How we create our realities: a physician coach suggests replacing​ our limiting beliefs

The Uber driver pulled up, saw our roller bags and exclaimed, “I’m so sorry!  My trunk is filled with my gear!”   I initially wondered why she would have agreed to take us to the airport, knowing her trunk was full.  But, after easily placing our bags in the front seat, she explained she was in the Army band and needed to keep her gear with her at all times.  She spoke more about her military career and shared that she had also chosen to attend “jump school,” where she learned to parachute out of planes.  It had been aParachutist in the war pivotal experience in her life.  In spite of being injured in a jump, she emphatically declared she would do it all over again.  This single choice had changed her perception of herself, increased her confidence, and allowed her to see she could expand beyond the limitations she had previously placed on herself.

It’s easy to see how our beliefs affect our choices.  If we believe people are innately good, we are more easily trusting and helpful toward others.  If we believe hard work will pay off, we apply ourselves and are willing to study or work extra hours in order to reach our goals.  But this cause and effect relationship can also work in reverse – we can just as easily affect our beliefs by the choices we make.

If we make a choice in our relationships – personal or business – that doesn’t turn out well, we might easily start to believe we can’t trust ourselves to make wise decisions, or that honest, trustworthy partners don’t exist.  That belief will then fuel other choices – not to open our hearts or engage in other collaborative efforts.  Instead, if we formed the belief that this particular person wasn’t the right choice or we weren’t a good fit, our future choices might be very different.  It makes it important to question any conclusion we draw from our experiences.

Many times we want to make a certain choice, but lurking in the wings and ready to derail our good intentions is a limiting belief we aren’t even aware of.  We might choose to take on a leadership role but inwardly believe we’re too introverted to succeed.  We might choose to begin an exercise program but secretly hold the belief that we don’t have the determination to stick to it.  Although some beliefs seem grounded in our values and therefore set in stone, most are simply subjective thoughts.  When our beliefs don’t support the choice we want to make, we are doomed to fail.

A very helpful step when we want to make a new choice in our lives is to explore the beliefs we have about it.  What is the evidence for these beliefs?  When we find a disempowering belief, we can ask ourselves what else we can believe that will make it more likely for us to be successful.  Instead of believing we are too introverted to be a good leader, we can recognize that many successful leaders are introverts who bring significant strengths to leadership, such as greater inclusiveness and engagement of their team. How will that change our attitude toward becoming a leader?  What new thoughts and feelings might that generate?  As we experience the internal shifts by changing our belief, we can sense our commitment to our new choice growing stronger.

What new choices would you like to make?  How much more exciting, fulfilling, or interesting would your life become, once you let go of limiting beliefs and find more empowering beliefs to support your new choices and success?

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Physician Burnout: Don’t forget to look under the rug

This weekend, I’m attending the SEAK conference, a large gathering of physicians seeking non-clinical career options. You might wonder why, after the time, energy Work Life Balanceand money physicians invest in their careers, so many want to walk away from it all. As we know, burnout affects more than half of all physicians. Many circumstances account for this epidemic – loss of autonomy, not feeling valued, frustration with increasing regulations and insurance company demands, erosion of the doctor-patient relationship, the disproportionate amount of time spent on clerical tasks…the list is long. As a physician, you’re probably cringing as you recognize the impact of each of these realities on your own satisfaction.

Many of these issues will require a change in the system in which we work or the culture of medicine in order to restore the sense of satisfaction that used to be the norm for physicians. If you are feeling burned out, waiting for a sea change doesn’t offer much hope. Is there nothing we can do to feel better now?

While it’s understandable to feel that our work IS our life, it’s crucial to realize that it’s only one aspect of it. Often, I’ve found that physicians focus their dissatisfaction on work, when their biggest source of unhappiness comes from somewhere else. This makes it worthwhile to take a look under the rug – at the other areas of our lives – to see where we have room and leverage to improve.

I’ve worked with clients who believed the source of their despair was work, when the greater concern was that their primary relationship was lacking in some way. Dealing effectively with their relationship led them to discover a more positive feeling about work. Others found that health issues were plaguing them, causing daily pain and anxiety. Once they addressed and found better ways of managing these medical concerns, they experienced greater comfort and confidence that permeated other areas of their lives. Still others, inundated by the demands of work and reluctant to share their concerns or feelings of despair, isolated themselves from friends and family. By reconnecting with these important people, their newfound relationships introduced a broader array of interests and balanced their lives, giving work a more reasonable and healthier degree of influence over how they felt.

One simple way to help us take stock of our lives is by using a “Wheel of Life.” This graphic allows us to easily see where we are most and least happy. By considering what would improve our assessment of each area, we can take steps to bring our lives closer to our ideal. We may still encounter the same frustrations at work, but as we lessen the dissatisfaction with other parts of our lives, we may find we’re better able to tolerate those frustrations. We might even discover we’re more creative and resourceful in dealing effectively with them. And we will open more avenues for joy to come into our lives. Work, although a passion and calling for many of us, is still only one aspect of our life. Let’s give it the proper amount of attention and not let it overshadow or limit the power we have to improve the overall quality of our lives.

