conversation with selected RxTBOM leadership and professional-development texts. The authors of these books do not necessarily make the philosophical arguments presented here, and the connections should be understood as interpretive applications rather than claims of direct influence.

About this resource

This Deep Dive was created as a companion to the RxTBOM video Setting Your Intention. It is intended for reflection and education, not as a substitute for professional mental health or medical care.

RxTBOM Foundational Reading

Book	Author	Primary RxTBOM Connection	Difficulty
Start with Why	Simon Sinek	Purpose, mission, professional identity, leadership	Accessible
Healthcare and Medical Office Accounting	Wayne Label & Weldon Havins	Financial literacy, practice economics, financial decision-making	Intermediate
Field Guide to the Business of Medicine	Christopher Clyne & Britton Jewell	Business of medicine, healthcare economics, practice management, operations	Accessible
Great by Choice	Jim Collins & Morten T. Hansen	Resilience, decision-making, discipline, adaptability, organizational excellence	Intermediate
Be the Best Part of Their Day	David Schreiner	Patient experience, service, communication, culture, relationship-centered care	Accessible
The Four Agreements	Don Miguel Ruiz	Communication, self-awareness, professionalism, relationships, accountability	Accessible
The Coaching Habit	Michael Bungay Stanier	Communication, coaching, feedback, mentorship, leadership	Accessible
Chief Inspiration Officer	Val Ries	Leadership, influence, inspiration, professionalism, culture	Accessible
Begin with We	Kyle McDowell	Teamwork, culture, collaboration, accountability	Accessible
Be the Unicorn	William Vanderbloemen	Professional development, self-awareness, career development, leadership	Accessible