Freelance MD - Nonclinical

What Can I Patent As A Physician? - The Process Patent

2017-10-09T20:09:35Z

You're a physician who thinks you may have a process that you can patent?

The US Patent law specifies 4 things that are patentable:

Processes,
Machines,
Manufactures, and
Compositions of matter.

When we think of patents most think of a gadget, which falls under the “machines” classification and is typically referred to as an “apparatus” when writing a patent. We will spend some time later on the apparatus patent but today will focus on the process patent.

First, a story to demonstrate the power of a process patent. In the 1950’s Monsanto produced the compound 3, 4-dichloropropionanilide and secured a patent on this compound. This compound is referred to as “propanil” which is obviously unrelated to the beta-blocker propanolol. In the late 1950’s Rohm & Haas found out that propanil was an excellent herbicide for rice. Monsanto filed suit against Rohm & Haas for patent infringement but the R&H lawyers found a paper from 1902 describing the compound and thus the patent was found invalid.

Note: this was all before the age of Internet search. Nowadays, there is no excuse for spending the money on a patent before an exhaustive (and largely free) search is done for what is called “prior art” in the patent lexicon.

Rohm & Haas then procured a process patent on a “method for applying propanil to inhibit the growth of undesirable plants in areas containing established crops.” Meanwhile Dawson Chemical was selling the compound so R&H sued them.

To the average person, this lawsuit must have seemed ridiculous. After all, R&H did not invent the compound nor were they the first to try to patent it. And, they were just lucky to find out that it was good with rice. What kind of breakthrough was that? Monsanto was long in the seed and herbicide business so clearly they must have thought that this compound could be used as an herbicide. Finally, Dawson was not actually applying the compound to the rice fields — it was the farmers. So, why not sue each individual farmer?

The appeals court ruled against Rohm & Haas but the Supreme Court took up the case. In one of the classic 5-4 decisions, the Supreme Court reversed the appeals court and ruled that:

1. A “repurposing” of an existing compound was worthy of a patent. In an informative paragraph the majority wrote:

“It is, perhaps, noteworthy that holders of "new use" patents on chemical processes were among those designated to Congress as intended beneficiaries of the protection against contributory infringement that § 271 was designed to restore. We have been informed that the characteristics of practical chemical research are such that this form of patent protection is particularly important to inventors in that field. The number of chemicals either known to scientists or disclosed by existing research is vast. It grows constantly, as those engaging in "pure" research publish their discoveries. The number of these chemicals that have known uses of commercial or social value, in contrast, is small. Development of new uses for existing chemicals is thus a major component of practical chemical research.”

2. Dawson was guilty of “contributory” infringement as propanil was not a staple good nor was there another substantial use for it other than as an herbicide. While Dawson did not actually apply the chemical they contributed by selling it when they had to know that it would be used primarily as an herbicide.

The decision can be read at: http://www.law.uconn.edu/homes/swilf/ip/cases/dawson.htm

How does this apply to the physician inventor? Imagine that your were the first to notice that your patients on the diuretic diamox came back from their ski trips mentioning that they now had no problem with altitude sickness? You could get a patent on a process (typically now called a “method” patent) of preventing altitude sickness by taking diamox.

Fine. Now you have a patent. How do you enforce it? Do you sue every skier or mountaineer that takes it? No. However, if a drug manufacturer put that indication in its training or sales material then you could have grounds for a suit. Since this would require an FDA trial, the very study materials and FDA filings would be about all of the evidence that you would need. That alone might be enough for a drug company to approach you for a license. Especially after the off-label prescribing grew to the point that the drug company noticed it.

What could you do if the drug company is content with the off-label prescriptions? Not much unless the other indications (hypertension and glaucoma etc) amounted to a trivial portion of the prescriptions.

Physician Leadership On Nonprofit Boards

2012-08-27T01:31:43Z

Practical insights for physician board members and chief executives.

Physician leaders are often asked to serve on boards of nonprofit organizations. Physicians in transition may also want to explore this—not only as an opportunity to apply their leadership skills outside of clinical practice—but also as way to give back to their communities.

