Kathryn Schulz - TED Talk "On Being Wrong"

What happens if we consider being wrong?

I just spent 17 minutes of my day watching Kathryn Schulz give a talk on the meaning of being "wrong". Best 17 minutes I've spent in a while.

Her premise is simple:  open yourself up to the possibility of what "else" is out there.  Challenge yourself to see the world (and reality) through a different person's window ... or at least recognize that there are millions upon millions of different windows out there.  Her message?  Embrace your wrong-ness.  It is an integral part of the human condition.  It drives us and helps us create.  It moves us forward as a species.

Physicians are especially prone to not wanting to be "wrong".  It's true, being wrong can have desperately negative consequences in your line of work.  But for many docs this fear of risk, failure, and error transfers over into other parts of their life... where being wrong is less clear-cut and the consequences are more of a grey area.  They agonize over life changes, career moves, interpersonal challenges with colleagues, to the point of "analysis paralysis" where they are immobilized and unable to do anything.  

But there is freedom in embracing wrong-ness as a possibility.  Kathryn speaks not only of being wrong, but of opening up your awareness of when you are unconsciously wrong, but think you're right.  This is a much more dangerous place to be, and warrants some thought.

Watch the video.  Think about how you feel about being wrong.  Open your window.

Do Physicians Need a "Personal Brand"?

Only if you want to stand out from the crowd, and successfully build your reputation and patient base.

I have the pleasure of going to Chicago in few weeks to attend the Society of Interventional Radiology's annual scientific sessions, and to help facilitate a workshop for physicians on marketing.  While I know that "marketing" is not a new concept to most, the point I'm going to be making about how they, the physician, are the most integral part of the marketing equation, may be.  Shifting their perspective from only looking at what they do, to who they are and how they do things, may be a challenge.  But for docs who (perhaps for the first time) are recognizing the increased competition in the marketplace and the need for marketing to "keep up", it is a message they need to hear.

And why should they care?  Why worry about "brand"?  If you think about your overall goal as a professional, it truly is about growth.  For my IR crowd the bottom line is about leveling the playing field with other docs/specialties that have been marketing themselves longer and have a much higher comfort level with it.  It is about increasing referrals, increasing the number of desireable procedures that the IR docs perform, and establishing a solid patient base for future referrals and procedures.  For anyone, it is about developing a reputation that makes people want to work with you, that allows them to trust you, and gives them an expectation of quality and delivery that meets their unique needs. Creating your brand helps you do this.  And I'll tell you why.

I recognize that the word brand has a bit of a negative connotation for many people... it somehow feels fake, or superficial.  But the first thing that should be understood is that developing your own personal brand is not about creating a contrived image or slick packaging covered in snappy slogans.  It is not an artifical veneer that you put on yourself to disguise or change what's within.  Quite the contrary, your brand is about creating a relationship with others, in a way that is authentically you and connected to your core values.  It is about how you visibly express those values, and the consistency with which you demonstrate them in your work.  Your brand is about building relationships that are based on trust.

Recognize however, that your brand is only as strong as how others perceive you.  Perception of your value is key.  Your brand - what you bring to the table, your "whole package" - exists in the mind of others, based on who they've known you to be and what they've known you to do.  It is a factor of both two things:  your competence (what you do) as well as your character (who you are).  Recognizing this is critical.  How can you create the perception you want others to have of you?

In their book,  "Be Your Own Brand:  Achieve More of What You Want By Being More of Who You Are", experts David McNally and Karl Speak talk about the specific things that you must have to truly build your brand and create the perception of value you need to be successful.  For them, there are three core elements to your brand:

1. You need to be distinctive:  where you decide what you stand for (your values) and you commit to act on them.  You recognize your unique value (based on your skills, experience, expertise, values, and point of view), and know what sets you apart.  You capitalize on that, not by selling yourself, but by connecting with others based on your unique value.

2. You need to be relevant:  where you have figured out who your customers are (referring docs?  hospital admin?  patients?), and what their needs are.  You move out of your world and into theirs... you figure out what's in it for them, and how your unique value meets their needs.  Start asking yourself, what do they want?  need?  value?   expect?  ... and then connect those thing to your unique strengths and abilities.  Being both distinctive and relevant in the eyes of others that count, is truly what ignites a personal brand.


