Doctors Coaching Doctors – Helane Fronek, MD Coaching and Consulting | love being a doctor again

Let’s talk friends, again: a physician coach’s RX for a happier life

Posted on September 27, 2014 by Helane Fronek

Recently I wrote about Facebook friends and suggested that we each make some time to contact those people who are our real friends. This suggestion was based on data that shows that those with friends and support systems live longer and healthier lives. It turns out that there is even more interesting research that shows how important friendship can be to the success we experience during our lives as well.

As Todd Kashdan, Professor of Psychology at George Mason University explains, some of the research is based on the feeding behavior of ostriches.

If you’ve ever seen an ostrich, you know they have big round bodies, long skinny legs, and a tiny head on top of a long curved neck. And, as Dr. Kashdan remarks, if you’ve ever tasted ostrich meet, you know they are delicious. Their predators know that, too. That makes it necessary for ostriches to keep their heads up, always alert to the proximity of a hungry predator. Unfortunately, when an ostrich is foraging for food, he has to lower his head to the ground. Elevating and lowering his head over and over again takes a lot of energy. So ostriches have adopted the habit of foraging in herds, so they can take turns lowering their heads. This saves a lot of energy, and also saves a lot of ostriches.

Similarly, we humans outsource many of our energy-requiring tasks. If we live alone, we know that we have to spend considerably more time and energy on our ADLs than if we live with others who will share some of these tasks. If we are in a dangerous environment, we stay awake unless we have someone to share the job of being a lookout. It turns out that we budget all of our energy-requiring tasks based on the proximity of trustworthy people in our life. This ability to share leaves us with more resources to direct to activities other than survival. Activities like professional achievement, enrichment, service and just plain fun.

But having friends impacts our success in other, more profound ways. College students (who were studied because they frequently fall in and out of love) were given a list of adjectives and asked “who are you today?” When they were “in love,” their assessment of themselves reflected a wider range of potential than when they were not “in love.”

In another study, people were asked to estimate the slope of a hill they were about to climb. When they were climbing alone, they over-estimated the slope. When they were climbing with a friend, they estimated the slope accurately. Life feels easier and we feel more powerful when we have people we can trust by our side.

What can you do TODAY to strengthen your own friendships? Your happiness, sense of self, potential and success may depend on this. With your actions, you will also build your friends’ sense of self, potential and success. What a powerful thing to do.

Posted in mindfulness, physician coach, physician coaching, physician communication, physician fulfillment, physician work life balance, work life balance | Tagged leadership, medical career, physician coach, Physician coaching, Physician fulfillment, Physician work life balance, relationships, success, work life balance | Leave a comment

Be the Re-decider! A physician coach’s RX for a less stressful life

Posted on September 22, 2014 by Helane Fronek

Many years ago our daughter signed up for a summer program, excited about the experience she anticipated she would have. What she encountered was quite different, and she instantly knew the program was not right for her. Although she was clear that she should leave the program, my mind was muddied with many confusing thoughts. I didn’t want her to be a quitter. I wanted her to honor her commitments. I felt this might be an opportunity for her to learn to “turn lemons into lemonade.”

Fortunately, a friend came to my rescue and introduced the concept of “re-deciding.”

Have you ever volunteered to do something and then realized you didn’t have the time? Or that your priorities had changed? Perhaps something happened in your life that suddenly made it difficult for you to continue with your plans. You wish there were some way to get out of your commitment! Most of the time, we do nothing about this. Instead, we try to push forward but end up feeling trapped and resentful and certainly don’t do our best work. After all, we don’t want to be a quitter or someone who isn’t trustworthy. We want to be known as the person who can be counted on.

Re-deciding is not only practical, it is an essential skill!

When we enter a room and realize there is danger, we re-decide to leave. When we order a meal and find that the food tastes bad, we re-decide to leave it on our plate or return it. When we commit to something and then find that it conflicts with our values or our availability, we can similarly assess the situation and allow ourselves to re-decide about this commitment. That is not to say that we should agree to things and then flippantly cast them aside. But holding onto commitments that don’t serve our life is not efficient or helpful. It fills our time with activities that don’t honor who we are or what we care about most. It frequently results in poor quality work, as we don’t put our best effort into it. This leaves the impression that we are less than competent and conflict with another aspect of our self concept.

When leaving something that we committed to, we can explain that we thought it would work in our lives but we were mistaken. If that leaves the person or organization in a tough position, we can offer to brainstorm other options. It might be possible to delegate the task to someone for whom it would be a great opportunity or a way to learn an important skill. There might be another way we can contribute that doesn’t require us to invest time we really don’t have. If we’re honest with ourselves, we know that none of us is indispensable – if we were stricken with an illness or an unavoidable situation that precluded our continued involvement, the world would go on!