I have found that a lot of ink has been devoted to the theories that drive nonprofit board leadership—but perhaps, too little about the nuts and bolts of ensuring effective boards. While serving on a nonprofit board can be richly rewarding, it can also present a leadership challenge. Depending on your past experience, you may want to take a closer look at the practical aspects of nonprofit governance, including formulating board structure and process, developing a strong partnership between board and staff, and structuring effective board and committee meetings.

Nonprofit organizations are one of America’s greatest heritages and a distinguishing feature of our society. Business supplies goods and services, government controls and regulates, but the nonprofit organization has a different mission. Its “product,” writes Peter Drucker, “is neither a pair of shoes nor an effective regulation. Its product is a changed human being. The nonprofit institutions are human-change agents.” We are drawn to what Drucker calls the “high ground effort of changing lives for the better” in a world of selfish interests.

Changing lives is exciting business, and working with people who have similar goals can be very gratifying. But it is also a challenge. The agenda is usually open-ended and subject to change at any moment. You must please many constituencies, often with differing priorities. Much of your success depends on raising enough funds and finding enough good volunteers. The measurement of results is difficult and open to various interpretations. The days are as long as they are in any professional job. And in my opinion, the board and chief executive of a nonprofit organization have a greater leadership challenge than their for-profit counterparts.

Fundamental roles of a nonprofit board

Just as boards are inherently diverse, so are the assumptions individual board members bring to the group. For this reason, a shared understanding of the roles of a nonprofit board is essential to effective governance. Here is a checklist of ten functions you can use for clarifying your board’s role:

Determine the organization’s mission (or purpose)
Select the chief executive
Support the chief executive assess his or her performance
Ensure effective organizational planning
Ensure adequate resources
Manage resources effectively
Determine, monitor, and strengthen the organization’s programs and services
Enhance the organization’s public standing
Ensure legal and ethical integrity and maintain accountability
Recruit and orient new board members and assess board performance

Here is a framework for clarifying role definitions. Think of each board member as having three hats to wear:

Governance hat: Worn only when the full board meets, propoer notice is given, and a qorum is proesent.
Implementation hat: Worn only when the board gives one or more board members authority to implement a board policy.
Volunteer hat: Worn at all other times, when board members are involved with organizaitonal activities as volunteers.

Problems arise when board members and /or staff confuse these hats or when board members assume that individual and collective board responsibilities are interchangeable. They are not. Much of the confusion has to do with authority. Governance is a group action.

Major differences between nonprofit and for-profit boards

There are fundamental differences between nonprofit and for-profit boards, such as their over-arching goal, size, and public accountability. But there are also similarities in these two types of corporate boards. (A nonprofit organization is an incorporated entity, too). The differences are in purpose, effectiveness, and motivation, not so much in legal principles.

Sorting out the board’s role in relation to the staff

Too many chief executives seem to compete with their boards, so they have little motivation to help them define a clear, strong role. This is unfortunate, because everyone can be more productive when roles are clear and board members and staff agree not trying to do one another’s work.

One good reason for clarifying roles is legal liability in organizations whose boards do not set and carefully document policy. But the most compelling reasons have to do with organizational effectiveness. In my experience, strong nonprofits have strong boards, and string boards become excellent with the help of their organization’s chief executives. The best boards stick to their governance role and stay out of staff responsibilities when doing board work. Conflicts arise when staff is equipped to do a better job than a poorly functioning board.

In the business of sorting our roles, the best advice is to put it in writing. Verbal communication does not work well in nonprofit governance. Turnover of board members and staff can lead to confusion. And besides, people bring different experiences to the board room and translate them into different assumptions about what should happen. The result is miscommunication, misunderstandings, and mistakes.

The best approach is to think ahead and give clear signals about what the board intends to do and what it expects the staff to do. Decide together what works for the organization, within the board roles, and then write it down in simple and straightforward terms so that the people involved, now and in the future, can easily refer to a written set of expectations.

How a board should be structured

There is no magic formula; the board’s willingness to make the structure work is more important than following a textbook definition.

