Physician leader Dr. Teresa Amato, Chairperson at Northwell Health, was speaking to an audience of over 200 female Emergency Medicine physicians. Her motive was to encourage more women to become physician leaders. Too frequently she had been told, “ I don’t have time to get involved in leadership”. Definitely women are busy and there may be another less obvious concern.
Ask any woman and she will tell you that she has to work twice as hard as a man to be seen as half as good. Social biases are real; women have to prove they are capable. Men, at least white men, are assumed to be competent until proven otherwise. This helps to explain why men ask to be considered for new opportunities, even if they only meet about 60% of the requirements.
“Women need to shift from thinking I’m not ready to do that” to thinking “I want to do that, and I’ll learn by doing it”. Sheryl Sandberg’s quote points to what keeps women from leaning into new opportunities. That is what Dr. Amato saw in the women around her- a mistaken belief that they were not ready- yet.
Fact is, most physician leaders are figuring things out as they go along. The higher up in leadership you climb, the more often you encounter something new, for which there is no procedure or best practice. You are better off to replace expecting you should know the answer to trusting you will find a solution that fits this situation.
Count on the following when you don’t know the answer:
- Belief in a compelling vision. What future possibility do you support?
- Shift your relationship to failure. Have you discovered the next place to apply extra effort?
- Be a curious learner. Release your grip on what you know and explore what is possible. Who can you ask more questions of?
- The willing support of friends and colleagues. Where can you go to speak your fears out loud and feel valued, even when you feel imperfect?
There will never be a time when you know enough or have seen it. Right now you are enough and your perspective is just what is needed. Jump in-you are already good at learning by doing!
Do you have career decision analysis paralysis? Making important career decisions can be tough for physicians. The stakes are high and the consequences uncertain, making it easy to put off important choices. If you tell yourself you do your best work facing a deadline, it is possible this is really an excuse for procrastination.
To move past indecision, Dr. Chang and I worked through three stages of decision-making. I’ll tell you more about Dr. Chang, who needed to make a decision about how to allocate her work roles for the upcoming budget cycle.
Stage 1: Getting ready to make career decisions
Why do we procrastinate? Behavioral psychology research points to a phenomenon called “time inconsistency”. Our human brain tends to value immediate rewards more highly than future rewards. This trips us up because our best-intention plans for the future can lose out to what’s more desirable today.
For Dr. Chang, the long term career satisfaction of working with Residents, conflicted with the current rewards of seeing patients. The decision once made, would be costly to change.
Stage 2: Make a decision
Making a decision to get what you truly want is particularly challenging for women. As caregivers, we women often put family and patient needs over our own. That makes career decisions even more challenging. In an effort to get it ‘right”, we lean into data and analysis to make decisions, but rational analysis is not enough. You need a decision you can put both your heart and your back into.
Dr. Chang imagined a future that did not include working with Residents. Getting in touch with the emotions of that scenario influenced her commitment to her choice, in spite of the possible consequences.
Stage 3: Make your decision right
Dr. Chang’s choice felt particularly important because it would have lasting consequences. Reality is, there are far too many variables to know in advance what career choice will be best. What you can control is how motivated you are to support the success of your choice. You already know to expect the unexpected in the outcome of any choice we make. Where we have the most control is our day -to – day choices and activities -after we make that big decision.
Release the grip indecision with by anticipating how your choice will feel the future. If your heart is in it, you can make it work.
P.S. Need more help moving past indecision? Schedule your consult today!
I often hear the lament, “How do I get seen?” in my work with women physicians. You need a leadership brand to land appropriate projects and grow your career in meaningful ways. A brand speaks to more than your skills and expertise. And a brand is a promise about what you plan to do and whom you promise to be while you’re doing it!
My client, Dr. Anna (pseudonym, but true situation), was excited about her role as Medical Director at a regional insurance company. As her long-term goal was to be a Chief Medical Officer, Dr. Anna’s current position should have provided the requisite experience. However, she wasn’t getting opportunities to demonstrate the value she could bring to her organization. Therefore, to ensure Dr. Anna was consistently showing her value as a leader, together we created her personal leadership brand.
Steps to a Leadership Brand
1. What results do you want or need to deliver to your organization?
This took some digging for Dr. Anna. Her specific goals initially were unclear.
2. What do you want to be known for? Your brand is a powerful way to be true to your values and strengths. Be sure to balance strengths that come naturally to you with new strengths you will need to develop to be effective in your role.
Dr. Anna wanted to be known as a direct communicator, who was focused on the bottom line, while showing deep respect and appreciation for the healthcare providers and their patient population. Therefore, we needed to work on strategies to ensure Dr. Anna’s heartfelt appreciation was communicated to the providers.
3) Make it real. Can you live up to the qualities you espouse? If you say you want to be seen as appreciating others, are you? Get feedback about how you are doing.
Whether you are aware of it or not, you have a brand. It’s better to be intentional about what you are known for and live up to it. Then, when people think about you, your brand and talents will come to mind for the next interesting assignment or an upcoming promotion.
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Overbooked, and overextended, it feels like there is more and more we “simply must get done”! When everything starts to feel equally important in your busy day, how do you decide the order of your to do list?
