In the January-February issue of Harvard Business Review, authors Sheila Heen and Douglas Stone explore a conundrum in their article, Find the Coaching in Criticism

Feedback is important, and yet, feedback doesn’t work.

More from the article:

 What makes receiving feedback so hard? The process strikes at the tension between two core human needs—the need to learn and grow, and the need to be accepted just the way you are. As a result, even a seemingly benign suggestion can leave you feeling angry, anxious, badly treated, or profoundly threatened. A hedge such as “Don’t take this personally” does nothing to soften the blow.Getting better at receiving feedback starts with understanding and managing those feelings. You might think there are a thousand ways in which feedback can push your buttons, but in fact there are only three.

The notion of difficulty recieving feedback is especially important for physicians.  This is a group of high achievers accustomed to “straight As” and being in the top 10% of their classes since high school at least.  Not only do they expect stellar achievements from themselves, they are unaccustomed to a more nuanced and narrative evaluation that many performance reviews present.

Authors Heen and Stone recommend six steps to improving the receiver‘s ability to accept and act on feedback.  Their premise is that it’s incumbent upon the receiver perhaps more than the giver to solicit feedback and coaching in order to improve effectiveness.

I was intrigued by a TED Talk given by  Social psychologist Amy Cuddy, an associate professor at Harvard Business School, who  investigates how people judge each other and themselves.  According to Cuddy, we make judgments along two critical trait dimensions:  warmth/trustworthiness and competence/power.  These visceral judgements then greatly determine outcomes, such as who we promote, who we hire, and — for leaders — who we follow.  The good news is we can help ourselves into a “power and competence” mindset by spending 2 minutes in a “power pose” just before we have to make the pitch, the speech or the debate.

Just stand tall, and take up as much space as possible.  This “power pose” causes our body to manufacture more testosterone and less cortisol.  More than just “faking it” we’ll start to feel more confident and become what we envision we can be.     Our body language not only visually signals “power”  (standing or sitting tall, taking up more space) or “powerless” (shrinking in, folding our arms and legs inward), it physiologically determines our attitude.

I encourage physicians and coaches to watch this intriguing talk by Professor Cuddy:

The following was an interview I did with Physician’s Practice in 2003, almost 10 years ago!  I think it’s as timely now as it was then.  —- Francine

Tap Into Your Potential

First published in Physicians Practice July 01, 2003 | Healthcare Careers
An interview with Francine Gaillour, MD, MBA, FACPE, founder and director of Creative Strategies in Physician Leadership, an executive coaching resource for physicians.

Q: When physicians decide they want to broaden their careers what do you advise them to think about first?

A: I use a model I call “The Three Dimensions of Professional Fulfillment” to help them focus on what they want to do.
The first dimension is purpose, passion, and values. That is, what is that essence or quality about you, what are those unique gifts that you may have had since you were 3 or 4 years old? What is it you’re into? What do you care about? What’s the most exciting thing you do now? What really gets you jazzed? What’s that pipe dream you’ve been thinking about? Almost everybody has one.

The second dimension is skills. Physicians have very deep skills, but they are very narrow in focus. So we help them recognize their own inventory of skills: What have you done, either in or outside your clinical practice, that shows you have skills that are transferable?

For example, a lot of physicians have done things with their church or nonprofit organizations [or] they’ve coached Little League. Maybe they’ve remodeled their house — that demonstrates they can do project management.

We also look at what kind of skills are going to be important to develop in order to be successful in another arena: What skills will be helpful if you want to go into a specific domain such as medical management or develop a consulting firm? Things like how to put together a business plan, how to engage a client.

Q: And the third dimension?

A: The third dimension is the economic engine. That is, how will society value what you bring to the table? This helps physicians do an exploration of industries and think creatively and openly about all the areas out there. There’s a specialty society for so many things and those are great resources and great places to network. A lot of physicians are petrified of networking or they just don’t know how to do it.

So when you have those three dimensions aligned — passion, skills, and the economic engine — the sweet spot in the middle is career fulfillment.

Q: What sorts of different things can physicians do with their careers?

A: There are physicians who are consultants for architectural firms or who have a space planning service to help hospitals or clinics design the flow of their space. One physician I know is now working for a foundation that’s part of his hospital and he does full-time fundraising. Several have entered the Internet arena. There are physicians who work with online services offering second opinions and e-mail consultations, and of course there are physicians who check or create content for healthcare portals.