Evaluate structure every couple of years and change as needed
Keep the board as small as possible to get the job done
Evaluate the chairman as part of the board evaluation
If the board has an executive committee, limit its authority to actions that are necessary between full board meetings
If the organization has paid staff, don’t allow chairman to act as the chief executive
Clearly designate chief executive as sole agent of the board
Have as few standing committees as possible
Use short-term, ad hoc task forces to address special needs of the board
Consider forming an advisory group in addition to the board
Limit board membership to volunteers with exception of chief executive

The role of board chairman

If roles are clearly understood, the partnership between the board chairman and the chief executive will help the organization flourish. If these two organizational leaders agree to do whatever is necessary to make each other successful, the success of the board will follow. Assuming the organization has a clearly identified chief executive and a volunteer board chairman, here are the chairman’s basic responsibilities:

Preside at board meetings
Coauthor board agendas (with the chief executive)
Appoint and assist committees
Manage group development
Maintain organizational integrity
Support eh chief executive
Link with the major constituencies

Concluding thoughts

A key take-away from my experience is that boards and chief executives have different, noncompeting roles. They must learn to complement one another for each to be truly successful. As Peter Drucker emphasized, nonprofits waste uncounted hours debating who is superior and who is subordinate—the board or the executive officer. The answer is that they must be colleagues. Each has a different part, but together they share the play. Their tasks are complementary. Thus, each has to ask, “What do I owe the other?

This is what servant-leadership is all about—each side of the dual leadership wanting the best for the other and taking initiative to help the other succeed. Everyone wins. Service in the organization is rewarding. Lives are changed for the better. Everything is possible in a team effort if it doesn’t matter who gets the credit.

Physicians In Transition: Learning To Bounce Back

2012-05-25T16:30:00Z

Overcoming setbacks to succeed in your career and in life

If we’ve learned anything from history, it’s that nobody goes through life unscathed—no matter how rich, how smart, how talented, or how fortunate they may be. One way or another, we can all relate to the raw emotion that strikes people when they are knocked down.

Perhaps you’ve been fired. Or you’ve been side-stepped for the promotion you wanted. Maybe you reached for a golden opportunity—and did not get the nod. Perhaps you’ve finally made it to the top—don’t like what you see—and you want out.

These sorts of things may be setbacks—but they are only permanent if you allow them to be. We can let the negative overcome us—and those around us—or we can plot a course to “bounce back” to make a life transition.

First, know that you are not the first, worst, or only. Others have been where you are, and they’re doing just fine now. But it took some time and effort.

Tips and Action Steps

Evaluate, come to grips with what has happened
Acknowledge the event, but don’t be limited by it. Learn from experience. Let your emotions run their course, and then focus on starting to bounce back with a positive attitude. Take stock of what has happened, and be prepared to attack your transition with passion and a positive attitude—no matter what.

Identify the “board of directors” for your life transition
Reach out and enroll a short list of trusted advisors. Include family members and friends as well as colleagues, and mentors. Ideally, these are people who know you and will support you—but will also challenge you. Ask them for feedback, follow through, and hold yourself accountable.

Engage a professional coach to help you achieve excellence in your life
Be open to the possibilities as your coach challenges and supports you in finding your path and reaching your full potential.

Keep moving forward and don’t look back
Develop a regular routine to keep you grounded and looking forward. Maintain perspective, and a good sense of humor will not be far behind. Trust that good things will come from where you are now. Don’t just recall the good; realize there were also things that were less than ideal. From this, you will come to appreciate the vast opportunities ahead of you.

Prepare yourself for an honest self-evaluation and serious introspection
Assess you past situation objectively and honestly, and be willing to mend fences. Understand what led you to where you are now.

Discover your own best story
What will your transition look like? Determine what the best version of you should look like—and show it to everybody. Work to reach a point where you are empowered by your confidence, positive attitude, and flexibility. Think long and hard about what you want to do next—and then what you want to do after that. Think it, talk it, and it is more likely to happen. Get specific and detailed about how you will capitalize on the reentry opportunity you will receive.

Visualize your success
Be relentlessly positive and believe in yourself. Dream big and don’t let anyone tell you that your dreams are unrealistic. They are your dreams. Realize there is nothing that is out of reach when you are part of a shared vision that serves as an inspiration to all involved. Pursue your goals with the blissful determination and enthusiasm of a youngster. Appreciate the unexpected outcomes your “trigger event” will lead to and whom you will affect. Let your board of directors know you value their opinions and can’t have them being afraid to speak their minds.