3. You need to be consistent:  where you meet the needs of your customers, and you do that again and again and again.  This is the hallmark of a solid brand - every time you meet someone's expectation of you, you build your brand and you build trust and confidence in the relationship.  Consistency is established by the dependability of your behavior, and this builds your track record and reputation.

Improving Your Perceived Value:

Traditionally, many physicians have only focused on their competence, or what they do.... their skills, their services, their technical knowledge and expertise.   And truly, it is the basis for any brand relationship (you can't build a reputation if you don't have the comptence to back it up).  It is the fundamental reason why you will be in the professional relationship with someone else.  However, it is recognized in the competitive marketplace that one's competence is only the baseline expectation that others have of you. It is required, but likely it will be perceived by others as fairly similar to your colleagues (even as much as you would argue that!).  Standing out also requires bringing in the elements of your character that people perceive about you.

Your character is really comprised of two things:  your standards (how you do things) and your style (the way you interact and communicate with others).  Your standards are what drive the way you deliver your skills/services.  They tend to set you apart from others - e.g., are you known as a meticulous, perfectionist?  or someone who has a high tolerance for ambiguity? ... no matter what they are, they are based on your values, and highly influence how others perceive you.  Importantly, your standards cannot only be lip-service - until you demonstrate them on a regular basis, people will not be completely bought into your brand.  They will not fully trust that you do what you say you do.  For example, if you want to be perceived as committed to excellence, what are your quality standards and how do you demonstrate them?  Recognize that people cannot see your intentions, only your actions, so delivery of your standards is critical.

Your style tends to be the piece that most people think of when they think of "brand".  It is your personality, and often has a strong, emotional connotation for people.  For example, people may see you as friendly, easygoing, strong, aggressive, etc.  It can carry a heavy weight for people when deciding when/how they want to work with you.  While style is only the tip of the iceberg when it comes to your overall brand, it is the most visible to others.  As such, it can be used as an important navigational aide when it comes to figuring out how you want to be perceived.  The good news is that there are many things you can do to strengthen your skills in this area.

In my work coaching physicians we often do a lot of skill development in this area, and here are my top 5 suggestions for improving your brand by enhancing your "perceived value": 

1. Become an expert communicator.  Your ability in this area is one of the key factors that affects how you are perceived by others.  The greatest skill you can have in order to instantly and significantly improve your communication skill is to understand other person's point of view.  Do this through collaborative listening, where you pay attention (no multi-tasking while someone's talking to you!), clarify what you think you heard, and ask for more detail.  Poor listening is the key ingredient in many communciation breakdowns.  If we don't listen and clarify, we are likely to misunderstand the facts, which can have negative results.  You can also improve your communication via the use of open and positive body language - e.g., keeping arms relaxed, making eye contact (not "glazing over", but genuine eye contact), leaning into the speaker, but maintaining appropriate physical space/distance.  Managing your assumptions when communicating is also critical - be aware of any assumptions you bring into the conversation, and try to double-check them with the other person (e.g., I've assume XYZ, is that accurate?").  Good communication is often sabotaged by too many unconfirmed assumptions. 
2. Be congruent to build trust.  Congruence = Integrity.  "Walking your talk" allows people to see that there is no gap between your intent and your behavior.  Inner congruence to your belief system and your principles (which is an essential part of your brand), inspires trust in relationships.  People see you as strong, solid and dependable, they know what to expect and it validates their confidence in you.
3. Have a consistent professional presence.  There is power in your professional presence - it is an inherent part of your style and your brand.  Do you have the ability to make a good first impression and keep it?  People will start to see you in this way, and reputation follows.  Small things can make a huge difference: e.g., respecting other peoples' time as well as you own, demonstrating body language that shows you are comfortable in professional situations, making good eye contact and demonstrating interest in others, being organized and in control of what you present, smiling appropriately and using professional language, keeping a professional distance until it is appropriate to be more familiar.  Your professional behavior needs to follow you in all avenues:  in-person, over email, on the phone, and online ... you must be consistent.
4. Be honest and transparent in your intent.  This is about establishing a balance.  Being transparent, or clear and truthful in your dealings with others does NOT mean that you have to "lay all your cards on the table" with others.  It means that you are transparent with appropriate information and with what you're trying to accomplish.  When people perceive you this way, there is no fear of hidden agendas or having to second-guess you.  There is no misunderstanding (whether unintentionally or not) your intent.  Bottom-line:  figure out what is appropriate to share in each situation, and do so with truthfulness and authenticity.  Err on the side of disclosure vs. keeping things hidden.  People will appreciate it, and trust in your relationships will increase rapidly.
5. Deliver the results you promise.  The best thing that you can do to establish a new relationship and build trust with a customer is to deliver results.  It gives you instant credibility and  demonstrates that you can add value and perform, and live up to your brand.  If you can do this consistently, you build trust, or what the experts call "brand equity".  Every time you deliver you create a deposit into this account.  The best way to ensure that you deliver is by doing two things:  1)  clarifying "results" up front and managing expectations from the get-go - sometimes people deliver but don't get the response they expected because they didn't take the time up front to establish clarity... don't assume that you know what "results" mean to the other person!, and 2)  ask yourself whether the commitment is realistic - you must make sure you always  underpromise and overdeliver.  To do it the other way around is the quickest way to blow your credibility and to diminish your brand.