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Making our own well-being​ a priority – today and every day. A physician coach offers steps to improve patient care, extend our careers, and bring joy to our lives

9.5 million entries on Google for “physician wellness”  speak to what a big topic it’s become.  Hospitals, medical groups, and medical associations are including an increasing number of programs on physician wellness.

So why do 300-400 physicians continue to take their own lives each year?

Because, for many of us, our own wellness is at the bottom of our list.

Human Pyramid and Thumbs Up
We need to recognize that our well being is the foundation of good medical care.  When physicians are stressed or suffer from depression or anxiety, the quality of our care is negatively impacted.  Our productivity diminishes. We leave our profession, or we leave our lives.  Wellness is like the people on the bottom of a human pyramid.  Although we tend to focus on the person at the pinnacle of the pyramid – look at their grace, balance and poise! – without a firm foundation, they would topple.  The same is true of our own personal wellness.

In her excellent article, Danielle Ofri cites the ongoing culture of perfectionism.  Clearly, one needs to be fairly perfectionistic to obtain the grades and scores to get into medical school,  to acquire exponentially increasing amounts of scientific knowledge and understanding, and to conform to high standards of practice.  Knowing the stakes are high compels us to drive ourselves and keeps our anxiety levels high.  As perfectionists, we focus on our small mistakes, our less-than-perfect outcomes, when a more balanced appraisal of our performance would be more accurate – and healthier.  We can improve our well being on a personal level by keeping a journal of our successes and asking ourselves, “What did I do WELL today?” as each day comes to a close.  This will provide a broader view of how we’re doing and allow us to balance our inevitable shortcomings with the many excellent actions and outcomes we provide.

As a group, we can address systemic problems – the inefficiencies of the EHR, a focus on productivity over quality of care, insensitivity to individual physicians’ needs.  Arranging exam rooms so physicians can see both the computer screen and the patient should be imperative.  Physicians’ requests to adjust their schedules so more complicated patients are given longer appointments or to allow for family or personal needs should be easily accommodated.  Support staff such as scribes should be immediately incorporated into the routine and culture of healthcare, just as the EHR has been incorporated.  This will help to alleviate some of the stress and will allow physicians to feel as if they are being supported by their organizations.

There are excellent, evidence-based interventions that build resilience and restore physician wellness.  Shanafelt et al showed statistically significant improvement in all measures of burnout when groups of physicians met biweekly for an hour for mindfulness, reflection, shared experience and small group learning.  The groups continued for 9 months and improvements were sustained at 12 months.  The benefits of mindfulness practices and exercise are well known.  We all know that nurturing outside relationships and passions improves our state of mind and lowers our stress.  What’s missing is our own prioritization of these things in our lives.

When we give ourselves even a small amount of time to focus on us – personal reflection, activities that nurture our soul or reconnect with ourselves such as meditation or walks in nature, time with those we love, eating healthy foods  – we tell ourselves that we are important.  Good decisions like this lead to other good decisions during the day.

What will it take to make your own well being a priority?  What small step can you take today to support yourself?  Give yourself 30 minutes a day for your own wellness, and watch your life immediately improve.

(Hint: For some ideas, click here)

 

 

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An Invitation to Become an Emotionally Intelligent Leader – free webinar 8/30/17

AAPL-WebinarEI

Our tweet chat last night was filled with great ideas and the sharing of many issues that confront physicians who wish to lead from their passions but are worried they will get tripped up if their emotions come out at inopportune times.  While both genders struggle with gender-based stereotypes regarding emotions, we would like to offer a program especially geared toward the challenges that women physicians face.

Deborah Munhoz, MS, PCC, and I invite you to join our webinar, hosted by the American Association for Physician Leadership (AAPL) (physicianleaders.org) on Wednesday, August 30th from noon-1PM Eastern.  We will bust some myths about emotions, discuss the importance of Emotional Intelligence in patient care as well as leadership, and you will leave with a simple, 3-step process for using your emotions powerfully to gain greater influence in your life.  AAPL has graciously allowed us to invite non-members to the webinar.  We hope you’ll join us! To register, click here.

Warm regards,

Helane

 

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The Secret to Becoming an Emotionally Intelligent Leader – please join me for a tweet chat Tuesday, August 22nd!

The value and power of Emotional Intelligence are well accepted. In fact, how we manage our own and others’ emotions can determine our own effectiveness as a physician and a leader.   It’s my pleasure to invite you to join the international discussion of how to best use our emotions in the healthcare setting on Tuesday, August 22nd at 8:30 PM Eastern.  Hosted by the American Association for Physician Leadership and HCLDR, we will explore this important and timely topic and focus on 4 questions:

  • How have emotions helped or hindered you in your career?
  • When does expressing emotions seem like an act of strength, rather than a weakness?
  • How can expressing your emotions help to form your reputation as an effective leader?
  • What are some tactics for expressing emotions in a constructive way, that have worked successfully for you?