Go for it
Build your self-worth—help others to help yourself. Find significance again through charitable endeavors of some type of community involvement, and make giving to others a priority in your life. Stay upbeat, and don’t become the caller ID no one wants to see. Get feedback from people who were around you when your fall was taking place. Be open to every opportunity, and view everyone you meet as a potential character in your transition. Decide what you want your brand identity to be, and then own it.

Let opportunity knock—and choose wisely
Do your homework and be prepared to capitalize on the best available opportunity. Don’t let bumps in the road detour you. Notice the lessons you are learning during every step of your transition; take the time to understand these lessons. Allow the crises of the past and interruptions in your progress to become unifying events and personal growth opportunities.

Plan your work and work your plan
Make a clear and concise plan for your immediate future. Continue your transition even when your personal goals have been met; grow and prosper as you become the flame for others.

How To Start Your Own Internet Business For The Risk-Averse Physician Entrepreneur

2012-03-12T21:11:09Z

In a recent issue of Medical Economics, I was astonished when I read the title of the cover "Passion Powers Success". To my amazement, the topic was discussing Physician Entrepreneurship, and the importance of running your own business.

For years, physician entrepreneurship was often considered "taboo". Just recently, I was approached to speak at a physician conference. However once I had mentioned the title 'Becoming Your Own Boss"- they asked if we could change the topic to something else.

"We don't want to train doctors that way" - says a nameless physician spokesman, as if somehow my speech will cause an exodus of doctors leaving the field and cause mass destruction to our healthcare system.

Is the phrase “physician entrepreneur” an oxymoron?

Becoming an entrepreneur, does not necessarily means quitting your day job. What it does give you is more choices of what you want to do in your life. I know many entrepreneurs who still maintain a partial or even full practice, yet are enriched with the challenges and rewards that being one brings.

Now being an entrepreneur is obviously not without its risks. If you have ever watched the ABC Show “Shark Tank”, you will see evidence of everyday inventors who have spent their life savings on creating products, and later finding out the hard way that no one else would want to buy it.

Some think being an entrepreneur requires you to buy a business or franchise. One couple I have been consulting with recently took over a jewelry business. They rent store space, hired employees and pay massive overhead. They take turns working at a store for 12 hours a day, including weekends, while still working their current job. Although they are now making a profit, they have in a sense “bought a second job”.

Many of the above examples, could have been solved by testing out ideas and products using the internet first. The internet is the greatest level playing field we could every have. It allows you to reach people in a cost-effective manner in almost any demographic, occupation, or niche market. My client could have created a website selling jewelry, hired a virtual assistant to run and take orders, and avoid the extra financial costs of running a “brick and mortar” store.

And if you feel you do not have the technical knowhow in building a website, sometimes you don’t even need one! I recently had a great conversation with a radiologist who I helped get his first ebook onto Amazon. In a short time period, he averages about 10 sales a day, and gets a nice check each month. The best part is he only had to create it once, but it is on a topic that is “evergreen”, content that will always be relevant, where we both expect sales to continue for years to come. He already has plans of creating five related books in this field by the end of the year now and building a nice nest egg for him and his family.

Becoming an entrepreneur opens you up to more business models and different ways of thinking. As doctors, generally we only make more money by seeing more patients. However through the internet, you have the ability to create and launch products such as ebooks, apps, information products, newsletters, subscription sites, and home study online courses where it is created once and get paid on a regular basis. If the only way you are generating revenue is by seeing more patients, it is time to open and consider different avenues of revenue.

Making Things Happen As A Physician In Transition

2012-01-04T18:00:00Z

Overcoming the obstacles between dream and reality.

You’ve thought a lot about leaving clinical practice and transitioning to a non-clinical career. You considered starting your own internet business or writing a book or investing in real estate. You thought you had a good idea at the time. So, what’s keeping you from making it happen?

As a physician, you’ve probably considered many great ideas—or dreams—about your future. But those dreams have little value, if you don’t follow through and make them a reality.

If you have encountered obstacles in executing your ideas, you are not alone. Countless ideas with the potential to transform lives—concepts for new medical products or models for new businesses—are probably conceived and misspent in the hands of talented physicians every day. The ideas that move people forward are not the result of tremendous creative insight—or inspiration—but rather of masterful planning and management.

