What is possible for your life?

That is a big question.

You don’t have to let it be intimidating though.

Sometimes when I am stuck, or when my clients are stuck, we start to use this simple phrase, “It’s possible that _______”

It opens up your mind just a little bit to things it may not really believe yet.

It’s possible that I might be able to get my charts done by 6pm.

It’s possible that I could start to take Saturday mornings to myself.

It’s possible that I could hire a babysitter a few times a month.

It’s possible that I could go on vacation without my children and they would survive and it would be totally fine.

It’s possible that I could propose solutions that would delegate some of the work I’m doing at home and at work to other people.

It’s possible that I could not spend way too much time on facebook (hehe).

It’s possible that this job is not for me.

It’s possible that I could go part time.

It’s possible that I could learn to be happy again one day.

Whatever kind of thing you are struggling with, in your home life or your professional life, just simply try asking yourself what might be possible?  Maybe, just maybe, it might be possible that _______ .  Then search your brain.  See what it comes up with.  You might just surprise yourself with what might be possible.

See things not as they are but how they could be

What would you like to believe things could be?

A woman physician who is a leader of large health care organiations told me not to spend time focused on how things are. 

Yes, we must be aware of how things are right now, to have a solid ground, footing, and foundation in where stand at this moment in time.

Yet, we must live as if we can see and believe in the more aspirational future of how things could be.

One of the best known illustrations of this is Martin Luther King’s I have a Dream speech. 

He did not focus on what was, he focused on what could be.

John Lennon and the Beatles song Imagine captivated the world.

Just imagine, for a moment, what medicine has the potential to be.

Imagine a world where healers could focus on healing.

Imagine a world in which you were able to focus on the reason you went into medicine, to help people.

Imagine a world that was unrushed, unhurried, and you never worried about running late, productivity, or patient reviews.  Imagine being present in the room with a patient without feeling you have to rush out to get to the next person.  Imagine an empty in box. 

Imagine enough time for vacation.  Imagine eating lunch without charting.  Imagine always being caught up.

Imagine a world where we have compassion for ourselves, for our patients, for our colleagues. 

Imagine a world where the health care system sees doctors as human beings too and our suffering is minimized in every way possible.

Imagine a world where physician distress, burnout, depression, and suicide is no longer epidemic. 

Imagine a world where people who spent a dozen years training aren’t spending their lives constantly daydreaming about leaving medicine.

Imagine a world where every day we are reminded that we love what we do and are honored to be a part of this noble profession.  Where we don’t have to sacrifice ourselves for others.  Imagine a world where we actually enjoy this life we worked so hard to create.

I am going to purposefully choose to see things not as they are but how they could be.

I believe in a future of medicine that we, our students, and our children would enjoy. 

I believe if anyone can do it, we can.

We are some of the hardest working and thoughtful people on the planet.  We have capability, and strength.   I fully believe where there is a will there is a way.  There must be a way.  We just haven’t found it yet.  We will.  We have to. 

I believe there still is no more noble profession and I am honored to be a part of it and happy to be a part of the generation that becomes the change we wish to see in the world of medicine.   

Applying the Scientific Method to your life

Instead of being worried about perfectionism and getting everything right, what if you could learn to approach everything with curiosity.  Each action you take can just be a little experiment where you are out in the world, gathering data, analyzing outcomes, making interpretations, and readjusting.

What do I mean by this?

Well, so many of us are afraid to fail.  So we don’t take action.  It’s too risky.  Too scary.  We ask what if I fail? Fear of failure is one of the biggest things holding us back. 

What if there is no failure and you either get the result you want or the lesson you need?

Struggles are common in science, exploration, and discovery.

Scientists review the literature, make purposeful observations, begin from an informed background, come up with a hypothesis, then test the hypothesis.  The outcome is unknown.  Yet they move forward.  They can’t know whether it will go the way the think it will or not, until they take action and actually conduct the experiment.  Once the scientist has run the experiment, they gather the data, analyze it, and interpret it.  They can then share the knowledge with others and plan to move ahead again better informed. 

