Beyond the white coat: understanding what drives (and drains) physicians

I was with some physicians recently and one, a vascular surgeon, had to leave early. He’d been a big personality for the beginning of the meeting, a fun participant that all professional speakers love to have in their audience. He came up to me at the break and looked at me with deeply sad eyes and said, “I have to go to the hospital to amputate a leg.” And then after a short pause, he continued, “I hate this part of my job.”

I felt for him and wished him well. He then left quickly head down, no big personality now. Had we had the time to talk, I would likely have paraphrased, empathized, and perhaps been curious about this part of his work with some gentle questions allowing him room to process “This part of my job.”

An anesthesiologist at the same meeting loved his job because “I always win.” A family doc said, “I love seeing all the generations, I get to see them all.” Each physician responded to my question about their specialty and I always followed up with, “Do you still like it?” I get the inner part of their name and their noun (the specialty) with an extensional question meant to convey that I know there are some challenges associated with being a physician today. It tends to create a quick bond. One responded to me, “Oh you know it’s not like they told me it would be in medical school.”

How about your KOL? What do they really like about their work? Or really don’t like about their work? Sometimes after the “Hello” and the “How are you?” kinds of pleasantries, we may have a moment to say, “I don’t think I ever asked you this question and I thought of you last night. OK to ask you before we dive in?” I always get an affirmative response. And then some variation of:

·        Do you still like this work?
·        What’s the most satisfying part of this work for you?
·        What’s it like to have a patient who just doesn’t quite fit the pattern of your other patients?
·        Did med school prepare you for this?! (this can be a question or an exclamation!)

Of course you must pick the right time, right place, right KOL to extend this invitation to talk, but in my experience some of them want to talk to a receptive ear. Much of their day like ours is on automatic. This can be a reflective set of moments to create that human (and memorable) connection. This conversation will not be forgotten (by either of you).

And don’t worry if they disregard it, they won’t remember!

Jump straight into the content

In your next presentation, just jump straight into the content! Watch this video to learn more and let me know what you think in the comments.

The power of doing things differently

There was a Seinfeld episode where George was belaboring his choices in life, and he said something like “every choice I have ever made in my life has been wrong…” The table discussion came up with a conclusion: Do the opposite! Of course, this leads to him ordering a different lunch, similar to one a woman ordered, and he winds up “doing the opposite.” He approaches her with the line “My name is George, I’m unemployed and I live with my parents!” She responds with a warm smile, “Hi, my name is Victoria!”

Watching this scene (way too many times) makes me reflect on my patterns, the ones that always work and the ones that seem to miss the mark by just that much… but I continue none the less! What about you? Is there a KOL, or an office receptionist, or a manager who you seem to “miss the mark” with no matter how earnestly you try? Or do you (and I) take some of our encounters way too casually when we could be more intentional?

That receptionist who seems a bit too busy, the flight attendant a bit too brusque, a KOL who seems to never pay enough attention, or the manager who seems to always have one more (discouraging/negative) thing to end our conversations with? What if you (and I) took an intentional look and decided perhaps not to do the opposite but certainly to do something different, perhaps vastly different, even if only within ourselves as we process what is happening.

Nido Qubein, president of High Point University in North Carolina, suggested to me once that my To-Do list could be radically altered if I also had a “Stop Doing List.” Then he continued that the shortest list is the most important list: the “To Be” list. George didn’t just do the opposite. He was fully present to Victoria even though he did not know her and was taking a risk.

In my coaching practice I notice so many of my clients struggle with that first step and often they too get a version of “Hi, my name is Victoria!”

A simple but telling question

Ask those who know you best (at work and at home) a simple but telling question: “What do I do well and what is one thing you might suggest that I consider doing more (or less!) of?”

We do this at the end of every semester with our students at Institute of Pastoral Studies - Loyola University Chicago. Everyone answers everyone including students telling professors. It is eye opening and encouraging.

We are already noticing it and thinking about it, so why not help another by offering it?

Routine

As leaders, we thrive on routines—they create structure, consistency, and efficiency. But not all routines are beneficial. Some keep us stuck, while others drive growth. Learn more in this video!

How did you decide to do that?

One way to initiate change for yourself or others is to find a small bit of change in the process and then inquire about it. In the world of therapy this is called Solution Focused Counseling. You won’t need a therapist to benefit from its genius. Let’s say you have a very disappointing meeting with your KOL (or your family member!). Normally we would give it a good mental post-mortem in terms of what we did wrong, the failure it represents, the times when our self-confidence was hit pretty hard, etc. Using the Solution Focused Approach, our first question to ourselves (or to our discouraged MSL colleague) would be something akin to “What’s it like when it’s not like that?” A follow-up to that might be, “How did you decide to that?” and “What gave you the courage to make that move?”