Successful entrepreneurs tell us that ideas don’t just happen by accident—or because they are great. Whether you have a solution for an everyday problem or a bold new concept, you must transform your vision into reality. Far from being some stroke of creative genius, this capacity to make ideas happen can be learned and developed by anyone.

Success depends on making things happen

Whether you are in clinical practice or in industry, success depends on developing and executing new ideas. You may come up with creative solutions to medical problems every day. Unfortunately, regardless of how great your ideas may be, most of them will never happen. Most ideas get lost or pushed to the back of our minds by questions and doubt. As a leader in healthcare—and the leader of your life—you must learn to defy these tendencies.

You can develop the capability to make things happen

Some feel they need a push. They are waiting for circumstances to force them to take action. Others believe they need to have a lot of money stashed away, before they can “jump off” the clinical track. Still others are waiting for “the right time” to pull the trigger. The truth is there are practices that creative individuals and teams use to make ideas happen, time and time again. And the discipline of execution can be learned.

Organization enables you to manage and ultimately execute your ideas

In our world of information overload and constant connectivity, you must manage your time and energy wisely. Otherwise, you will fall into state of what some call “reactionary workflow,” where you act impulsively—rather than productively—and simply try to stay afloat. Everything in life can be approached as a project—and every project can be broken down into action steps. Prioritizing each step can help us manage our energy and attention. And the discipline of taking even small steps every day can help us live and work with a bias toward action.

The forces of community are invaluable and readily available

Ideas don’t happen in isolation. You must embrace opportunities to broadcast and then refine your ideas through the energy of those around you. Have you talked to your spouse about your ideas? What about your friends and business partners? Have you appointed a "board of directors" for your transition?

Execution requires a unique capacity to lead

Leading any sort of creative pursuit requires an overhaul of how we motivate others and ourselves. The most admired leaders are able to build and manage teams that can overcome the obstacles faced in complex projects. There is a mindset we must achieve to withstand (and capitalize on) the doubts and pressures we face along the way.

How to build your capacity to make your ideas happen

Clarify your core values and beliefs. Tap into your emerging purpose and passion.

Use change as a resource—and learn how to deal with your resistance to change. Take advantage of change by “holding on” to your values, “letting go” of bad habits, “taking on” new knowledge and skills, and “moving on” with your plan for the next chapter in your life.

Achieve balance in your life, linking your purpose to selected roles and activities.

Manage your time to ensure you achieve what’s most important to you.

Identify and overcome the obstacles that get in your way or hold you back.

Focus on your future, no matter what your age or circumstance. Tap into your special “gifts.”

Recognize the predominant themes in your life story—and your limits and constraints for moving ahead. Develop and explore possible scenarios and make optimal choices.

Connect your dreams to realistic plans. Develop new and exciting visions of your future—and connect your dreams to realistic action plans.

Create a learning agenda for renewal and sustained resilience. Embrace learning as a way of being and achieving.

Engage a professional coach to help you achieve excellence in your life. Be open to the possibilities as your coach challenges and supports you in finding your path and reaching your full potential.

Physician Leadership Of Teams, Part II

2011-11-09T07:18:39Z

Read Part 1 of Physician Leadership Of Teams here.

Developing Your Team and Increasing Its Effectiveness

Leadership involves skills and abilities that are useful whether you are a physician in clinical practice or an executive in industry. You could be developing a new medical device or managing a clinical trial for a pharmaceutical company. Simply put, leadership is everyone’s business. And the ability to build a team and improve its performance is becoming increasing important.

Charles Elachi, director of NASA's Jet Propulsion Laboratory, put it best: “No matter how good you are, the thing that makes the difference between success and failure is how good a team you have.” The team you build, develop, and contribute to will reflect—above all else—the behavior you model. The symbolic aspect of your behavior, both as a team leader and as a team member, is often its most influential dimension.