Are there activities that you wish you hadn’t said yes to? Maybe you just need to re-decide!

Posted in physician coach, physician coaching, physician communication, physician fulfillment, physician work life balance, work life balance | Tagged leadership, medical career, perfectionism, physician coach, Physician coaching, Physician fulfillment, Physician work life balance, success, work life balance | 2 Comments

Facebook friends: a physician coach’s RX for a happier life

Posted on September 12, 2014 by Helane Fronek

Several years ago, I was involved in a program with participants located around the globe. Wanting to create opportunities for connection, the group decided to form a Facebook page – a private web page on which only we could place messages, post questions, and offer ideas for one another. The problem was that one of us wasn’t on Facebook. As you might have guessed, I was that person.

Yielding to my colleagues’ pressure, I joined Facebook (much to the concern of my children!) and was suddenly asked by many Facebook users to be their “friend.” I contributed to the discussions but stopped checking the page once the program ended. So I was surprised when, on my next birthday, I received numerous “Happy Birthday!” messages from my “Facebook friends.” Wanting to express my gratitude that they had thought of me, I called each person. None of them called back.

What is this thing called a “Facebook friend” and what does it say about the value and meaning of friendship today?

We all have many levels of friendship: the expanse of people at each level becomes increasingly narrow to form a sort of pyramid of friendship. At the bottom, we have lots of “friends” we greet as we pass them in the hallways at work or in our neighborhood. Many people call them “acquaintances,” rather than “friends.” We have fewer “friends” we enjoy spending time with and with whom we will talk about certain things in our lives. One level up from that, there’s a group we can count on to take us to the airport, feed our cat when we’re away and share many of our concerns with. At the very top are the few people – our “peeps” as one of my friends calls them – who will sit with us at the hospital when our spouse has surgery, keep our confidences, help us sort out our real dilemmas until one o’clock in the morning, and remember when we have a big event and call to wish us good luck.

Research shows that people who have friends feel happier and more fulfilled. Those with friends live healthier and longer lives.

I doubt the studies were referring to “Facebook friends.”

And yet, through the course of medical training and career, many of us let our friendships erode as we become buried in charts, journals and administrative tasks. We let this truly important part of our lives slip through our fingertips.

Consider your own friendship pyramid. Starting from the top, make a plan to contact each one of your “peeps.” Let them know what’s happening with you and find out how they are. That simple connection, all by itself, may enrich your life immeasurably. After that, contact those on your next level. Take time to reach out to those people who mean the most to you. You know – those people we call friends.

Posted in mindfulness, physician coach, physician coaching, physician communication, physician fulfillment | Tagged medical career, physician coach, Physician coaching, Physician fulfillment, relationships | 1 Comment

Aim in front of the ball – a physician coach’s perspective

Posted on September 7, 2014 by Helane Fronek

On a recent trip to Newport RI, we took a golf lesson. I admire instructors who are able to observe a student and understand exactly what needs to change. It’s usually a very small aspect of what we’re doing, but they pick up on it right away. And then, they offer a simple piece of advice that makes all the difference in the world. After watching me miss several swings, Andy suggested that I aim, not for the ball in front of me, but several inches in front of it. So I focused my eyes on that piece of grass in front of the ball and was amazed when the ball went flying in the air, exactly where I had wanted it to go. Each time I aimed at the ball, it dribbled off the tee and rolled a few yards. And each time I aimed in front of the ball, it flew, apparently effortlessly, toward my actual target.

I think this tells us something very important about life.

Often, we get mired in the frustrations or the excitement of the many and varied opportunities of life, not really clear about where we actually want to go. We might try on this thing or that, searching for what feels right, and instead find ourselves going in circles. All of our efforts result in increasing frustration as we don’t manage to achieve a lot of movement toward anything. It’s important to have an idea of what’s important to us – where we want to go. Do we want a bigger component of research in our career? Do we want to become an expert in a particular subject? Do we want to travel and present talks? Do we want our children to be self-reliant? Each of these are admirable goals, and will likely take a lot of effort to achieve them. Taking time throughout our life to take stock of where we are and where we want to go is crucial if we want to arrive at a place of fulfillment in life.

When do you have a day, or even a few hours, to spend time alone or with the people who share your life, to have an honest conversation about your goals? At your next opportunity, check your calendar and schedule this important activity!