Things which matter most must never be at the mercy of things matter least. ~Johaan Wolfgang van Goethe.
Preparing to leave on a short vacation intensified my week. Then good news, bad news, that first counseling session I had been anticipating with my husband worked. We began to have some important conversations that were long overdue. Good outcomes, bad timing! Important conversations take time, and there was no way I would get everything I had planned done!
Feeling overwhelmed, even a little inadequate, it was clear my usual strategy of working longer and harder on my “To Do List” wouldn’t cut it. Some things, even important things, would have to wait!
You may have heard about the 80/20 rule that asserts a small amount of causes create most of the results. What do you do when after patients, charts, and meetings, there is no way to complete your “To Do List”?
Allow What Matters To Drive Your Day And Your To Do List
Family, health, a clinical contribution? Listen to your heart and ask, “What will I most regret not having done in life?” Do that. Your happiness depends on it.
- Go small – consistently
- Identify what is most fulfilling to you
You’ve acquired a lot of knowledge, but not at one time. Success is sequential, not simultaneous. Do the right thing, and then do the next right thing.
What is the right thing? It depends on where you are going. When you know, you can make better/faster decisions.
So much is changing in healthcare, and often the best choices are unclear. The change in medicine is not where my clients seem to struggle. Managing relationships, where they are called to constantly morph to adapt to new situations, is more challenging.
Managing relationships is much more than being friendly. It’s all about your ability to get the best out of others, to inspire and influence, to communicate and resolve conflict. Problem is, what works for one person may not work with another. So you have to be agile, willing to learn from your experiences and apply that learning to perform well in new situations.
I can’t tell you how many times I have heard a client say: “I can’t do that – it is not authentic.” Flexing, modifying or adjusting your approach is not being inauthentic. You are being agile so you can really connect with the people involved and get results.
- The thoughts, beliefs and fears of others may not be the same as yours. The only way to find out what they are is to ask and listen.
- Adapt your behavior to create connection. What do they need to feel understood and supported in this situation?
- Flex your communication style to talk their language. If they get straight to the point, limit your explanations to the bare necessities, or risk loosing their attention!
The goal with emotionally intelligent awareness and thoughtfully considered actions is to improve outcomes. The benefit is connection and acceptance!
At the request of her staff, Dr. Sara Teal, medical director, negotiated change in her work schedule. After making the case and getting approval from administration, she shared the good news with staff, only to be met with resistance. Frustrated and confused, she asked, ”What could I have done to avoid resistance?”
Implementing change is especially challenging now, when many forces reshaping healthcare leave physicians feeling powerless.
Myth: People naturally resist change
A common belief is that resistance is the natural human response to change. However, not all change provokes resistance. We seek change that we choose freely.
Reason For Resistance
Based on over three decades of research, human development expert, T. Falcon Napier, reports that what people resist is loss of control. The sense that you could lose control of what is important creates tension. Of three criteria – logic, feasibility, and level of tension – that must be met before change occurs, level of tension is most critical. Too little tension provides no motivation to change. Too much tension results in feeling overwhelmed.
Often, we focus on logical and feasible cases for making a change, instead of exploring tension experienced by individuals involved. The change implemented by Dr. Teal was both logical and feasible. Resistance occurred due to staff having tension about change. People who resist change have something else they know, care about, or enjoy.
Symptoms Of Resistance
Anger and complaints are obvious expressions of resistance. Other symptoms of resistance include:
- Verbal agreement, despite limited follow-through
- Slow progress
- Excuses for lack of progress
Position Power vs. Personal Power
Viewing resistance as healthy, natural, and a useful part of the change process is key to addressing resistance constructively. Dr. Teal could have used the authority of her position to push the schedule change through. Instead, she recognized that it would be faster and better for her to acknowledge individual perspectives and concerns and for the team to rely on trust and respect. Her goal was to leave everyone feeling more in control of the change, rather than feeling coerced, which would have lead to more resistance.
Resistance can be mild or major, depending on how disruptive the change feels to an individual. One of Dr. Teal’s team, Dr. Jones, clearly was upset by the proposed change. Instead of one more group meeting to review the facts, Dr. Teal met personally with the reluctant physician. She focused on understanding, acknowledging, and addressing his concerns.
Strategies For Addressing Resistance
- Start with yourself. Dr. Teal explored self-honesty first on how she felt about the change, to avoid conveying unintended non-verbal messages.
- Acknowledge that, with every change, even good ones, a loss occurs.
- Listen to understand, not just to respond. Listening without judgment acknowledges validity of another’s perspective, even if you don’t agree.
- Create a safe space for concerns to be expressed, by listening and acknowledging emotions described, not merely the words spoken. Being comfortable with strong feelings is required!
My recommendation to Dr. Teal to be proactive about addressing resistance was to go beyond the logical, feasible case. In the future, she will explore physical and emotional components of a proposed change. Taking the time to listen and asking good questions when resistance is encountered are investments that pay off in the long run.
Deborah Munhoz coaches physician leaders to have greater influence and job satisfaction. For questions or comments, contact Deborah here.