In my experience, the best teams demonstrate a number of key attributes. Here’s what I’ve learned about high-performing teams—and what we can do as leaders of teams:

Best Team Attributes – Four Dimensions

Environment
- Passion
- Optimism
- Shared vision, transcending mission
- Respect, trust, collegiality, deep mutual understanding
- Clear objectives

Communication
- Constant, high bandwidth, two-way, multi-level communication

Diverse Perspectives
- Openness to new ideas
- Open discussion and debate of difficult issues
- Team problem-solving

Self-Renewal
- Relentless drive to do better as individuals and as an organization

What You Can Do—Leadership Themes

Create the Environment and Set the Tone
- Create an environment that liberates the energy of individuals and the team, thus enabling success.
  - Grant respect and trust. Respect and trust are truly fundamental. Without these building blocks, it’s hard to accomplish much. By immediately granting respect and trust to your team members, you can set the open, positive, and collegial tone that is essential for team cohesion and effectiveness
  - Set expectations. Set expectations, define guidelines from day one.
  - Define the space for success. Create the space for success; define the envelope of goals. Describe what success will look like, and outline (to set up for further team discussion) the general way by which you envision the team achieving that success. Everyone needs to see a possible path to the finish line.
  - Build ownership. Build ownership by broadening participation. Even though this point is so simple and straightforward, many unseasoned leaders underestimate the power of shared ownership.
  - Reinforce cohesiveness through values. Values guide leadership actions. Seize every opportunity, large and small, formal and informal, to build and reinforce team cohesiveness.
  - Create heroes. Give away the glory, take the blame. Provide air cover for your team.
  - Maintain optimism in adversity. Calmly and thoughtfully evaluate the problem, resolve it, and then return to normal operations. Stay optimistic, calm, and focused on success, no matter what.

CommunicateThere is never enough communication—and communication starts with listening.
- Listening
  - Just listen
  - Apply proven techniques
    - Ask questions: Use structure, language, and tone to allow the broadest response space and information content
    - Pause
    - Think it over (“I wonder why…”)
    - Mirror (“So from your perspective, you see…, have I got it right?”)
- Speaking
  - Begin from first principles. Professionalism begins with putting the patient’s interests first.
  - Create a shared reality. The first task of the leader is to define reality. Beyond that, share your thinking and your concerns.
  - Give everyone the big picture. The more people understand, the more they can contribute, and the more they’re motivated to contribute.
  - Clarify the logic. Be very clear about the logic. Strategies based on faulty or inconsistent logic cannot be communicated and understood clearly. As a result, however powerfully executed, they will not succeed.
  - Close the loop. Get everybody on the same page. Give executive presentations and provide debriefs, written lessons learned. Summarize and discuss high-level meetings for those not in attendance. Critique and suggest improvement directions in individual work products. Conduct team meetings to initiate specific feedback.

Encourage Diverse Perspectives
- Encourage open, challenging and diverse perspectives; build a “culture of candor” (Warren Bennis).
  - Appreciate dissent. First off, express appreciation when someone articulates a different or dissenting point of view.
  - Seek newcomers’ views.
  - Embrace peer review. Peer review is an indispensable component of performing challenging multi-person efforts successfully.
  - Appoint a “Devils Advocate. This is a way to invite critical thinking, stimulate dissent, and reinforce the importance of looking at all points of view.
  - Structure competitions. Set up competing teams and/or perform simulations.
  - Search for alternative approaches. Actively lead and encourage the search for and use of alternative approaches and tools, to help uncover hidden assumptions, identify critical-path success elements, and highlight potential failure points.
  - Extract lessons from experience. Review “lessons learned” from unclear objectives, flawed logic, hidden assumptions, inadequate challenging, and poor listening. Consciously extract lessons from past experience and apply them to current challenges.
  - Implications: Different perspectives are valuable. Diversity of backgrounds and experience of team members contributes strength to the team. Each of us can teach and learn from others. Collegiality and cohesiveness matter.

Model Self-Development and Renewal
- Model professional growth, development, and self-renewal
  - Build a development plan
  - Critique your own performance
  - Ask stretch questions—pose questions specifically designed to encourage “stretch thinking” and develop management perspectives. Example: “What would you do if you were in my position?"
  - Seize teaching/learning opportunities. View every task an interaction as a teaching and learning opportunity. Provide commentary / feedback on your own and others’ efforts.
  - Use a mentor, ask for coaching, seek outsiders’ advice and perspectives
  - Commit the time
  - Reflect—use and communicate self-reflection as a learning path

Read Part 1 of Physician Leadership Of Teams here.