But Andy didn’t tell me to look at the green, my final destination. He told me to look a bit in front of my ball. Similarly, if we only focus on the ultimate goal, it may seem overwhelming and we’ll give up. It might feel as if we’ll never get there. Breaking our journey down into smaller steps can make it more manageable. In looking at your eventual goal, ask yourself what you need to do, step by step, to get there. What resources do you need? What extra knowledge or training might be helpful? Who might mentor you or give you advice about the easiest way to reach your goal?

After we define where we eventually want to go, it’s helpful to post a visual reminder of our ultimate goal to keep us motivated and inspired. By breaking our path into steps we can accomplish – continuing to focus on the spot just in front of our ball – we propel ourselves into action. As we succeed at step after step, we can celebrate our progress and before we know it, we will reach our goal. If only golf were that easy!

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

Posted on August 28, 2014 by Helane Fronek

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, Debbie 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?

Posted in mindfulness, physician coach, physician coaching, physician fulfillment, physician work life balance, work life balance | Tagged medical career, Physician coaching, Physician work life balance, success, work life balance | Leave a comment

Tired of Conflict? A physician coach suggests commitment, acceptance and alignment

Posted on August 19, 2014 by Helane Fronek

We live in an atmosphere of perpetual conflict that seems unsolvable and growing by the week. Military conflicts continue to escalate around the world. Our government is ineffectual, as neither side wants to work together to find solutions. There are many reasons for this situation, including some developments that were intended to encourage greater exchange of ideas. For example, cable TV was supposed to allow peo Screen Shot 2014-08-04 at 10.27.45 PM ple to be exposed to different points of view, but the actual result is that we remain indoctrinated by only those who share our opinions. It serves to insulate us from other perspectives and reinforces the idea that our ideas are the only rational ones. Even in our own small spheres, there are numerous conflicts, replete with hurt feelings, resentment and dug-in heels.

How can we break this cycle of misunderstanding and conflict?

Several years ago, two groups of people – one pro-life and the other pro-choice – met in Chicago to discuss the problem of unwanted pregnancies. Can you imagine two more antagonistic groups? On the first day, they were instructed, coached and given practice in communication skills, but were not allowed to discuss abortion or any other social issue. On the second day, they were tasked with developing a program they could work on together. The result? After only a few hours, the group easily accomplished its task.

How did they do it?

As part of the program, each person agreed to commit to finding a solution. Similarly, the first thing we need to do in any conflict is agree that a solution can be found, and set our intention to co-create an agreement. We must accept that the other party has legitimate rights and desires, just as we do, and believe that a solution exists that can satisfy both of us. Without this foundation, we will never succeed. When it seems as if no acceptable decision can be found, we need to have a commitment that we will continue to work towards one, opening our minds and using our creativity, until we find one.

As each side states their requests, it’s helpful to ask why that is important to them – what principle, value or aim they are looking to fulfill. This can often help to show common ground, which is important in the next step, which is to find alignment.

What CAN you align around? For the pro-life and pro-choice groups, they were easily able to align around reducing unwanted pregnancies. While each group has a different approach for dealing with pregnancies once they occur, both were able to support an overall reduction in unwanted pregnancy. Alignment is generally found around something bigger than just one’s point of view.

Once we have alignment, we can share our differing points of view more easily, since they are only different ways of looking at the issue around which we already agree. By sharing our views, we begin to really understand each other. Each differing perspective allows us to be more creative in finding an agreement.

There will always be times when negotiations break down, but by returning to our commitment to find a solution that works for all, listening to understand and accept the other person’s priorities, and gaining alignment around a bigger, common issue, we can generally find a solution where none appeared before. I encourage you to select an unresolved conflict in your own personal or professional realm and put these principles to work. What would it be like to live with fewer conflicts in your life?

Posted in mindfulness, physician coach, physician coaching, physician fulfillment | Tagged Building relationship with patients, communication in healthcare, leadership, Physician coaching, Physician fulfillment | Leave a comment

Communicating care and concern – in the blink of a patient visit: how physicians can make the most of their time

Posted on August 12, 2014 by Helane Fronek

Recently, I visited a friend in the hospital. As her condition improved, the nursing staff suggested it was time to discuss discharge planning and called the social worker to make the necessary arrangements . The social worker entered the room, remaining close to the doorway, and announced that she had very little time since she had many other things to do. We certainly didn’t feel confident that the plans would go well.

As we rush through our days, we frequently feel just like this overworked social worker – too much to do in too little time. Our patients, on the other hand, are frequently worried and need not just our expertise but our time and reassurance.