Q: When physicians enter the business world, what is the most difficult change for them?

A: One of the most challenging areas for physicians, and it sounds trite, is learning how to participate in a team of peers where you are contributing and not just sitting back and throwing out your opinion.

There’s a healthy give-and-take that requires respectful communication. In the business world, physicians are going to meet a lot of smart people like them. The way people interact in the business world is by creating something from nothing — creating something from ideas. The way that’s done is in a team environment and through communication. The sooner they can learn that, the more effective they’ll be and the faster they’ll advance.

Q: Talk about your own career change. How did you get to where you are today?

A: I was in clinical practice for 10 years and had a very full, enjoyable practice. But I was ready for the next thing. I enjoyed the part of my practice where I was building it and once it was fulfilled, I thought, ‘What’s the next challenge?’

I knew I didn’t want to be on the traditional medical-director-in-a-hospital track. I was on a couple of hospital committees and had participated in that, but I had a feeling I wanted to be in business.

So I worked for a couple of technology companies as their medical director and that’s where I cut my teeth and learned about business, how to be a team player, how to change ideas into a product. That introduced me to dozens of healthcare organizations across the country — so I don’t feel like I have ever left healthcare. I was and am still completely immersed in healthcare — not one-on-one patient care, but I know that what I’m doing is affecting patient care and helping to transform healthcare.

One of the first things I tell physicians to do is to write an intention statement. It’s an intention of where they want to go. So my intention statement was: ‘I want to work for a healthcare technology or medical device company and be a liaison between the developers and the users of the product.’ I would repeat that to people and it opened doors; someone heard me say that at a party and said, ‘The company I work for might be interested in talking to you.’

Even so, I’ll always be a doctor. I was actually seeing patients part-time until last year. I still have my license and I have yet to give it up completely.

Q: What has been most enjoyable — and most difficult — in your move to the business world?

A: I am a very creative and strategic person so I was in heaven coming up with ideas, being part of a design team, giving talks, and supplying a lot of the ideas that went into becoming a product. The other part that was enjoyable was the autonomy and the flexibility. As a young mother, I found that much more amenable to a family life, even when I was traveling.

What I found difficult was learning to communicate respectfully. I don’t think I had an attitude problem, but I had to learn a whole level of advanced communication that is different from patient interaction, where the patient is always kind of a subordinate. Being part of a team, everyone’s battling for their ideas, and there’s a way to do it that’s respectful.

Q: What about those physicians who simply want to continue practicing medicine, but are finding it less and less satisfying? What can they do to make their careers more fulfilling?

A: I think there are two parts to this. First, I suspect there are a lot of physicians who have not optimized their practice. I mean not only the collections and the billables, but many doctors fail to examine how the staff works as a team. Do the staff feel good about coming to work every day? How do I interact with my colleagues so they are sending me referrals? There’s a lot of interpersonal development that physicians can do that will really enhance how it feels to go to work every day.

I was fortunate to work in two clinic environments where it was fun — the staff enjoyed each other; people got along. That makes a huge difference. Is everyone getting along? If not, fix that; no doctor should tolerate it. Most staff are very anxious to create a warm environment for patients and each other, and are very creative in doing it. I think there’s a lot of untapped potential there. It’s important to set expectations: ‘This is how I want the clinic run.’ The clinic will take on the tone of the physician.

Second, it’s important for physicians to develop an area of interest outside the clinical practice. Lots of physicians say, ‘I don’t have time. I work from 6 in the morning to 7 at night.’ But it’s about choice and establishing personal boundaries. My deal is to help physicians live from the inside out, to live their core values and passions. Sometimes that means a tripling of their salary and sometimes it means they have an apple orchard somewhere.

I truly believe there’s an untapped brain trust among physicians. It pains me to think there are so many physicians who believe they can’t change their environment or can’t affect change around them. I’d like them to experiment a little bit. I tell physicians, ‘Get outside of yourself because I honestly believe the world is counting on you to be the leaders in healthcare, and you can be leaders in many, many ways.’

This article originally appeared in the July 2003 issue of Physicians Practice.

Francine Gaillour can be reached at

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