Exercise 2: Awaken Your Learner

By Michael O'Brien, Ed.D

Your mind has two primary modes of operation. Call them the Auto mind and the Executive mind. Think of your Auto mind as the part of the self that handles your routine affairs, such as driving to work or doing a preliminary diagnostic on a patient. Think of your Executive as the part that pays attention, purposefully changes, and learns new skills when necessary; such as in your role as a physician leader working with a project team of people you don’t know well or present on a new topic to a group unfamiliar to you.

Neither mode of operation, in itself, is good or bad. It is good, however—in fact, vital to a physician's leadership role—that you develop the ability to choose which mode to operate in at any given time.

Your Mind on Autopilot

Left to its own devices—when the Executive in you leans back, as it were, feet on the desk, hands behind the head—the mind will spend most of its time running in the Auto mode. There is a certain logic to this: it conserves energy and allows you to respond to the demands of your environment with the least effort. Proper use of the Auto mind allows you to accumulate a reserve, to maintain a surplus, of what amounts to high-octane mental rocket fuel for those critical moments in life when the big move, the important decision on a critical case, the bright idea, or the new direction is needed.

The Auto mind runs the programs for feeling, thinking, memory, and sudden reaction. The Executive mind has the capacity to observe this process and to choose which programs to run. Naturally, the division of labor between the two isn’t rigid; they often do job sharing. As a physician leader (or for any leader) it is the capacity of the Executive mind that must be cultivated.

Executive in Charge

To illustrate: the Auto mind is the only reason a baseball batter can ever connect with a ninety-five-mile-an-hour fast ball. If it were the Executive mind trying to do the job, the batter would still be analyzing the pitcher’s windup long after the barely visible ball had already slammed into the catcher’s mitt.

But here is an interesting paradox. The Auto mind is also the reason that a pitcher with a ninety-five-mile-an-hour fast ball can fool a batter by throwing a slow change-up. The batter’s Auto mind takes in the situation—the count, the inning, the score, whatever body language the pitcher is conveying—and says, “Here comes the heat, get ready, swing,” making the batter tie himself into a knot and look like a complete fool as a fat slow pitch floats lazily across the plate. There’s nothing like an embarrassment like that to wake up a batter’s Executive mind. Now it’s the Executive mind glowering back at the pitcher through the batter’s eyes, daring the pitcher to throw the same pitch again.

The Auto mind and Executive mind are good teammates, natural teammates, and natural learners.

So while the mind’s tendency toward homeostasis, to run in the Auto mode, is usually a good idea, it isn’t always a good idea. It’s best to keep the Executive in a sort of semi-alert state all the time. You want to let the Executive decide when the Auto mind is equal to the task at hand and when it’s time for the Executive to take over.


Knowing When to Switch

How do you know when the Auto mind process is working for you or against you in your physician leadership role? There’s only one way. From time to time, you must examine your assumptions in critical areas of your job and your life. Once you’ve brought them to consciousness, you can assess their accuracy and evaluate whether they are a help or a hindrance. Without doing this, the personal initiatives you are taking at any given time are likely to be unbalanced. Your actions will probably be too reflexive and not intentional enough if you do not consciously review them every now and then.
Here’s how: Write down three beliefs you have about each of the two focus problems, that you previously identified in Exercise 1. (Let your thoughts flow freely; don’t belabor or edit them. If you’re keeping a Journal, do your writing there.)

Example:

Let’s say one of your focus problems is chronic financial stress. Your entries might look like these:

1. I must have some learning disability when it comes to earning and managing money.
2. My parents weren’t good money managers. Maybe they taught me their faults. Or maybe my financial incompetence is ­hereditary.
3. I’m afraid I don’t have either the aptitude or skills for earning a secure livelihood.

Now, write down three positive alternative assump­tions (you don’t have to believe them, just write them).

Example:

1. I can learn to manage money. The truth is, I’ve never really worked at it.
2. My parents certainly had the intelligence to be better money managers. It obviously wasn’t very important to them.
3. I’ve never honestly worked at developing my skill at doing what I really love. If I did, I know those skills would support me nicely.

In a simple statement, assess the likely consequences of both sets of assumptions.

Example:

I’ve always had these negative beliefs about myself, and I’ve never experienced anything but frustration with money. If I started believing in myself, my earning and handling of money would probably improve.

Which consequences would you prefer? Go ahead, write it down.

(Note: This exercise is being used here to inven­tory assumptions about a specific topic—the ­focus problems of exercise 1. It can also be an effective tool for shedding light on the general assump­tions that so often unconsciously govern our lives. For example, applying it to assumptions about yourself, your health, your job, your family, your relationships, your sex life, your future, etc., can yield valuable clues for personal growth.)

Learning is an increase in personal currency. How will you get it, and where will you spend it?
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For more information on O'Brien Group's approach to Physician Leadership, please visit http://obriengroup.us/about-us/physician-leadership/

Exercise 1: Change is Possible

by Michael O'Brien, Ed.D

The truth is, you really can change yourself. It is just very hard. And you can’t do it with New Year’s resolutions, with wishing and hoping alone. And you certainly can’t do it by simply understanding the theory of leadership or personal change, which isn’t all that hard to grasp. As a physician you were trained to think one way, and now, as a physician leader, you're being asked to think another; therefore, change is even more important and more difficult. 