2nd Down, The 4th Inning, Friday At The Masters & You

2011-10-19T15:54:48Z

By engaging the middleness of events in our life, we can often find great value.

I am a big sports fan and so I enjoy listening to sports talk radio where there is always talk about different stats from that game or this player. Often, they talk about how well teams play in the very beginning and end of games and ignore the middle part of these games.

For example, there are countless stats about players getting off to a great start and/ or finishing well, but we don't hear much at all about how these same players do in the middle of the games. We hear about players and teams who are great "closers" but rarely hear about how well they perform in the middle of their respective sports.

This happens across sports: from professional Golf (Saturday is moving day and Sunday is the closing day, but what about Friday?) to professional football (all types of stats about third down conversions, for example, but none about second down), to baseball to hockey (rarely do we pay attention to the second period stats--it is only the first and third period that sticks out).

We are also familiar with this same outlook in books, movies and plays. When writing we are told to engage the audience with a strong opening line and paragraph and make sure we finish strong. This same thinking is played out in the movies and plays we watch as we tend to remember the opening and closing scenes but often forget those middle ones.

Are our brains wired for only the bookends in life? Do we have such short attention spans that we are only interested in the beginning and ends of life's events?

While I certainly don't have the answers for those questions, I do know this: embracing the middleness in life leads to tremendous value. This applies to your business as much as to your personal life. Allow me to walk you through some examples:

The middle of the day or I feel like I'm going to fall asleep because it is 3 o'clock syndrome: we are all familiar with the middle of the day and how oftentimes we get sleepy and can't seem to focus well. Again, we do well in the morning and have lots of energy and focus, but by the middle of the day, we feel like we need to take a quick nap to recharge. I encourage you to take a different approach--everyone around you is snoozing during this time of the day so it is the perfect time to energize yourself, your colleagues and your patients. Make phone calls, write blog posts, do something with energy at this time of day and you will leave yourself and your audience impressed. Because we have fallen into the rut of thinking that the middle of the day is the lull, we don't put much effort into making it a productive or eventful moment for ourselves.
The middle of your patient appointment or business meeting: this is where we tend to lose interest and start looking at our phones and our watches preparing for what we are going to do after the appointment or meeting. What if you saved your idea or your advice until this time? I am confident you would have an easy time impressing whoever it is you are talking to. Again, because we don't put much effort into the middle, we tend to roll right through these times. This is the very best time to wow your clients and patients.
The middle of your next project: again, in line with the theme of this article--the middle is when we tend to put less effort and less enthusiasm into our projects. We start well with energy and ideas propelling us forward and we end well with images of our clients enjoying the fruits of our labor. But the middle of the project? This is when we stall, we hit the wall and delay. A better approach is to embrace the middle by reigniting your energy and focus for this very purpose. Not only will your co-workers be impressed and motivated by this, but so will you.

When we stop and think about the middle, though, we do realize that the bulk of life is lived "in the middle". Think about your last family get-together or the last time you ate out at a fancy restaurant. Likely, the fun and enjoyment of those occasions came from the middle, what is supposed to be the boring section.

As our lives get more and more sped up with pressures and deadlines and staying two steps ahead, what we often value most is the peace and calm and quiet of the middle. This is the family dinner around the table after a long day. This is the milling around on Saturday afternoon without knowing what to do. This is the in-between moments of our lives that we cherish more than we realize. Sure, getting to Disney World is exciting, but the laughter in the hotel room is what we usually carry with us.

Embrace the middle, the boring section and all the in-betweens in life. Not only will you find that you become more productive and stand out of the crowd more, you will also find that you will cherish those moments more. And as we all search for the ability to find more tranquility in the roaring storms around us, living in the middle-moments makes so much sense.

Doctors Underestimate Their Options

2011-10-11T16:09:29Z

By Franz Weisbauer MD

Most of us who studied medicine went into medical school thinking that they were going into the coolest profession that was ever invented. It’s exciting, it’s intellectually stimulating, it’s well respected, it’s well paid etc. etc.

