How to run your life, and not let it run you

Posted on September 26, 2011 by Helane Fronek

We were lucky enough to spend the weekend with our kids in New York City, watching the Yankees handily beat the Red Sox. Our son, a true student of baseball noted, “the Red Sox are doing their best to lose their chance at the wild card.” Along with seeing our daughter and son so grown up, that comment caused me to reflect on how quickly life passes, and with what ease our dreams can slip away – if we don’t actively take charge of creating the future that we want.

As a coach, my goal is to help my clients take hold of their lives and consciously mold them into the biggest and most fulfilling lives they can imagine. I frequently begin the process of coaching by asking my client to fill in the Wheel of Life, an exercise that routinely illuminates several areas of the person’s life that they would like to improve.

Take a few minutes and examine your own life. Place a line reflecting how satisfied you are (a “10” means you’re 100% satisfied) with each aspect of your life at this time. For example, if you don’t have a significant other in your life and would like a stable, close relationship, you might rate your satisfaction low. But if you aren’t currently interested in putting your energy into a relationship, you might rate your satisfaction a “10.”

Now, select one area that you would like to be happier with. What would be happening in your life if it was a “10”? What would that mean to you? How would your life feel different? Let your mind run free and think of 5 things that you could do in the next week to become more satisfied with that aspect of your life. And then choose one of them.

Promise yourself that you’ll do that one thing in the coming week.

Using this tool and consciously selecting one thing each week to move an aspect of your life closer to a “10” will gradually place your life in the hands of the person who should be in charge of it – you.

Posted in physician coaching, physician fulfillment, physician work life balance | Comments Off on How to run your life, and not let it run you

Getting it right

Posted on September 25, 2011 by Helane Fronek

The other day, my very experienced and highly competent yoga instructor referred to “happy baby” pose as “child’s pose.” While they both sound juvenile, those poses could not be more different. Later that day, I told a patient that she should walk for 30 minutes a week, when I meant to tell her to walk for 30 minutes a day. Fortunately, both of those very small errors were obvious enough that the listener easily caught and corrected them. But how many times do we misspeak and thus convey the wrong information? Our patients do the same. At other times we can mis-hear or misunderstand what is being told to us. To guard against this, it’s wise to paraphrase – both what we just said, and what we think we heard from our patients.

After our patients have told us the history of their concern, we can stop and say, “just to make sure that I understand you…” and then repeat what we think they said. This allows them to correct any inaccuracies and lets them know we were listening.

Similarly, after a section of our explanation or recommendations, we can reiterate the main points. If we’ve goofed and misspoken, our patient can point out the inconsistency and we can clear it up. And if we said it right the first time, paraphrasing serves to underscore its importance and help our patient remember.

Happy baby pose and child’s pose both provide a great stretch, so it might not matter if the yoga instructor mixes them up. But we all know that in caring for patients, the accuracy of our communication can be a matter of life or death. The simple skill of paraphrasing may help you get it right when it really counts.

Posted in effective communication in healthcare, paraphrasing, physician communication | Comments Off on Getting it right

Advice from a recovering control freak

Posted on September 17, 2011 by Helane Fronek

Recently, I overheard several people lamenting that they were not better delegators. As a recovering control-freak, I can assure you that good delegators are not necessarily born – they are developed. And I guarantee that you, too, can become more proficient in this important skill.

Imagine how much more you could accomplish if you could really get other people to do what you wanted them to do. And how stress-free your life would seem if your kids actually did things that you asked, like cleaning their rooms! Most of us have had the experience of asking/telling/demanding that others do something, only to be disappointed that the task was not done, or not done to our satisfaction. So we decide that we don’t know how to delegate, and we do it ourselves.

The truth is that most people want to feel accomplished, and they welcome the opportunity to be successful.

So, the most important principle in delegating is to set the person up to achieve success. Try following these steps to effective delegation and see if you don’t lighten your load.

1. Clearly define the task – make sure that the person knows exactly what you want them to do. Be specific. Ask for their interpretation of the job so you know if you have the same vision or not.
2. If it’s possible to assign various tasks to different people, find out who is most interested in each one. Allowing people to work on projects in which they are genuinely interested improves the chance of success, especially if they have certain skills or experience to contribute.
3. Discuss what knowledge, skills and equipment are needed for the task, and assess whether the person has them.
4. Determine what other resources are needed – people, equipment, access, technology, etc. and facilitate that.
5. Describe the outcome you are expecting – exactly what will it look like when it’s completed to your satisfaction? Again, be very specific.
6. Specify when the task needs to be completed and how you are to know it’s finished.
7. Outline the consequences – if it is completed by that date, and if it is not. This usually includes some reference to the goal of the task – its importance and relevance.
8. Ask for any final questions or considerations.

At first, following these steps may feel awkward or unnatural – but didn’t it feel that way the first few times you examined a patient? Delegation is a skill that must be practiced to gain competency. Try delegating something every day for a while. See how easy and natural it becomes. And then take a few minutes to decide what enjoyable things you will do with the time that you just freed up for yourself by not giving in to your old habit of doing everything yourself.

Posted in control freak, effective delegation, physician communication | Comments Off on Advice from a recovering control freak

Avoiding the dreaded “door knob conversation”

Posted on September 10, 2011 by Helane Fronek

We are all way too busy – so we prioritize. We put the most important things first and relegate the less important to any time we have left. We assume that our patients do the same. But, as my kids’ fifth grade teacher wisely warned, “When you assume, you make an ass out of u and me.”