Here’s a blog post to pique your interest and provide additional resources on the topic.

To join the chat, log on to your Twitter account and search #hcldr – I hope to see you there!

Helane

@helanefronekmd

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Let’s ASCEND to a more effective flow of communication with our patients. A physician coach shares a useful mnemonic

Communication, as they say, is a two-way street.  For several years, we have taught Male doctor discussing reports with patient in medical officemedical students the art of communication.  They learn to develop rapport with patients through eye contact, body language that conveys interest in what the patient is saying, and by demonstrating an interest in the patient as a person .  They learn to signpost their
way through the encounter to let the patient know what to expect next, reducing the patient’s anxiety.  They learn to deliver “bad news” with the SPIKES protocol.  Strategies to help patients remember what we tell them are taught and practiced.  Although doctors are often criticized for their communication style, our profession is working to improve our skill set.  That’s one side of the communication street.

But what are we doing to enhance our patients’ ability to communicate with us?

Many times, patients leave our offices more confused than when they came, their real questions unanswered, even though we offered our best care.  In order to change this, it’s time for us to assist our partners in communication – our patients.  Karen Knops MD, an experienced palliative care specialist in Washington, along with the Gold Foundation, dedicated to Keeping Healthcare Human, provide us with an excellent tool for this purpose.  ASCEND is a simple mnemonic that provides six principles and practices to assist patients in becoming strong and effective partners in their care.

Dr. Knops suggests that patients develop the habit of Anticipating their doctors’ appointments by thinking about the purpose of the visit and considering what questions they want to be answered and who should accompany them.  After her experience as a teenager with scoliosis, she shares that, “I’ve never lost my awareness that commonsense can easily go on hiatus when we are gowned and vulnerable.  Taking notes should have occurred to me as a straight-A student, but never once did I try that.  I would log hours practicing for a youth symphony audition, but preparing for a doctor visit never crossed my mind.”  Once in the room, patients can ask their physician for a Summary of the big picture before details are discussed.  They can share their Concerns, Explore the risks and benefits of planned tests or treatments and ask for Explanations, including what the Next steps will be.  And they should be sure to Document the important information and instructions.

We provide patients with all sorts of assistance – why not suggest a simple mnemonic that will help to ensure the smooth flow of communication in both directions?

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The Art and Power of Saying “NO” -Physician coaching clears the path for fulfillment and impact

It’s a common experience- someone asks us to do something and, while our heart and gut are screaming, “NO!” we hear the word “yes” come out of our mouth.

Woman Scientist: Stop SymbolWhy and how does that happen? And, more importantly, how can we change that behavior so our response reflects our true desire?

When we find ourselves saying yes, it may be for a variety of reasons. Unfortunately, we rarely take time in the moment to examine our priorities so we can come up with the most appropriate response. Instead, old patterns, such as wanting to please others, not believing we have the right to say no, a fear of missing out, or a variety of other worries hijack our response system.

One protective approach is to invoke an automatic response. “That sounds like an interesting idea – let me think about it and get back to you,” buys some time so we can consider the pros and cons in a safe environment, without the pressure to please.

Then, we can sort through our values and decide whether the opportunity aligns with them or not. This alone may help us decide to say yes or no.

Another important step is to imagine how much time the new project will take. By consulting our calendar, we can see if we have time for this. If not, our answer may be simple. And if we still want to say yes, what might we have to say no to in order to fit this new commitment in?   Conversely, if we say no, what might be possible instead? Often, when we hold one option up next to the other, we see clearly which is the wiser use of our time. If we truly don’t have time to do a good job, it’s always better to decline. Otherwise, we’ll end up disappointing others with poor quality or late work. Our reputation is built on the integrity we show and the product we produce, rather than on our willingness to say yes if we end up turning in poor quality or late work.

Many of us feel guilty if we refuse various offers, as we don’t want to appear selfish or not a team player. Yet, if we decline an offer, it may create an opportunity for someone else to step up. Who might be good at this besides us? Who might appreciate the chance to learn or receive some recognition?

In the end, if we decide we don’t have the interest or time to accept the offer, there are a number of ways to say no that still maintain our connection to the person who asked. We can offer to do part of the project, to work on it after a certain date if time is the issue, or to work on another project if we just don’t have an interest in the current offer. And, if none of these responses fit, we can offer our encouragement and acknowledge the importance of their efforts – these are important sources of assistance as well.

By becoming more skillful at discerning where our time is best spent and learning to say no, we’ll have more time for the things that are truly a yes for us.  Only in this way can we are live our most fulfilling lives and have the most impact in the world.

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