Fortunately, there are concrete things we can do to help us balance these opposing demands.

Research shows that when we sit down at the bedside, our patients perceive that we are spending more time with them than if we stand. So even if we are pressed for time, it is important that we sit down, even for a minute or two, and talk eye-to-eye with our patients and their family.

Another effective communication strategy is to share our own frustration with our limited time. Patients are generally quite sensitive to the fact that we work very hard and have a lot to do. When we share our wish that we had more time to spend, we let them know that we care about them, even if our time is short.

Lastly, we can focus the conversation on what is most important. When I first began my practice as a general internist, I saw 20-25 patients each day and frequently ran behind schedule. Due to the clinic’s policy that new patients arrive an hour before their appointment, one patient waited two hours to see me and was understandably furious. As I entered the room and apologized for keeping her waiting, she launched into a tirade that included sentiments such as, “my time is just as important as yours,” and many others. After listening for a minute, I interrupted, apologized again, and then suggested that she could continue berating me for my tardiness, or we could spend our time together solving the problem that she had come in for. The tension in the room was immediately defused and we spent the next 30 minutes taking care of her concerns in a productive and cooperative way. Similarly, by stating that we wish that we had more time to spend with our patient today but want to be sure to take care of their concerns – either today or at a future date – we focus the conversation on what is most pressing and let our patient know that we understand the importance of their concerns and are committed to addressing them.

The doctor-patient relationship is a partnership. For it to be most effective, we need to build a foundation of honesty and trust. As we become increasingly squeezed for time, it is essential that our patients understand both our situation and our continued commitment to doing what we can to insure their health. It doesn’t serve us, our patients, or our partnership to pretend that we can promise unlimited time. There are, however, ways of saying this while also expressing care and concern, so that our partnership remains strong, even as our patient visits grow shorter.

Posted in building relationship with patients, effective communication in healthcare, physician coach, physician coaching, physician communication | Tagged Building relationship with patients, communication in healthcare, patient satisfaction scores, Physician coaching | 1 Comment

Dodging those Queen or King Bees – a physician coach’s recommendation

Posted on August 4, 2014 by Helane Fronek

While the Queen Bee Syndrome is usually used to describe a woman in power who limits opportunities for other women (the book by that name was the foundation for the movie, Mean Girls), Bernice Sandler, considered to be the “Godmother of Title IX,” widens the term’s range to include men as well. Women do not hold the patent on being mean, that’s for sure. Whether it’s a senior colleague’s decision to sequester the better paying patients for himself, a department chair’s formulation of a reimbursement formula that favors the procedures that she does, or a committee chair’s preferential treatment of his friends, most of us have been stung by a Queen (or King) bee at one time or another.

When asked for her advice regarding how to counteract the damaging and hurtful effects of the Queen, Bernice’s recommendation was surprising. The woman who wasn’t afraid to wage such a difficult and treacherous fight suggested that we step around the bee. While there are many communication strategies to deal with difficult situations, sometimes the power differential leaves us without enough leverage to even begin a conversation. So Bernice advised that we simply enlarge our network. Find others who might be able to help us achieve our goals. Ask extensively to learn the rules of engagement in whatever world we are operating in. Develop relationships with people who can mentor us.

This advice reminded me of the wisdom of an old friend. When one of the girls at our son’s school was singled out and excluded from the larger group of girls in the grade, my friend suggested that she find a new group of friends. The girl, who rode horses, began to spend more time at the barn and found a new group of girls that accepted and liked her, as they had so much in common. It didn’t change her situation at school, but it removed most of the hurt. In time, the Queen moved on to another victim, as the first girl no longer seemed to be suffering.

When we allow ourselves to waste time and energy being hurt, angry, or resentful that the bee won’t give us her blessing, we give our power away. But when we reach out to others and ask their assistance, we frequently develop new and healthier relationships. We build a network of people who believe in us and will help us develop our skills and improve our game. We may even stumble upon a path that suits us better than the one we first imagined.

So if a Queen or King bee gets in your way, look beyond your immediate hive – better opportunities may be waiting for you there.

Posted in mindfulness, physician coaching, physician fulfillment, work life balance | Tagged physician coach, Physician coaching, Physician fulfillment, relationships, success | Leave a comment

Take a moment to listen to the voice of success: a physician coach listens and learns

Posted on July 28, 2014 by Helane Fronek

As someone who loves to learn, I have gotten myself into many periods of overwhelm as I take on more things than I have time to deal with. Most recently, I signed up for a training I was really excited about. Originally scheduled for October, it was delayed to January and again to April, when many other commitments were already waiting for my attention. In mid-March, I received several emails requesting preliminary work that had to be completed by early April. Not wanting to disappoint the people who selected me for the program and reluctant to turn down a great opportunity, I stared again and again at my calendar, hoping that my intention alone would make it shift. Unfortunately, no matter how hard I stared, none of my other obligations disappeared. As I lay awake at night, wondering how I would find the time to complete the work, I was aware of a voice that simply said, “You can’t do this.”