Science teachers have discovered that if they simply teach students about the scientific method and ask them do conduct an experiment they may still get frustrated if things don’t work out as the students initially planned.  A more traditional approach to teaching science may teach that great scientists have exceptional talent, intellect, or ability. 

However, when science teachers introduce stories about great scientists (such as Einstein or Marie Curie), how they struggled, how they failed, then had to start over, persisted, never gave up, and eventually overcame challenges, then made important discoveries children were much more likely to persist in their own scientific experiments in the classroom.

If you can apply the scientific method to your life, purposefully stepping back, and become somewhat more objective about the background data, hypothesis, testing, data gathering, and analysis, this skill can serve you greatly.  You don’t have to make the outcome mean anything about you as a human being.  If you don’t get the result you wanted, you simply start over better informed.

Thomas Edison said, “I have not failed 10,000 times, I’ve successfully found 10,000 ways that will not work.” 

Buckminster Fuller said, “There is no such thing as a failed experiment, there are only experiments with unexpected outcomes.”

Start with yourself.  You don’t need a randomized controlled trial.  A simple pre / post study design in your own life will do.

For more information on the scientific method and applying it to your own life, download my free guide at https://empoweringwomenphysicians.com/guide/

Remember everything is temporary, and life has inevitable phases

The only thing constant is change.  It’s a quote from 2500 years ago. 

Yet, we are still resisting change.

Somehow, remembering that there are seasons of life, that there are phases of our journey, that this too inevitably shall pass can be really helpful.

Particularly, I find as a woman physician that my life is defined in phases.  There was high school, college, medical school, residency, my first jobs as an attending, becoming a faculty member, getting married, being pregnant, breastfeeding, the nanny phase, the preschool phase, and now the kindergarten phase. 

Each phase has required different things of me.  The biggest changes I found were in the pregnancy, baby, preschool phases.  I just no longer work could work two nights a week until 10 or 11pm.  Those two nights a week away from my family were no longer acceptable to me.  Working from home all night every night was no longer possible, nor was it acceptable to me. 

I could no longer leave the house without an Act of God. I could no longer bathe alone or in peace.  Now I see that these are choices and I could have hired someone to help care for my little one so that I could leave the house easily or bathe easily, but I didn’t. 

Those baby and preschool years was a phase.  It required different things of me than now this kindergarten phase allows.  I learned from female physician leaders at a meeting of women physicians for us to accept ourselves at different phase of our journey and perhaps adjust expectations for ourselves based on our own desires, expectations, and bandwith. 

Now, I’m not saying that women should change their work due to their childrearing, I’m saying every woman has a choice how she wants to do this.  What worked in the past may or may not work.  What is working now may or may not be what will be in the next phase of life.  Our life phases most certainly don’t have to be defined by our children.  Wherever we are, in our 20s, 30s, 40s, 50s, we can look that this too is a phase, a season of our lives.  There is education, working, and retirement. 

I remind myself often that this will one day be the good old days.  So I might as well try to do whatever I can to enjoy them while they are here.  Because is there is one thing that is for certain, these days won’t be here for long.

How to ask for what you want

Women are less likely to ask for what they want in negotiations. 

As a group, we don’t advocate for ourselves as strongly as males due to the way we are socialized and our culture.

 Typically we are more concerned about what others think of us (although we have no actual control of what others think of us).

It’s not that women are poor negotiators.  In fact, we are outstanding negotiators in the right circumstances.   We negotiate very well when we are negotiating on behalf of others.

This is called, “The mama bear effect.”

No joke, this is a real thing.  It plays into our societal norms.  Negotiation researchers have discovered that women will indeed advocate as strongly as men and achieve the same outcomes as men when they are fighting for others.  We find our voice, our passion, our strength. 

