Key challenges to physicians include low reimbursement, loss of autonomy, and patient overload. As these issues are unlikely to change any time soon, there is high dissatisfaction among physicians.
However, the way we process issues can change today. We all have heard, “Life is 10% of what happens, and 90% of how you react to it.” Many challenges we experience can be traced to stories we tell ourselves, which are in our control. Although there may be a good reason for these stories, they produce bad outcomes.
Dr. Lisa, a hospitalist, was the physician lead for a pilot project to increase palliative care requests prior to discharge. In our coaching session, she shared that, while enthusiastic about the project, she didn’t have confidence she could keep attending physicians engaged. Dr. Lisa questioned her ability to be convincing about the project’s value, as English was her second language. “How can I possibly manage all the details, when I don’t even keep my house organized!”
As Dr. Lisa began to implement her program, she realized the problem was not her language or organizational skills, but unsupportive stories in her head. Things began to change as Dr. Lisa became aware, took control of the narrative, and started telling herself a different story.
Five ways to take control of your narrative:
- Recognize the voice in your head. It doesn’t matter where the story is coming from (your parents, a teacher, a colleague); just recognize that it is happening.
- Jot down what the voice is saying. Perhaps it says:
- “You’re too old/young.”
- “You’re under-/over-educated.”
- “You don’t have the right experience.”
- “You can’t leave after all you invested.”
- “You don’t have time.”
- Evaluate whether this story is empowering. Under many stories is a fear waiting to be updated. Is this story supportive of who you want to be in the world and the outcomes you want?
- Write down a different story. I’m not talking about pie –in-the- sky thinking. Just tell yourself the truth from another perspective. If we get to choose the story in our heads, why would we not make it an empowering one?
- Start telling yourself the new story. Every time your inner narrator begins telling the old story, stop it. Say to yourself, “No! Here’s the truth.” Then repeat your new story.
New stories, new lives
Dr. Lisa and I crafted her new story:
Yes, I am foreign born, and my perspective helps me think outside the box. I am passionate about this work and the impact it will have on patient care. My enthusiasm matters. My role as physician lead is not to manage all the details, but to enroll others. I have everything I need to be successful in this situation.
Using her new story, Lisa stepped over imagined obstacles and took steps to move the project forward. Within six months, Lisa had collaborated with staff that could exert influence at key points to result in more palliative care requests. The project outcome and how Lisa felt about herself both were better than she imagined. Now, instead of focusing on the behavior Lisa wants to change, she pays attention to the story she is telling herself!
How do you think your behavior or outcomes are linked to the story you tell yourself?
There are things in the world we can control, and things that we cannot. You always have a choice of how you are going to respond. Take control of your stories. You have the power to make things happen.