For some, the points above are second nature.  There are people out there that are inherently gifted in these things.  But physicians - as a group! -  have not traditionally been on the higher part of the bell curve in this regard, which is understandable.  Medical school doesn't choose you for your ability to relate to others - you get chosen because you excel academically, and then are taught to be technically skilled.  Unless you were lucky enough to have a mentor that was good at these things, no-one was teaching you how to relate to your patients, colleagues or staff in a way that built these skills.  Continued individualistic practice keeps many physicians limited in their ability to build these skills and perform to their highest capability.  Many don't understand why they have such a difficult time keeping patients happy (even though their technical skills are excellent), or why they tend to have conflict after conflict with peers.

But, the good news is that these things can be learned and practiced.  You can become experts in these "soft skills", the things which are now understood as what distinguishes the top performers from everybody else (true across industries and geographies - see Daniel Goleman's work on Emotional Intelligence).  They can truly be what sets YOU apart from your peers, and an inherent part of both your standards and your style.  They can set your personal brand apart.

How do you build these skills?  Find a mentor - someone you know that excels at these things, and learn from them.  Model their behavior and ways of interacting/communicating - see if you can can become more comfortable doing it.  Or, work with someone like me - a coach who is skilled at helping docs enhance these skills and attain higher levels of performance and professional fulfillment.  Or, do it yourself - do your own self-guided learning through books, readings, exercises, and practicing new skills. See if it starts to make a difference for you and how you are perceived.  I guarantee it will.

Physician Career Transition is a Process, Not An Event

Remember that old saying from Ralph Waldo Emerson about how life is a journey, not a destination?

Well, the same can be said for successful physician career transition.  The process can be as important, if not more important than the end result.  True!  End results will change and evolve ... but without careful consideration of the steps required to make a sustainable career change, the direction you take may not be the right one.  I've seen this lead docs into repeated unsatisfying attempts to move into non-clinical environments ... and has the propensity to end up convincing them to stay right where they are, resigned to being unhappy in the work they've chosen.

But this doesn't have to be the case.

The tricky thing is, by the time that most physicians have made the mental and emotional decision that they want to leave clinical practice, they become impatient to act.  Sometimes their drivers are purely negative ones:  they're burned out, frustrated, they want to escape what medicine has become and their place in it.  But more often than not, I see the drivers that really get them going are the positive ones:  they are excited by the potential opportunities they see, directions that they can take their medical knowledge in, possibilities for doing something bigger.

The problem is for some docs (at least some of the ones who call me), is that they see the possibilities and they want to do it now.  I'll never forget a mid-career physician who contacted me in July and decided that he wanted to be in a new, non-clinical, non-healthcare related role by January ... could I help him make that happen?  After speaking with him at length, I could respect and admire his enthusiasm and his desire to get it done ... but I had to give him the major reality-check that this just would not, could not happen in the timeframe he desired.  There were some critical things that he would need to do first.