When we ask our patients what brings them in to our office, they give us an answer. But often, their answer doesn’t reflect the real reason they came in. Maybe it’s the most recent issue that occurred, or perhaps it reflects what someone in the waiting room was discussing. We are fooled into believing that this is what our patient wants us to evaluate, so we spend the entire visit questioning, examining, and explaining just what to do about it. We think we’ve done a good job and begin to leave the room. And then comes the “door knob conversation.” Just as we place our hand on the door knob to leave, our patient says, “Doctor, there’s something else that’s been bothering me.” We ask ourselves why they didn’t tell us before we spent all of our time on what we thought was the real and only reason they came in.

The answer is that we didn’t ask.

To avoid this situation, try using the technique of scanning. After eliciting the reason for the visit, stop and ask, “Is there anything else you would like to discuss today?” Keep scanning until your patients exhaust their list. Then, powered by a more complete understanding of all of the issues, you can do what you do well – prioritize – and negotiate an agenda that will fit in the time available.

Posted in patient agendas, physician communication, scanning | Comments Off on Avoiding the dreaded “door knob conversation”

There’s power in word placement

Posted on September 5, 2011 by Helane Fronek

Have you ever noticed that two people can hear the same words and have very different interpretations of what was said? We respond to our world on the basis of our experience and our expectations, so it is not uncommon that our patients “hear” very different things than we actually said. Sometimes just the intonation of a word can completely change its meaning (consider the difference in meaning between saying “right” vs. adding a sarcastic intonation and saying the same word).

Yet another important way in which our brains interpret words is based on their placement in a sentence. We are wise to make use of this powerful fact and design statements that deliver information so patients will interpret it in helpful ways. One consideration is to place the most important items first and last when presenting patients with a long list of information. We all remember the first and last (especially the last) thing that we are told better than what comes in between. A second tool is to use “turning words,” such as but and however. These words essentially negate whatever information came before them in a sentence. For instance, when telling patients about symptoms that might arise after a procedure, it’s best to state the possibility of symptoms first, add a turning word, and follow it with the appropriate reassurance. For example:

You may experience discomfort for a few hours or develop a fever, rash, or swelling for a day or two, BUT most patients do just fine.

As Thomson and Khan discuss in Magic in Practice, doctors “often report an increase in unnecessary calls or visits by worried patients” when the order is reversed.

So, in explaining the risks and benefits of a procedure, providing information about potential complications after surgery, or simply educating our patients about their condition, we can use word placement to our advantage – to emphasize what’s important and helpful, while putting the other information in proper perspective. In this way, we can improve the likelihood that our patients actually hear what we want them to and reduce the chance that they will experience unnecessary anxiety or distress.

Posted in effective communication in healthcare, physician communication, word placement | Comments Off on There’s power in word placement

Starting off on the right foot with every patient: physician coaching to help you make the best first impression!

Posted on August 30, 2011 by Helane Fronek

Patients (as do all of us) respond best to physicians who are happy doing what they do, and happy to be seeing them. Unfortunately, all too often we are pressured, worried about something that just happened or might happen, and preoccupied as we rush through our day. We enter a room with a patient waiting inside and THEN we glance at the chart. This gives our patient the impression that we are scattered, unprepared, way too busy to really pay attention to them and that they are not as important to us as they want to feel.

So, instead of that usual way of doing things, try this:

Before you knock on the door, take a deep breath (or two), make sure that you know the patient’s name AND how to pronounce it (you can write it phonetically on the chart if it is unusual, or simply ask the patient if it’s their first visit), and consider that you are about to make a difference in the life of a fellow human being who has come to you for help. (How fulfilling does that feel?)

After knocking and waiting for an invitation to enter, smile and make eye contact as you walk into the room and greet your patient. With this simple practice, you will begin your relationship or your time together in the very best way. You will be telling your patient that you are confident, approachable, and ready to take care of their concerns.

What a great first impression.

Posted in building relationship with patients, effective communication in healthcare, first impressions, physician communication | Comments Off on Starting off on the right foot with every patient: physician coaching to help you make the best first impression!

Welcome! A physician coach offers perspectives and practices for your most powerful self and your biggest life

Posted on August 27, 2011 by Helane Fronek

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, “Who am I to be brilliant, gorgeous, talented, and fabulous?” Actually, who are you not to be? —Marianne Williamson Even doctors, with all of our training, with all of our prestige, with all of the good that we do for our patients and in the world – even we continually hold ourselves back. We spend countless hours and give away so much of who we are in the service of being the best doctor we can be. We deny ourselves the time and space to truly reflect on what is important to us and what our priorities are. Because we don’t invest in learning the skills that would help us move forward in new, fulfilling directions, we don’t believe that we can actually have the life we want. I am passionate about effective communication, work-life balance, and reflective practices because they have allowed me to live a rich, satisfying life as a doctor and a human being. It is those skills and activities that make it possible for me to have a close, loving family and wonderful friends, to engage in a range of exciting non-medical pursuits and continue to be a leader in my field. I love my life. This is what I want for you, too. Through this blog, I hope to share useful ideas and practices that steer you toward your biggest and best life. Again, welcome.

Posted in effective communication in healthcare, physician communication, physician fulfillment, physician work life balance | Leave a comment