This is such a useful illustration of how we are conditioned to care for others more than we care for ourselves. 

Other tips for negotiating for others women have used is asking others for advice.  You can use the tools say of mentioning to a superior at work, “I am interested in advocating for women physicians.  What would be your advice?”  People will search their own brains to come up with knowledge that may be helpful, they may think of assets, resources, allies, methods, that you would not have thought of, but perhaps equally as important is they begin to see themselves as your ally.  They can become more invested in your cause.  Women also are often typically strong in building relationships. 

Know when to be a humble advice seeker and a passionate mama bear, have evidence, build human connection and community.  Persistence.  Clarity.

When you argue with reality you lose 100% of the time.

-paraphrasing of a quote by Byron Katie

Some say all stress = resisting / not accepting what is.  Wishing it was different. In our minds.

What has happened has happened.

There is no changing what happened.

There is only changing how we perceive what has happened.

We can change the narrative.

We can change the story we choose to tell ourselves about the same circumstance.

Perhaps a slightly more useful story.

And that story, that can make all the difference.

We’re not in Kansas anymore

The Norman Rockwell era is over

The iconic photos of the old white male physician caring for patients in their homes or in the office no longer represent modern day medical practice.

These days we spend more time facing our computers than facing our patients.

How has it come to this?

By accident.

It wasn’t purposeful that society decided to take the noble profession of healing and turn physicians into the world’s most expensive, overburdened, and overworked data entry clerk..

The United States health care system was never purposefully planned to be the way it is (whether you are referring to the complexity of the current health insurance landscape or the impact of the Electronic Health Record on doctor-patient interactions).   Our current reality is just a result of previous decisions that hadn’t fully considered the long term impact. 

Now that we know the impact of the current health care system on physicians, one thing is certain, this is unsustainable.

Things have to change.

We have to say goodbye to the old romanticized Norman Rockwell image, but we also have to say goodbye to the doctor facing the computer screen more than they face the patient.  This is the end of an era. 

The sooner we realize that they way it is now was never planned, it was never intentional.  People didn’t realize the consequences of their actions as we implemented Electronic Health Records.

We didn’t realize that children all across the country would start pretending they are doctors by sitting behind laptops in their homes in their beds and on their sofas typing saying they are “charting”.  This is not what we want our children to think being a physician is.  This is not what we will allow medicine to become.  The care of the patient is not in the care of the computer.  The care of the patient is in caring for the patient.  Presence.  Listening.  Caring.  Examining.  Not charting.  No my precious little ones, charting from home is not what being a doctor was meant to be.

Rather than allowing the future of medicine to further develop randomly, we must purposefully lead with humanism, compassion, caring, healing, and include the health and well-being of those of us who will live much of our adult lives in the health care system. 

Done is better than perfect

I’ve heard this a million times.

Perfection is the enemy of good enough. 

Embrace mediocrity.

But we are doctors.  We spend our entire lives striving to be the best.

That is how you get to be a doctor. Your whole life, you are at or near the top of your class, achieving, receiving external rewards, striving for perfection.  At each step we are rewarded for this behavior.  Gold stars, awards, admissions, scholarships.  My medical school has a 2% admissions rate.  That means 98% of the well intentioned 10,000 students who believed they had a chance to get in will be rejected.

You can imagine the culture and mindset this has created for those of us in medicine.

We are immersed in a culture of perfection and self-sacrifice.

We have to pay close attention, we can’t miss anything, lives are at stake.

Yet, this perfection, is at what costs?

When is done better than perfect?

My coach talks a lot about B minus work.  Many doctors just can’t even fathom B minus work.  We are not B minus people.  We are A or A+.  Well, if B minus is just too far to go, how about A minus or B plus. 

You know, we have found an interesting thing in medical school.  Changing preclinical years from a traditional A, B, C graded system or a Honors, Near Honors, High Pass, Pass graded system to a Pass / Fail system actually decreases distress.