 

But, if you take a few minutes every day, both previewing the ideas and taking the actions I recommend, you will notice your relationships with others improving, conversations and meetings will be more satisfying, your priorities and values will be more a part of your life. You will achieve more.

Woven into my methodology are four overlapping practices:

1. Raising consciousness
2. Imagining
3. Framing and reframing
4. Integrating new perspectives

Raising your consciousness means not just thinking, but thinking about thinking, noticing—and managing—the workings of your mind so your mind won’t run away with your life like a startled horse. I will discuss simple and immediate ways of raising your consciousness later in more detail. Practice them; chances are you’ll notice an immediate improvement in your quality of life.  

When you imagine, you create a mental picture—the most vivid image you can—of an outcome you desire. If you’re typical, however, most of the imagining you do goes by another name: worry. This most common form of imagining leads not to something you want but to something you don’t, and it works depressingly well.

 

Framing and reframing are about interpreting the world, making meaning, assigning significance to the events of life. It is not the events of life that matter but our opinion of them. You don’t have to think of anything in any particular way. You can think of green as white if you wish. But some ways of thinking about things are more helpful than others. Learning to frame and reframe means learning to see things in the most helpful light, that’s all.

 

Where Does It Hurt?

This first exercise offers a practical, intimate beginning for the process of personal change. At the heart of controlled, intentional personal change and leadership lies personal mastery. Think of mastery as an expan­sion of your ability to produce precisely the results you want in your work and in your life. Mastery requires the discipline of noticing what’s working and what isn’t, what you’re ignoring, and where you can grow.
Take ten minutes with a journal or notebook and answer the following questions. (Please don’t be too analytical. Trust your gut. Write down the first ­responses that come to you.)

1.   Where are you suffering in your life right now? (Or, where are you stuck, where are you not producing the results you would like?)

2.   What are the rubs, distresses, upsets, or crises in your life? (Put another way, what mistakes are you in the middle of right now? Is there something unpleasant you are ­ignoring?)

3.   Are there any relationships that are troubling you, or are not as productive or satisfying as they should be?

When your list is complete, make a note in this journal or notebook entry titled “Focus.” Under this heading select two problems from your list that you’d like to handle soon.

Now make another entry titled “Review.” When you are finished with the twenty-one exercises to come, I will ask you to return to this entry and file a brief report to yourself on the current status of these problems. As your life changes, this is a good exercise to repeat often.

Getting Ready to Grow--Going from Great Medicine to Great Physician Leadership

by Michael O'Brien, Ed.D

This Physician Leadership blog is designed to help you effectively navigate what could rightly be named a “perfect storm”: The intersection of a rapidly and dramatically changing healthcare industry together with the significant need for more high-performing physician leaders--all of which requires dramatic personal change.  This information is based on my book Profit From Experience and O'Brien Group's work with the very top healthcare leaders in the U.S.

The problem is that personal change is not automatic and it is very hard to accomplish. What happens consistently is that people don’t notice when change is required. To actually learn something new from experience requires an intentional and disciplined effort: What do I change and how do I change it?

For you as a physician leader, the work of medicine could not be more different than the work of a senior leader. For example, to successfully move from prescribing and expecting compliance to leading, influencing and collaborating, you must be conscious of the differences and adjust -- read change-- their approach to a situation or a task at hand. (For more on what we call Physician Whiplash, please visit http://obriengroup.us/wp-content/uploads/Phys_Whiplash-1.8.12.pdf)


Why You Should Read About Physician Leadership Here.
This blog is offered as a systematic approach to help you go from good to great. To lead better and achieve more. It will help you to consciously change and improve your patterns of behavior and dramatically increase your personal effectiveness.

The methods I will offer you—which require small, daily effort—can help you inventory the areas of your life where change is most needed. The methods will then help you start producing the life and leadership results you’re looking for.

The approaches and exercises to be presented here, grew out of years of work I have done with senior leaders in organizations across many industries. For the most part, these organizations are run by people with more than enough education, intelligence, and expertise. But time and again I see physician leaders and senior executives do something irrational and inexplicable. On the one hand, they grasp new concepts of learning, growing, improving. Then they turn around and go back to their old ways, making decisions and interacting with others just as they always have, as if they’ve learned nothing and don’t need to change at all.

Concepts of profound personal and organizational renewal are easy to understand. Acting on them takes discipline, plus a personal commitment to learn, and go on learning, what our changing environment has to teach. The path to great Physician Leadership is a balance of concept and action—daily action, constant action. Action that will help you develop a discipline. Without the action, the concepts are interesting but not much else.

What follows are some ideas and exercises that will start you on an expedition to lead better and achieve more in your professional and personal life. It is designed to raise your consciousness of the things you need to change and the unique talents you can bring to bear to lead healthcare into the future.