How to handle frustration with the "system"

1 00:00:00,000 --> 00:00:05,860 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills 2 00:00:05,860 --> 00:00:11,260 to build their own research program, whether or not they have a mentor. 3 00:00:11,260 --> 00:00:17,340 As clinicians, we spend a decade or more as trainees learning to take care of patients. 4 00:00:17,340 --> 00:00:22,380 When we finally start our careers, we want to build research programs, but then we find 5 00:00:22,380 --> 00:00:27,780 that our years of clinical training did not adequately prepare us to lead our research 6 00:00:27,780 --> 00:00:29,200 program. 7 00:00:29,200 --> 00:00:35,480 Through no fault of our own, we struggle to find mentors, and when we can't, we quit. 8 00:00:35,480 --> 00:00:40,580 However, clinicians hold the keys to the greatest research breakthroughs. 9 00:00:40,580 --> 00:00:46,200 For this reason, the Clinician Researcher podcast exists to give academic clinicians 10 00:00:46,200 --> 00:00:51,800 the tools to build their own research program, whether or not they have a mentor. 11 00:00:51,800 --> 00:01:01,000 Now introducing your host, Toyosi Onwuemene. 12 00:01:01,000 --> 00:01:03,520 Welcome to the Clinician Researcher podcast. 13 00:01:03,520 --> 00:01:07,160 I'm your host Toyosi Onwuemene, and it is always a pleasure to talk with you. 14 00:01:07,160 --> 00:01:08,840 Thank you so much for tuning in. 15 00:01:08,840 --> 00:01:11,640 I am speaking because you are listening. 16 00:01:11,640 --> 00:01:12,640 Thank you so much. 17 00:01:12,640 --> 00:01:18,920 So Jay, I'm talking about how to handle frustration with the system. 18 00:01:18,920 --> 00:01:21,200 Plug in any system you want here. 19 00:01:21,200 --> 00:01:23,480 I am definitely talking about health systems. 20 00:01:23,480 --> 00:01:27,640 I'm talking about academic medical centers, but it's whatever system you want to plug 21 00:01:27,640 --> 00:01:33,120 in because there's always the system, either the system of grant submissions, the system 22 00:01:33,120 --> 00:01:37,560 of research administration, the system of seeing patients in the clinic. 23 00:01:37,560 --> 00:01:38,560 There's always a system. 24 00:01:38,560 --> 00:01:44,520 So I'm going to give some thoughts about how to handle or some thoughts to consider about 25 00:01:44,520 --> 00:01:48,040 how to handle frustration with the system. 26 00:01:48,040 --> 00:01:57,120 So I think when I was a younger faculty member, when I was earlier in my career, I feel like 27 00:01:57,120 --> 00:01:58,960 that was not that long ago. 28 00:01:58,960 --> 00:02:02,960 I was so much the crusader, like, oh my gosh, this is wrong. 29 00:02:02,960 --> 00:02:05,080 I can't believe how terrible this is. 30 00:02:05,080 --> 00:02:07,560 Somebody should fix it right now. 31 00:02:07,560 --> 00:02:12,320 And then I would go marching to my division chief and I would say, hey, this is a problem. 32 00:02:12,320 --> 00:02:16,960 And here's my one page proposal that I spent all night agonizing over about how best to 33 00:02:16,960 --> 00:02:18,160 fix it. 34 00:02:18,160 --> 00:02:22,360 And you know, kind person that he was, he did not laugh at me outright, at least not 35 00:02:22,360 --> 00:02:28,680 to my face, but clearly must have been thinking, okay, she just, just was born yesterday. 36 00:02:28,680 --> 00:02:29,680 What is she doing? 37 00:02:29,680 --> 00:02:35,480 But I was really serious about my crusades and I would get angry and I'm like, I can't 38 00:02:35,480 --> 00:02:40,160 believe, I can't believe you haven't done, oh my goodness, I was such a crusader. 39 00:02:40,160 --> 00:02:41,560 And you know, it's not a bad thing. 40 00:02:41,560 --> 00:02:43,920 I think, you know, I was young, I had a lot of energy. 41 00:02:43,920 --> 00:02:46,480 I'm still young, actually, I will tell you. 42 00:02:46,480 --> 00:02:50,600 But just, I had a different perspective then than I do now and a different understanding 43 00:02:50,600 --> 00:02:55,040 of how much, how valuable my time was and how valuable my energy was. 44 00:02:55,040 --> 00:03:01,240 And a lot of my energy just went into all these crusades that sadly I've won none of 45 00:03:01,240 --> 00:03:02,240 those crusades. 46 00:03:02,240 --> 00:03:07,960 And maybe I'm a little bit wiser now, but actually it just, the memory was triggered 47 00:03:07,960 --> 00:03:11,840 for me by a recent person that I met and she's a little bit younger. 48 00:03:11,840 --> 00:03:15,960 She just started her faculty career, maybe about a year, two years ago. 49 00:03:15,960 --> 00:03:20,960 And we were having a conversation about how the clinic sucks and this person doesn't know 50 00:03:20,960 --> 00:03:24,200 how to do this and I can't believe this patient didn't get scheduled for an appointment with 51 00:03:24,200 --> 00:03:25,200 me on time. 52 00:03:25,200 --> 00:03:30,960 And wow, there was a lot going on and she was so hot, she was so mad. 53 00:03:30,960 --> 00:03:38,480 And I remember, I remember that experience of being so angry all the time because people 54 00:03:38,480 --> 00:03:42,080 should know better, should do better and they're not. 55 00:03:42,080 --> 00:03:47,200 Anyway, so it was actually that conversation that sparked this podcast episode because 56 00:03:47,200 --> 00:03:53,920 I want to share with her and with actually me when I was there and with people who are 57 00:03:53,920 --> 00:03:58,280 in the same place of frustration, I want to just share with them thoughts about how to 58 00:03:58,280 --> 00:03:59,880 handle frustration with the system. 