It’s true, when you stop grading students, even perfectionistic medical students, their well being improves.

What are the lessons from this for us that are further along in life?

How about we learn we have finally reached the pass / fail portion of our lives?  We can start to embrace the pass / fail mentality.  We don’t need to get honors anymore.  We don’t need the gold stars.  It is proven and well documented in academic medicine literature that changing to the mental construct of pass / fail improves well being. 

The test scores didn’t change, the pass cut off didn’t change, USMLE Step 1  didn’t go away.  Just the perception of the pressure to be perfect or that they were always being ranked or that they had to constantly strive for Honors went away.

Try and think outside the box a little for yourself.  Where are you striving for Honors?

Is it your notes? Do they have to be perfect?  I’m sure you have a good reason they have to be perfect.  Maybe you are the consultant and you want to send a thorough assessment and plan to the primary physician.  Maybe your patients are very sick.  Maybe you can’t stand those other physicians notes that are terrible. 

When my students are in distress, I always tell them P = MD.

You’ve likely heard the old joke asking what do they call the person ranked last in their medical school class?  Doctor.

Now, I don’t want you to be a bad doctor.  But I know you are not.  You are reading this blog. That means you care.  That means you are engaged.  That means you are curious.  Chances are your notes are pretty great.  Perhaps you could cut them down just a little bit?  Outline format for part of it?  Only you know yourself and where you have room to grow or room to cut back.

Where else are you criticizing yourself for not being perfect? Perhaps in your parenting?  What if however you are showing up as a mom is totally okay?  What if you don’t have to be the perfect Pinetrest mom?  I know I’m not.  I don’t even pretend to be. 

For me, it’s mostly in my work life where I obsess.  Long emails, long letters of recommendation, “perfecting” my papers before submitting.  The notes sitting way too long in my inbox.  But I am learning, growing, practicing, and seeing so much more every single day that “Done is better than perfect.”  I swear I need this as a tattoo.  A constant reminder. 

Because in life, there is no more Honors, Near Honors, High Pass, Pass.  That phase of life is so far behind us (thank goodness).  P = MD.  And uh, our passing or “good enough” is most way more than B minus work for most people.  It’s just our personality, we are over-achieving perfectionists, it’s in our nature.  We have been selected and rewarded for it our whole lives.  So now that you have arrived, as a full-fledged attending, after years and years of sacrificing yourself for others and 80 hour work weeks while others were on vacations, getting married, and having babies, I encourage you to continually remind yourself over and over and over, “Done is better than perfect.”   Then find a way to go enjoy this life you worked so hard to create.

What if?

You know how your brain is always coming up with disastrous stories?

If someone is late or missing? It often isn’t long before our brain starts having to create some explanation for things it doesn’t understand.  The lack of knowledge creates a burning desire to create a story to make sense of the world. 

You brain starts to come up with, “What if….”

If someone is late unexpectedly, your brain may offer up something like,

“What if they are no showing me on purpose?”

“What if they forgot about me?”

“What if they don’t like me?”

“What if this is never going to work out?”

 “What if they were in a car accident?”

“What if they died?”

Yeah, within a few minutes we might go from just a little bit of curiosity to worry to they are likely dead.

What if is usually followed by something our brain is offering up that is a worry or concern.

But what if…. we could use this framework and redirect it toward possibilities that were exciting or inspirational?

What if….

This is the moment it all starts to change?

This is the time things will finally start to get better?

I could find a way to create a life I love?

This is all here to teach me something?

I have way more choice in my life than I ever saw or realized?

I chose to live as if my life is short, because it is?

I could actually design my life on purpose rather than live by default?

I were responsible for my life? What would I create? What would I allow?

We could bring some joy back into medicine?

I didn’t have to spend nights and weekends on the computer?

I could focus on my patients and on healing rather than administrative tasks?

I could find a babysitter?

I could get a massage this weekend?

Every day is a step closer to living the life of my dreams?