NO! I exclaimed in my mind. I HAVE to do this. I could feel the little voice shrug, as if to say, “Believe what you will, but you cannot do it all.”

Fortunately, a few days later I heard Arianna Huffington, founder and CEO of the Huffington Post, introduce her new book, Thrive. She spoke about the mainstream definition of success as money and power. And she shared her life changing experience in 2007 when, after working 18 hours a day, 7 days a week for 2 years to start her business, she collapsed on the floor of her office. On the way down, she cut her eye and broke her cheekbone. As Arianna wisely remarked, “when you’re lying in a pool of blood in your office, you’re not a success.”

So, as one who likes to learn, I realized I had some learning to do. I sat quietly, listened only to my breathing, and again heard the little voice saying ever so gently, “You already know you cannot do this.” It was a loving voice, a comforting voice, and a wise voice to be sure. This time, I listened. I contacted the training organization and explained that I could not participate. They were appreciative that I cancelled with such notice, before they spent more time and effort on my behalf. I felt immediate relief. Now I would have the time to do the kind of job I wanted to do with the things still occupying my calendar. I felt very successful.

Are there issues in your life that you are wrestling with? Decisions that seem mired in mud? Take some time to be quiet, so you can hear your own inner voice. It has something important to say. Something that may make you happier and more satisfied with your life. And that…is success.

Posted in mindfulness, physician coach, physician coaching, physician communication, physician fulfillment, physician work life balance, work life balance | Tagged leadership, Physician coaching, Physician fulfillment, Physician work life balance, success, work life balance | 3 Comments

Compassion: a simple way to a more peaceful life – a physician coach’s choice

Posted on July 6, 2014 by Helane Fronek

As I walked through a parking garage the other day, a very surprising thing happened. This garage isn’t well designed – there is barely enough space for cars to drive in and out and some of the parking spots are pretty tight. The driver of a small SUV decided to pull into one of these tiny spots, and as she inched forward into the space, there was a loud, crunching sound. She had scraped the car next to her.

She backed up and got out of her car. As she stood looking at the damage, the driver of the car she had hit came out as well. “I’m so sorry,” she said sadly. I anticipated that the other driver would display some anger and frustration. After all, he would now have to get at least two estimates for the repair, be without his car while it was fixed, and possibly pay the amount of his deductible. Most people would be angry. Instead, the two talked quietly and then began to laugh.

Although I wasn’t privy to their conversation, it was possible they realized that they were in this unpleasant and unwelcome experience together. Maybe they were also relieved that no one was hurt. It was obvious that she was sad and regretful. The other driver showed compassion for her.

When we are pitted against another person, compassion can be difficult to feel. We want to be the one who is right! It can be frightening to allow ourselves to truly understand the other person’s situation. As Pema Chodron tells us in Living Beautifully: with Uncertainty and Change, compassion is threatening to our ego. When we really open up to another person’s view, we might find out we are wrong. Although he certainly had no part in the accident, the other driver couldn’t be angry once he opened his heart to compassion.

When we see situations and people through this lens, it is certainly kinder to them than blaming or criticizing. What might be surprising is that it is kinder to ourselves as well. When we are angry, our fight or flight response is activated, our ability to think rationally and solve the problem is compromised and we suffer many detrimental physiologic effects. In addition, when we verbally attack the other person, we deprive ourselves of a partner in helping to fix the situation. Compassion dissolves this anger and negativity and can give us a sense of connection and hopefulness.

Is there a situation in which you feel wronged? Try opening your heart and allowing a sense of compassion in. Just for a moment, see things from the other person’s point of view. How does this shift your relationship with this person? What possibilities might it create? Notice how much more peaceful you feel without the anger and resentment.

We each have the power to choose compassion when conflicts arise. We simply need to decide how we want to live.

Posted in building relationship with patients, effective communication in healthcare, mindfulness, physician coach, physician coaching, physician communication, physician fulfillment, work life balance | Tagged Building relationship with patients, communication in healthcare, Physician coaching, Physician fulfillment, relationships | 2 Comments

Doctors Coaching Doctors – Helane Fronek, MD Coaching and Consulting