Make the right thing easy – a physician coach looks at change

During the decade in which I tried, in vain, to become a competent horsewoman, I had the good fortune to work with a smart, experienced horse trainer.  In her beautiful North Carolina drawl, Screen Shot 2014-08-05 at 4.08.52 PMDebbie told me to lift the reins and put pressure against my horse’s side with my leg in order to tell him to pick up his gait.  “Make it easy for him to do the right thing,” she would say.  Although I’m not sure that my horse ever felt that my efforts encouraged him to do the right thing, let alone anything in particular, my trainer was right – about horses and about people.

Each of us has tried (frequently unsuccessfully) to stop or start a habit.  We lament the fact that we don’t have enough “willpower.”  Willpower, it turns out, is very overrated.  In fact, our willpower fluctuates depending on our level of stress and how much we are using it.  We only have a certain amount of willpower, and often, it doesn’t seem to be enough. For instance, when we invoke willpower to spend many hours studying, we frequently demonstrate less of it in choosing the food we eat.   More reliable in supporting our efforts to change is what Anne Thorndike, MD calls choice architecture.  In her two phase study, published in the American Journal of Public Health (Am J Public Health. 2012 Mar;102(3):527-33.), she caused unsuspecting patrons of a cafeteria to significantly improve their buying habits, simply by placing healthier beverages in more accessible locations.

How can we use this to our benefit?

If we want to start an exercise regimen, placing the equipment in a visible, pleasant location rather than down in a dinghy basement will encourage us to use it more often.  If we exercise at a gym, finding a location between our home and work will increase the chance that we will stop there en route.  Conversely, if we want to select healthier foods instead of cookies and chips, placing the former in accessible locations and the latter on shelves that are difficult to reach may help us make the choices we truly want to make.  If reading our journals or a book for pleasure is something that we would like to add to our routine, we can arrange a comfortable reading spot, schedule the time in our calendar, or place the material we want to read next to our bed where we will be most likely to pick it up.

Is there a change that you want to create in your life?

How will you adjust your architecture to support your choice?

About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
This entry was posted in mindfulness, physician coach, physician coaching, physician fulfillment, physician work life balance, work life balance and tagged , , , , . Bookmark the permalink.

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