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Is There a  Science to  "Change"?

Why do people do what they do? In this issue of Daring Doctors, lets tease apart the concept of motivation. I assume all of us have areas in our lives we want to change, some small and some as big as our career. It is also true that most of us are crisis motivated. For the most part, we don’t change anything unless the status quo becomes intolerable. I invite you to explore the following questions for yourself.
  • How do I decide to stay in a particular job, location or relationship?
  • How do I make the decision to move on, to create something new?
This question is important in our personal lives and also very important for leaders. I would define all physicians as leaders. We lead care teams in the office, we have the opportunity to lead our patients to better health and many of us are in leadership positions in the non-clinical world. Here the question is why do people follow you and listen to your advice?
There are several theories we can use to understand motivation.
1) The most popular is the “fear of the unknown” theory. This is especially powerful for physicians. We spend an entire career attempting to completely master our craft and eliminate uncertainty. (After all, the malpractice lawyers are waiting for us to make a mistake!)
Making a change in your life involves doing something new and admitting you want to learn more…that you don’t “know it all”. It can feel like stepping off a cliff.
  • What has been your experience of the first steps of a change in your life?
  • What have you learned about how you view change and what attitudes and fears get in the way?
My experience of my physician colleagues and clients is we are all intelligent, hard working people committed to making a difference. We are masters at critical thinking (diagnosis) and communication skills. We are all hard wired with the essential toolkit for successful change. The stopper is attitude.
2) Another theory is “inertia”.  My routine is well known and I can accomplish what is expected with minimal effort.  It might not be fulfilling, yet it doesn’t take the effort of learning something new.  This comes out in the thought, “Changing careers would be so difficult, why don’t I just stay put.”
  • What are your thoughts on the effort involved in making a life or career change?
My observation is that NOTHING could be more difficult than the experience of Medical School followed by residency followed by a good stint as a practicing physician. All of us have been there and done that. Simply because we are physicians we are capable of tremendous and prolonged effort if we think it’s worth it.
Inertia comes in two common flavors:
The “you worked so hard to get here” flavor. Usually, family members voice this as you discuss your initial thoughts of doing something outside of clinical medicine. (What will your mother say?)
How does the effort to become a successful physician hold you back when you contemplate a different future?
Certainly we all worked our tails off to become physicians. We could choose to see it as an indication of the effort we are capable of when we decide to move rather than an anchor that holds us back.
And the flavor called “enoughness”.  If I have enough, I am much less likely to go for more. Most of us make enough money, have enough time and are engaged enough at work. We are comfortable enough that fear hasn’t pushed us look for more.  Is it possible to get too much out of your life?
· What is enough in your life?
· What would you like more of?
3) Then there’s the most powerful motivator of all, the “no compelling vision” theory. We stay put because the change options we envision are not attractive enough.  We are not inspired to do anything different. For most of us, our vision of the future is not nearly as clear as our appreciation of our current discomfort.
  • What is your vision of the change you want in your life? 
  • How can you make it big enough to be inspiring?
  • Does your pulse quicken as you imagine yourself 5 years from now?
Of all the fuels for motivating change, inspiration is the cleanest and most powerful. Once you create a vision of your future that is sufficiently inspiring you will be drawn to it with such attraction that fear and inertia are naturally overcome. There is a major difference between being drawn by the power of inspiration and pushing through obstacles by sheer will!
As leaders, once we create a vision for our team or business that is big enough to inspire, the efforts of our followers will be self-generating.
How can you use these principles of attraction and inspiration in your own change process?
It starts with a compelling vision. It starts with a question that is big enough, big enough that its answer is powerfully attractive.
I talk to many doctors who ask, “What should I do to make a living outside of medicine?”  I believe this question is too small. Most of us have found that our medical careers defined our life. We are looking for a more fulfilling life and found medicine got in the way.
I suggest the BIGGER QUESTION to ask, the question that will lead to an inspiring answer, is;
“What do I want my LIFE to look and feel like 5 years from now?”
Take some time to contemplate this vision of your LIFE in your future. Envision a life that gives you everything you have always dreamed of; total fulfillment…whatever that means to you. Don’t be surprised if dreams you had in college or earlier come rushing in. You may wish to close your eyes and envision it, really feel it.
Then write it all down. What are you doing? Where do you live? What are your friends like, your pets, your diet, your clothes??? What does this life feel like?
If any little voices of guilt or “that won’t happen” come in, let them pass and keep on until you have a crystal clear, whole-body sense of what your future will be like.
The NEXT question you may choose to ask is,
“What job do I have that supports this life?”
You may wish to flesh this vision out by asking,
What am I doing?   What talents and skills am I using?
How much am I working?  How many hours a week, months a year?
Who am I interacting with? The people, the staff, the technology?
What contribution am I making? To my vocation, my clients, my family, myself?
How much money do I earn? Per month, per year?
Where am I? In the country, in the world?
What does this “job” feel like and how does it support my vision of my life?
You may find the answers to these bigger questions don’t leave you with a job description you can find in the classifieds. This is a good thing! Stepping in to something new takes a little bit of the entrepreneurial spirit. You can create an “Ideal Job Description” and use it to evaluate available job opportunities or even step fully in to your entrepreneur shoes and create your own vocation.
Creating a compelling vision doesn’t guarantee that fear, inertia and enoughness won’t sneak through to put on the brakes from time to time. You will have a much greater chance of unqualified success and a much more pleasant change experience when your vision is big enough to pull you forward. You can harness the power of attraction to power you onward. Ask the bigger question and play the bigger game to create a future so attractive it generates movement.
As a leader, the ability to create an attractive and empowering vision for your team is crucial. Your ability to communicate the big inspiring picture is a defining skill of a great leader. It is the spark that generates buy-in and maximal effort from your teammates. Without it, your team is probably motivated by fear, inertia and enoughness. That is a difficult thing to admit and a recipe for mediocre performance.
When we are able to frame our goals in this larger context and set a target that is truly worthy, the change process begins. Given the differences between where you are and the future you imagine, movement happens.
So, what would you like to change in your life right now? What future can you envision that is so attractive for you or your team that you can’t wait to get started? How can taking on the role of a visionary provide motivation to your life and your business? I encourage you to start building your vision today. The world is waiting!

Dike Drummond, MD, Executive Coach for Healthcare Leaders dike@physicianleadership.com, (206) 686-4205



Francine R. Gaillour, MD, MBA, FACPE
15600 NE 8th Street, Suite B1-173
Bellevue, WA  98008
(206) 686-4205

Francine R. Gaillour, MD   ©2006 Ki Health, Inc.