Unfortunately, too many physicians considering non-clinical jobs (like my caller) only keep their eye on the finish-line.  With a vague idea that a particular job might be interesting of "something they could do", they forge ahead.  They skip going through the process of stepping back... that is, making sure that the desired job / industry / career is a good fit for them, making sure it will provide them with their "must haves" for fulfillment, and assessing whether they could be successful doing it.

And this process of stepping back takes time.  But it is worth it.

Successful career transition - particularly when you're moving from a highly specialized field into an industry or role that requires a significantly different skill set (most non-clinical jobs!) - takes focus, effort, money, and yes, time.  It is a process that requires moving through a series of critical phases to ensure that you are setting yourself up right.  The last thing you want to do is dive into a new career, taking your family along with you, only to discover a year or two later that you're as unhappy as you were in clinical medicine.

To ensure sustainability, success, and overall happiness with your choice of "next chapter", you  need to ensure that the change you are making fits you, that you are comfortable with your skills/expertise and the value you bring, and that the market has a need and recognizes your value.

So how do you do this?  You start by paying attention to the process.  You start from the beginning.

Get Introspective.  You may think that you know what you want, who you are, and where you need to go to be happy and professionally fulfilled.  But do you really?  Until you have truly taken the time to dissect some of these things, it is easy to miss some very critical truths about yourself that may impact the direction you decide to take.  Inventory your values -  not your professionals ones, not stewardship and teamwork and all that, but your personal ones.  Really clue into what motivates you, and what makes you tick.  This may take some deep, personal work.  Prioritize your values, and figure out how well-aligned your current professional life is to them.  You may find that there is a significant disconnect that is fueling some of your discontent.  Start to explore and research work that aligns better to what matters to you as a human being.  

Go further to figure out exactly what you bring to the table by sifting back through all of your past experiences and identifying the skills (healthcare and non-healthcare related) that make up your unique value proposition.  Find your specific leverage points - those particular skils/experiences that can launch you towards your next career.  Research where you could best fit the needs that are out there.  Figure out what your "optimal job" characateristics are and prioritize them.  Compare any potential opportunities to that list of must-haves and be honest with yourself.  Make sure you understand and honor what you truly need to be happy and fulfilled in your next career.

Too many physicians want to skip this introspective work and start developing their resume.  It is true that resumes are a critical part of the career change process, but they are not where you start.  Until you really understand your unique value proposition and your unique direction, building your resume at this point is premature.

Introspection is a critical component to professional fulfillment.  You can't start in the right direction without truly knowing what the right direction is.  Once you've figured this out, you can begin to see what your finish line might be - the right one for you.  All subsequent steps in the career transition process - exploration, preparation, acquisition, and finally transition (thanks to Dr. Michael McLaughlin and his book "Do You Feel Like You Wasted All That Training") - will go much more smoothly if you know that you are moving toward a goal (job) that will be what you need when you get there.

Lastly, recognize that moving from one career to another will not be a linear process.  It will have its stops and starts, and sometimes it will circle back.  But as long as you know that you are going in the right direction, you will be making progress toward your goal and venturing toward the best finish line for you.  And that is what matters in the long run.

So to get started, get to know yourself really well. You might be surprised what you learn.

Trust Between Physicians?

Is trust between physicians possible? Is it necessary? (The simple answer: Yes!)

In my coaching work with physicians I hear many anecdotes about the rivalry and distrust that exists between doctors and within healthcare teams. We all know these stories - that physicians have not been trained to trust others or delegate tasks (and in fact were often publicly reprimanded for doing so while in training), that they don’t trust nurses to do things right, that nurses don’t trust doctors to “have their back”, that physicians don’t trust each other’s intentions, credibility or capabilities, that clinical staff don’t trust hospital administration to be on their side or have the best interests of their patients at heart … and the list goes on and on.

Have we ever stopped to think of what this “deficit of trust” that exists in healthcare teams does to the core functioning of the healthcare providers or how it affects the key issues of patient safety, quality and the hospital’s or practice's economic health?