Here is a short example: Let’s say your new KOL decided to evaluate you out and things didn’t go so well. You became more nervous as time went on. More and more like a final oral exam, all you could do was quietly count the minutes. It ended awkwardly. You walk out to the car and call a friend, and she says, “How were you able to stay there the whole time?” and/or “How were you able to keep your composure?” and/or “How did you decide to call me instead of just feeling bad by yourself?” Each of these questions will yield a positive response. But what if your friend said, “Oh my, that must have been terrible!” and/or “You don’t have to go back there do you?” and/or “That happened to me once and…”?

Look for small moves. “I stayed because he kept talking and I shifted to listening mode, I thought of myself as a student with a teacher” and/or “I kept my composure by remembering pharmacy school exams, I have to barrel through” and/or “I knew that if I didn’t call you, I’d be a mess all afternoon and I have more appointments today.” All positives. You don’t need to call a friend, simply ask yourself!

Who do you love to talk to about your profession?

Who do you love to talk with about the law? I recently asked a group of attorneys this question, and without exception, they all said they loved talking to other attorneys, law professors, and peers. Not one mentioned enjoying conversations about the law with their clients, spouses, or partners. Not one!

How about you? Who do you love to talk to about your profession? If your answer is limited to those within your field, it might be time to stretch a little—focus on another audience and see if you can effectively translate what you know.

I recently told one of my physician clients that I have another 25 years left of active service before I slow down. He smiled and said, “All I can tell you, Kevin, is that all of my 90-year-old patients have two things in common.” Then he pointed to his head and said, “They stay active here,” and pointed to his legs and said, “And they stay active here!”

My internal response? “Well, I’m 50% of the way there!” My external response? “Understood!”

All of the medical tests, history, advice, and notes in a file were less impactful than his ability to align with my 25-year goal in a way that stuck with me.
If you know how to communicate your expertise so it resonates beyond the moment, you gain more than an audience—you gain non-experts who genuinely understand and appreciate your work. Translate what you know, so others truly know what you know!

Now what

Singer Paul Simon, Chef Grant Achetz, Diva Celine Dion (and maybe you) have faced the loss of hearing, tasting, bodily control, and hundreds of other challenges beyond our prediction. We all know someone who woke up one morning fully alive and by evening was a different person. Some resign themselves to their fate while others take a different approach. There is a Japanese therapist who has a three-sided small pyramid in his office. On one side it is written “Poor Me” on a second side is written “Those Bad People” and on the third side it is written “So what am I going to do now?” When you come for therapy, he hands you the pyramid and says, “So what do you want to talk about today?” You can certainly talk about any side of the pyramid you want but ultimately that third side is staring you in the face.

How you spend your miles

It's not about how MANY miles, it's about how we've spent those miles. Watch this video to learn more...

“Could I be wrong in my thinking about this?”

“Could I be wrong in my thinking about this?” -Mohsen Shabahang, Wellspan Health

I wondered as I heard him present about the nature of change, what this question could do for me. It does go counter to my usual question when I am stumped, “Something is wrong here." His question forces me to own the issue, my question externalizes actually making the issue even bigger. When I own the problem, I can decide what to do regardless of what the other person (or issue) is doing.

"Dare to have the courage to be imperfect"

The operative word here is “dare.” We all know that we are imperfect beings, and we often fight that realization struggling for one more grade, bonus, sign of approval, or award. But realizing our imperfection and then being able to operate within it are two vastly different things. Often, we compare ourselves to others or we compete, or we criticize. All these activities are on the vertical plane where one is up, and one is down. It is based on a model of being with others based on who is superior and who is inferior. But if we realize our humanity, our common humanity, we realize that we can live in a horizontal world where each person can contribute to the whole without having to be better than, more important than, or even…perfect. Of course, games and sports have winners and losers. Our science needs to be as accurate and perfect as possible, but when you visit your KOLs or your team or those who report to you think “How can I be useful here?” rather than “I must be perfect!” Let your PowerPoint be perfect if you must, but for you and me… We are at our best when we are seen as useful.

Dessert first!

When giving a presentation, I always say: Dessert first! Why? Because people come to your talk with a hunger for something specific. When you lead with the most valuable insight upfront, you grab attention, create engagement, and ensure your audience stays invested in what’s next. Watch this video to learn more!

