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Trust Your Inner Voice

You'll Know Why Eventually!

We just finished our ACPE Annual Meeting last week.  As I watched some of our best physician faculty members teach what they're passionate about, I thought about how they got to this point of their career.  At one point, they were at the same intersection that many readers of this website can understand.  Here are some people and their journeys that might convince you that your inner voice deserves your attention.

John Kenagy is a surgeon who fell out of a tree years ago, fracturing some cervical vertebrae.  During his convalescence, he thought about the inefficiencies and frustration in his daily routine as a surgeon, and as a patient.  It led him to a decision to get a Masters at Harvard.  Once that decision was made, he found himself intrigued by Toyota's manufacturing process, which is legendary for producing a product with few defects compared to their competitors.  I met John a decade ago, when I was also fascinated by Toyota.  At the time, we had to contend with our physician colleagues who thought our intellectual diversions from medicine were useless.  Wrong!  Though we might wonder ourselves why something fascinates us, it is always worthwhile to pursue that fascination.  It led John to work with Clay Christensen, the business thinker who's written books on the concept of disruptive innovation.  John has also made a major contribution to health care leadership with his new book Designed to Adapt, which summarizes his experiences and thinking about transforming health care.  He's taken Toyota's Lean concepts and applied them to health care.

Alan Kaplan, the CMO of the Iowa Health System, and Immediate Past President of ACPE, is a very dynamic and engaging speaker.  I asked him how he got so good at extemporaneous remarks and connecting with his audience.  Improv.  When he worked in the Chicago area, he joined an Improv group to learn how to connect with an audience.  Was that just another restless doc daring to have fun?  No relationship to health care?  That would be the conventional "wisdom".  Maybe that's an oxymoron.  The secret to Improv, Alan (and another faculty member who's really good) says, is to think "Yes.....and?.....".  That keeps a conversation going.  That little tip has been really helpful to me when I'm in the inevitable trap of having at least one physician in a group who wants to shut down a conversation with the entire audience by making comments that will stop the conversation.  One of my goals this year is to find someone in my hometown of Albuquerque who can teach me more about Improv.

Grace Terrell, CEO of a large physician group in North Carolina, is an insightful thinker, speaker, and powerful writer.  She's combined her passion for writing, strategic thinking, and compassion for people in her role as CEO.  She just finished her three year tenure on our board.  She made a connection with a first time attendee, a young physician grappling with her career interests.  The connection that provided the bond: English literature.  That's something both had in common, in addition to being physicians.

Barbara Linney, our career counselor, leader of our CPE program at ACPE, and wife of a physician, typically  counsels physicians individually.  She says that a common issue is boredom.  Most physicians are high achievers, have perfectionistic tendencies, and work really, really hard.  At some point, doing excellent work becomes well......boring!  These physicians tell her, "Everyone tells me I should just shut up about it.  You're a physician, you're supposed to be happy."  Some find that new challenge they seek in leadership and management.  Others want to explore concepts of engineering applied to health care.  Sometimes you must indulge your passion for music, the arts, stonemasonry, or quilting as you wrestle with your career boredom, until you figure out where you're heading.  It's all OK, whether it takes a month, or a decade to figure it out.   

Finally, take a tip from my oldest son, a commercial pilot.  He came home from a fourteen and a half hour day working at our shop (old truck restoration), and said, "I am really tired - but NOT fatigued."  A big difference, and a good difference.  Fatigue is what pilots, physicians, air traffic controllers, and others with stressful jobs experience when the brain and body are overloaded from stress.  His comment resonated with comments I heard at the Annual Meeting: we often don't realize how little time we have to think, because we are often fatigued.  Take time - non-fatigue time - to talk with your family and friends about what you're mulling over.  Don't allow the "shut up, be happy" dialogue to enter the conversation.  Just ask for support or indulgence in what may be a whim.  But it just might be really important!

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