I am the one who can change all this and all I have to do is decide it is going to change and then it will?

Ask yourself some “what if” questions.

See what your brain starts to come up with.  It’s so fun.

Asking better questions / the Socratic method

Questions open a pathway in your brain.  When you are asked a question, your brain seeks to answer it.  It’s like an itch that needs to be scratched.  When something is left undone, your brain wants to close the loop.

Personal development guru Tony Robbins has a saying that the quality of your life is determined by the quality of your questions.

However, asking better questions is certainly not a new concept.

In the 1700s Voltaire said, “Judge a man by his questions, rather than by his answers.”  (Well change that to gender neutral and say judge a person by his questions…”

In fact, over 2000 years ago, Socrates laid the foundation for western systems of logic and philosophy with the Socratic method of questioning.  

Socrates said ultimate wisdom comes from knowing oneself.

He then says the more a person knows, the greater his or her ability to reason and make choices that will bring true happiness.

I love that.  It focuses on choices.  It emphasizes that the person themselves has the knowledge and the power to make their own choices to bring happiness.  So many of us believe that the circumstances of our life (how many patients are on our schedules, where we work, what our spouses say, etc) determine our happiness.  Yet, that gives the locus of control and power to someone else.  Happiness is an inside job.  Per Socrates the more we know ourselves, the more we can make choices that will bring happiness.  

However, what is so interesting is that Socrates didn’t lecture about what he knew.  In fact, he claimed to be ignorant.  He simply asked questions. 

He asked questions that led his students to think for themselves, he led them to come to their own logical conclusions.

His questions were designed to enlighten.   These kinds of questions can stimulate critical thinking, curiosity, discovery, learning, and even challenge your own beliefs. 

Purposeful questions in the Socratic method can serve as a logical step-wise guide to help students come to their own insights.  The Socratic Inquisitor models joy in the quest for knowledge.  He or She is curious, seeks self-improvement, and realizes that we never stop learning from one another.

When done well this can allow people to a journey of discovery. 

When done poorly, the person can feel humiliated.  I’m guessing that having been in the culture of medicine, you likely have seen this done poorly.  This is what we refer to as “pimping”.  This is asking a question for the intent of humiliating the learner

Most of us in medicine are familiar with the Socratic method, whether we realize it or not.  Some of us are more familiar with how it evolved and was warped into “pimping,” which has evolved to maintain the hierarchy and cultivate humility.

For you, we’d like to focus on you formulating questions for yourself in the true Socratic method to stimulate learning. 

Yet often the questions we ask ourselves are more like pimping.  We ask ourselves things like,

“Why can’t I ever get my charts done?”

“Why am I always behind?”

“Why can’t I ever change?”

“Why can’t I ever lose weight?”

“Why is my partner such a pain?”

Our brains are designed to then answer these questions.  The disempowering questions and resulting answers are more along the lines of pimping.  Not helpful.  Designed to humiliate.

Think of what kind of questions you could repeatedly ask yourself that might be more helpful.  That Socrates might ask you (or us) if he were alive today and trying to create insights and learning through supporting someone on their journey of growth.

Perhaps things like

“What do I want to do more of?”

“What can I delegate today?”

“What can I say no to?”

“What can I control in this situation?”

“How can I make this a little better?”

“Are there any easy wins here?”

“How can I enjoy this process?”

“What is good about this moment?”

“What do I love about myself?”

“What are my strengths?”

“How can I make my life a little more fun?”

 “What am I excited about?”

“What can I learn from this?”

“What did I learn today?”

“Who have I helped today?”

“What is a possible solution to this problem?”

“What else could this mean?”

“How could I take better care of myself?”

“How could I choose to show myself some kindness in this situation?”

“Why has everything about my journey prepared me perfectly for this moment so that now I can take the next steps I want to take in my life?”

Practice asking yourself some useful questions.

That brain you have is pretty powerful and designed to answer questions.  You may just be surprised what great answers you start to discover.