"Make the change easy for me"

We have more control than we think when it comes to helping someone change. To change their prescribing patterns, to change the way they think about something, even to change how they feel about the last sales rep from your company. Make it easy for them to talk about it without judgment, make it easy for them to try a new behavior, make it easy on them in all the many ways… Just make it easy.

Use metaphors and stories

·        “Think of it as….”
·        “Sort of like…”
·        “It is as if….”
·        “I remember this one time when…”
·        “I once noticed…”
·        “One of my professors remarked that…”

In your meetings and presentation keep using metaphors and stories to keep the audience in alignment with you, to keep them interested, and to turn your expertise into useful information.

One of my attorney clients said with some exasperation, “How many ways can I explain the term ‘negligence’?” To all of us non-lawyers it is worth the effort. Your audience will always be polite and nod in agreement but retain nothing! So, check at the end of any technical explanation with the simple and powerful, “I’m trying to get better at this. Please tell me in your own words what you think negligence is.” You will be amazed how clear you were…or maybe you’ll have some clearing up to do!

"The issue in all human conflict is never about things, but always about respect"

We can so easily lose sight of things when we find ourselves in conflict over who did what to whom. Dr. Rudolf Dreikurs the famous Chicago psychiatrist said that ongoing conflict is never really about money or sex or how we load the dishwasher. Rather it often takes the form of:

-         “My right to decide is being weakened here.”
-         “My right to control is being jeopardized.”
-         “My judgment and my ideas are not being considered here.”
-         “My prestige and my status are being questioned by this person.”
-         “My feelings just don’t seem to count here.”
-         “I feel unfairly treated.”
-         “I feel defeated.”
-         “I feel powerless.”
-         “I feel inferior.”

Ever feel those ways regardless of the content? These feelings of respect or rather feeling disrespected linger long after the event that initiated them. Attend to the real issue and you may find resolution around the corner.

People's power

I recently had a reminder that power and influence aren’t what define a person’s impact. It’s not about titles, status, or authority—it’s about how we show up, how we connect, and how we make others feel.

Watch this video to learn more.

Creating a community through connection and care

“Building a Community.
Physicians go where they are Welcomed…
Remain where they are Respected…
And grow where they are Nurtured.”
- Bill Leaver, CEO, Iowa Health System

Substitute the word physician with these words: nurses, security guard, housekeeping, receptionist, etc. Maybe even replace the word physician with MSL! This is the key to community regardless of working out of your car or on the phone. You and I can add to a community feeling (The German word is “gemeinschaftsgefuhl,” indicating a connectedness of well-being with others). On your KOL visits, you can bring that shining light of welcoming, respect, and nurturance to every practice and university you visit. When you do, they want you back and will remember you. And you will remember them as well.

Deepen your understanding of language

Teaching at the Institute of Pastoral Studies - Loyola University Chicago gives me a worldwide view of life, with students from Korea, Poland, China, Spain, South America, India, Pakistan, and even Atlanta, Georgia! The diversity of perspectives in my classroom is both a gift and a learning opportunity.

As I teach, I’ve discovered a unique way to deepen our understanding of language—I ask my students to use their native language to teach me more about our English vocabulary.

Recently, I asked my students to put the word "hunch" on the board in their native languages and then define it. None of them defined it as simply "hunch"—instead, they painted vivid images of the word in action, bringing its meaning to life in ways that transcended traditional definitions.

I then asked a student from Thailand to write "empathy" on the board in Thai—it turned out to be a very long word! When I asked her to define it, she paused for a moment and said, "Sitting on my grandmother’s lap after dinner before the fireplace." Perfect.

These moments remind me of the powerful world of words, images, metaphors, and inclusion. Try using the languages of your international colleagues or neighbors early and often—you might be surprised at how it enhances your own understanding of English.

It's showtime folks!

"The average person looks without seeing,
listens without hearing, touches without noticing,
eats without tasting, and smells without awareness." - Leonardo da Vinci

I was struck by this quote when I was playing with the DaVinci robot attempting to get a rubber band off some pretend tissues. Not easy! What I noticed was that my whole self was in a state of awareness, not the ordinariness referred to in the master’s quote. When we are in awareness, something happens not only to you but to us. I have a new awareness of when I am talking and when I should go quieter, when to ask a question and how to answer one and being especially aware of how I look not in the mirror kind but in the engagement kind. Performers remind themselves: “It’s showtime folks!”