Simply stated, that there is a significant lack of trust in the healthcare environment is not new news. But what is new, is the understanding that trust is a critical component to both personal and organizational success – and that it underlies and affects the quality of every communication, every patient case, and every team effort.

But what is trust exactly? Well, simply put, trust means confidence. When you trust people, you have confidence in them, in their integrity and their abilities. When you distrust people, you are suspicious of them – of their integrity, their agenda, their capabilities or their track record. It is that simple. We have all had experiences that validate the difference between relationships that are built on trust and those that are not. These experiences clearly tell us the difference is not small; it is dramatic.

In a great book written by Stephen M.R. Covey (no, not that Covey, actually the author is the more famous Covey’s son) called “The Speed of Trust: The One Thing That Changes Everything”, these issues are explored and peeled away to their core. And wow, does it all begin to make sense.

The Economics of Trust 

One of the biggest “ah-ha’s” that come from this book is about what trust – or a lack of trust – does to any organization’s bottom-line. It is the most simple concept, and as Covey puts it:

"Here is a simple formula that will enable you to take trust from an intangible and unquantifiable variable to an indispensable factor that is both tangible and quantifiable. This formula is based on this critical insight: Trust always affects two outcomes – speed and cost:

• When trust goes DOWN, speed will also go down, and costs will go up
• When trust goes UP, speed will also go up, and costs will go down

 It’s that simple, that real, that predictable."

Think about healthcare environments, organizations or teams that you’ve worked in that may have had non-existent or low trust – do any of these “typical” workings sound familiar?:

• Militant stakeholders
• Micromanagement and redundant hierarchies
• Punishing systems and structures
• Initiatives that drag
• Many unhappy employees
• Intense politics with clear camps and parties
• Excessive time wasted defending positions and decisions
• Common “CYA” (cover your ass) behaviors

What about the alternative? If any of you have had the luck to be part of healthcare organizations or groups that have a healthy- to high-trust environment, you may have experienced:

• A healthy workplace with good communication
• Aligned systems and structures
• A focus on work (not politics / rumors / grievances!)
• Effective collaboration and execution
• Positive partnering relationships
• Strong creativity and innovation
• Positive, transparent relationships
• Strong engagement, confidence and loyalty

The way Covey puts it, in organizations where trust is high, you see material improvements in things such as communication, collaboration, execution, innovation, engagement, partnering, and relationships between stakeholders.  

You also see the “dividends” of increased speed, collaboration, and improved economics. This translates into improved patient safety, quality, and clinical outcomes - a win-win-win for the healthcare team, the organization,  and most importantly, the patients and their families.

Trust Changes Everything

But it is not just organizations that suffer the results from a lack of trust – you personally can suffer too. Physicians are well-known for generally not trusting each other or members of the healthcare team – if this is true, or even “rings a bell” for you, I want you to think about how this might be affecting your performance and overall happiness on a daily basis.  Let’s make it real – from Covey:

"Think of a person with whom you have a high-trust relationship – could be a spouse, friend, child, sibling, or colleague – and describe this relationship. What’s it like? How does it feel? How well do you communicate? How quickly can you get things done? How much do you enjoy this relationship?

… Now think of a person with whom you have a low-trust relationship – could be a colleague, boss, family member – and describe this relationship. What’s it like? How does it feel? How is the communication? Does it flow freely and quickly … or do you feel like you’re constantly walking on land-mines and being misunderstood? Do you work together to get things done quickly, or does it take a disproportionate amount of time and energy to finally reach agreement and execution? Do you enjoy this relationship… or do you find it tedious, cumbersome and draining?

The difference between a high- and low-trust relationship is palpable!

Can you imagine the difference it would make if you were able to increase the amount of trust in the most important personal and professional relationships in your life?"

Said another way, what would developing your “trust quotient” do for you, for your patients, for your team, for your career growth, and for your overall happiness?

There are excellent tools in Covey’s book for improving your own personal “trust competency” and enhancing the working relationships that affect your overall professional fulfillment.  Next time I will share what some of those tools are, and how some of my physician clients have embraced them to improve their success in both the clinical and non-clinical environments.

Until then, I highly recommend you go and pick up the book - it's a great read!