Many of us started to work as physicians after medschool and realized that there were parts to our work that we did not like that much: the long hours, death, grief, paperwork, administrators, bad pay (but everyone told us that doctors were rich?).

Some of us did not get over these undesirable aspects of the physician life, they are unhappy with what they are doing but unable to quit….after all, this is supposed to be the coolest profession (remember?). Plus, what would my friends, parents, grandparents, …. (fill in blank) think of me?

Very few of us jump in at the deep end and either don’t start to work in medicine or quit this highly respected profession to do whatever feels best to them. Many of those who are stuck, who don’t dare to exit think that there is really nothing else they can do. Think twice. You are highly educated, smart, creative, eloquent, analytical. Otherwise you would have never made it into medical school.

There are tons of jobs out there waiting for you: be it as a medical writer, entrepreneur, public health expert, medical advisor to the industry, teacher, speaker, blogger, coach, psychotherapist, angel investor etc. etc. etc. If you are one of those people who think that you are not creative enough to come up with alternatives to your current job, this video is for you….Enjoy!

By the way, we highly recommend Derek‘s book “Anything You Want”. It describes his lessons learned from founding, running and selling cdbaby an online platform for indie music. Derek can serve as a role model for all of us.

About: Dr. Franz Wiesbauer is a founder of Medcrunch

Submit a guest post and be heard

Making Choices As A Physician In Management

2011-10-10T03:00:00Z

Physicians in management and leadership roles can use a strategic choice framework to improve the quality of their decisions.

Problem solving and decision-making are important skills for all physicians, in business and in life. Problem-solving often involves decision-making, and decision-making is especially important for management and leadership. There are processes and techniques to improve decision-making and the quality of decisions. Decision-making may be more natural for some personalities, so these physicians should focus more on improving the quality of their decisions. Physicians that are less natural decision-makers are often able to make quality assessments, but then need to be more decisive in acting upon the assessments made.

Too often, the process of making a decision is cumbersome and unfocused.

Making Choices: The Traditional Approach

Study lots of things -- Broad, ambiguous direction to work team
Review findings -- Binders of unconnected bits of data and ideas
Develop options -- Pressure to converge on workable options
Seek alignment with key managers -- Lots of time spent in meetings before the meeting
Polish the presentation -- Usually over and over again
Seek approval by senior management -- Try to get in and get out with your plan intact

With this approach, decision-makers often end up delegating the complexity away. There is no time to think. Insufficient consideration is given to the art of defining “what’s doable.” Too much emphasis is given to an elaborate “buy-in” process. And the outcomes involve inspecting quality at the end and incremental choices at best.

Making tough decisions—whether at the executive committee level or in the course of a physician manager’s day-to-day work—can consume high levels of resources but still produce unsatisfactory outcomes.

Challenges of the Traditional Approach

Choices do not get made. Example: Unable to reach consensus on core segments.
Choices appear to get made, but fall apart. Example: Management selects a path forward, but their staff does not implement the choice into activities.
Choices get made, but action is not timely. Example: Valuable partnership opportunity is missed due to slow decision-making process.
Choices are not robust. Example: Poor acquisition decision based on unreliable data and faulty analysis of implications.

Overview of Strategic Choice Framework

The Choice Framework optimizes the decision-making process by identifying critical; issues up front and converting them to discrete choices, allowing more time for focused, deeper analysis to overcome major uncertainties.

Frame choice -- Convert issues into at least two mutually independent options that might resolve the issue
Brainstorm potential options -- Broaden the list of options to ensure consideration of an inclusive list of options
Specify “what we must believe” -- For each option, specify conditions that must hold true for the option to be a good strategic move
Identify barriers to choice -- Determine which of the conditions you feel least confident are true
Conduct analysis -- Test the conditions with the lowest confidence first
Make choice -- Review analysis against key conditions and make informed choices

Advantages of the Choice Framework

Focuses on decisions to be made in a particular planning situation, whatever their timescale and whatever their substance
Highlights the subtle judgments involved in agreeing on how to handle the uncertainties which surround the decision to be addressed
The approach is interactive, designed not for use by experts in a board room setting, but as a framework for communication and collaboration between people with different backgrounds and skills