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Change How You Change


How and whether you change will have a big impact on your emotional and physical health, and that of your patients.

Changes Adaptation, Human Resource, Physician Entrepreneurship

Doctors and physician entrepreneurs are dealing with a lot of change and typically use three ways to cope:

1. Ignore it, just hoping they can stick it out until they retire, get fired, get sick, become disabled, or die

2. Move on to something else

3. Embrace it and adapt. Float down the river.

How and whether you change will have a big impact on your emotional and physical health, and that of your patients, so consider these things:

1. How-to books, blogs, and commentaries are a growth industry, so there must be something in the water. Self-help books are still very much in demand, with around 2,000 new titles coming out every year. Most of these works promise to improve some aspect of your life — to help you to become more successful, gain confidence, stop smoking, or find Mr. or Mrs. Right. Whatever your problem, you can guarantee there is a book that swears to have the solution.

2. Leading change and making change are different. For example, trying to change patient behavior is a big nut to crack and everyone is trying to find the Rosetta stone, whether at the personal, population, or national policy level.

3. Change starts with your mindset, which drives emotions that drive action. Here are the subcomponents, for example, of the entrepreneurial mindset:

a. Personal growth relates to the size of the challenge, not the size of the kingdom. What motivates real innovators is the more exciting challenge, not the number of people reporting to them. The “size of the difference” they will make is more inspiring than the “size of the business.” They relish getting out of their comfort zone, and into the unknown.

b. The new direction is the challenge, not the destination. The challenge is the transformation vehicle for true innovators, and not a performance goal. They focus on legacy creation, not legacy protection. They ignore failures and are constantly looking at the progress made. They treat innovations reviews like performance reviews.

c. Be an attacker of forces holding people back, not a defender. Real innovators start by questioning the world order rather than conforming to it. They begin by confronting the forces holding everyone back, rather than living with it. The forces include mindset gravity, organization gravity, industry gravity, country gravity, and cultural gravity.

d. New insights come from a quest for questions, not a quest for answers. This discovery mindset searching for new questions drives real innovators away from more of the same. They fundamentally become value seekers; they look for value in every experience, in every conversation. They don’t seek prescriptions, they seek possibilities.

e. Stakeholders must be connected into the new reality, not convinced. True innovators tip stakeholders into adopting and even co-owning the orbit-shifting idea. They go about tipping the heart first, assuming the mind will follow. They seek smart people, who openly express their doubts, and then collaborate to overcome them.

f. Work from the challenge backward, rather than capability forward. Overcoming execution obstacles is combating dilution, not compromising, for these innovators. Their mindset is not “if-then” but “how and how else?” They convert problems to opportunities, and often the original idea grows far bigger than the starting promise.

4. Doctors are products of a culture that reinforces conformity and compliance, not change, imagination, or creativity, so acting differently does not come easily for most physicians and creates anxiety.

5. For some, change is simply too much to bear or they use maladaptive coping strategies that just makes things harder. There are personality inventories and instruments that can help you identify those toxic behaviors or blind spots and help you take a breath between the next change trigger stimulus and your response. In fact, the next time you apply for an employed physician job, you might be required to take one to determine your cultural fit with your perspective new employer.

6. Change takes courage. Fear, greed, laziness, doubt, anger, and hubris makes cowards of us all.

7. Most doctors don't enjoy giving up control and "going with the river." It was not how they were selected, trained, and developed. In fact, singing from the wrong page in the hymnal can get you into a lot of trouble.

8. Sh#t happens. The only thing you can do is control your response. A good place to start might be to unclutter your life and let go of the banana.

9. It's convenient to play the blame game, retreating to the safest belief system you can find.

10. The last thing you want to happen is not saying "I wish I had done this sooner"

If you are part of the 60% of Americans who take their vacation days, this Spring Break, spend some time changing how you change while changing into your bathing suit. Enjoy one on me at the pool bar.

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Victor J. Dzau, MD, gives expert advice
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