59 00:03:59,880 --> 00:04:02,500 So I'm going to share seven things. 60 00:04:02,500 --> 00:04:06,740 So the first thing is to recognize that you don't have the power to change anyone. 61 00:04:06,740 --> 00:04:10,140 And that's just a fundamental thing to recognize. 62 00:04:10,140 --> 00:04:15,120 This is so important because you always want to know like what power do you have? 63 00:04:15,120 --> 00:04:16,480 Let's say you're a superhero. 64 00:04:16,480 --> 00:04:17,800 What is your superpower? 65 00:04:17,800 --> 00:04:21,880 Okay, your superpower is that you can breathe underwater like a fish. 66 00:04:21,880 --> 00:04:22,960 Really great. 67 00:04:22,960 --> 00:04:25,260 But your superpower is not flying. 68 00:04:25,260 --> 00:04:29,120 And it's really important because once you know your superpower, you know what your superpower 69 00:04:29,120 --> 00:04:33,400 is and you know what your superpower isn't, there's some things you just don't try to 70 00:04:33,400 --> 00:04:34,400 do. 71 00:04:34,400 --> 00:04:39,000 The superhero who can swim like a fish underwater but cannot fly should not be trying to fly 72 00:04:39,000 --> 00:04:43,840 because trying to fly may result in an early death. 73 00:04:43,840 --> 00:04:50,480 Okay, so coming back from the superhero talk for you, okay, maybe you're not a superhero, 74 00:04:50,480 --> 00:04:53,240 but you got to know what powers you have, right? 75 00:04:53,240 --> 00:04:56,040 And I hope you have the power of influence because that's really good. 76 00:04:56,040 --> 00:04:57,040 That works. 77 00:04:57,040 --> 00:05:01,400 But the power to change someone else, the power to make them do what they don't want 78 00:05:01,400 --> 00:05:06,040 to do, the power to make them see things like you see it so that they can do it the way 79 00:05:06,040 --> 00:05:09,080 you want it done, you don't have that power. 80 00:05:09,080 --> 00:05:11,040 I'm just very sure you don't have that power. 81 00:05:11,040 --> 00:05:17,600 Now if you told me that you go around threatening people and they're afraid and you use fear 82 00:05:17,600 --> 00:05:21,200 to drive them, okay, that might work. 83 00:05:21,200 --> 00:05:24,240 There's a lot of fear tactic use in medicine. 84 00:05:24,240 --> 00:05:25,240 Okay, okay. 85 00:05:25,240 --> 00:05:28,080 There's a lot of strong arming and there's a lot of manipulating. 86 00:05:28,080 --> 00:05:29,240 Sure, you can do all that. 87 00:05:29,240 --> 00:05:31,440 It's a lot of work, but sure. 88 00:05:31,440 --> 00:05:38,320 But just recognize that until you have no power to change them, I mean, you can for 89 00:05:38,320 --> 00:05:42,640 as long as you're wielding fear as a strategy or you're wielding manipulation, it might 90 00:05:42,640 --> 00:05:44,280 work for a little bit. 91 00:05:44,280 --> 00:05:47,160 If you're really good, maybe it'll work for a while. 92 00:05:47,160 --> 00:05:50,840 But ultimately, even if you win them over, you win them over grudgingly, not because 93 00:05:50,840 --> 00:05:52,200 it's something you want to do. 94 00:05:52,200 --> 00:05:58,280 And as soon as you stop wielding whatever stick that you have, it will go back to normal 95 00:05:58,280 --> 00:06:00,460 pretty quickly. 96 00:06:00,460 --> 00:06:04,920 So it's just important to understand your superpower so that you don't invest time 97 00:06:04,920 --> 00:06:07,280 pretending to have a superpower that you don't have. 98 00:06:07,280 --> 00:06:11,320 And I will guarantee you have no power to change others and you know that. 99 00:06:11,320 --> 00:06:13,600 You intuitively know that. 100 00:06:13,600 --> 00:06:20,000 And so I hear people say, oh, I told him exactly what to do. 101 00:06:20,000 --> 00:06:21,800 I told him exactly how to do it. 102 00:06:21,800 --> 00:06:23,120 And he still didn't do it. 103 00:06:23,120 --> 00:06:25,520 It's like, yep, yep, that's not your superpower. 104 00:06:25,520 --> 00:06:27,320 All right, that's number one. 105 00:06:27,320 --> 00:06:31,360 Number two, I mean, I think this is really important to sit down and consider. 106 00:06:31,360 --> 00:06:35,840 Again, I always talk about Simone's maxims because somebody quoted it to me and I think 107 00:06:35,840 --> 00:06:38,560 it's still an important paper today. 108 00:06:38,560 --> 00:06:42,180 And this is this kind of comes, I mean, it's along that flavor. 109 00:06:42,180 --> 00:06:47,040 But it's just you need to recognize that systems are the way they are because they work. 110 00:06:47,040 --> 00:06:50,340 Yes, it may be completely dysfunctional. 111 00:06:50,340 --> 00:06:51,880 It may be totally crazy. 112 00:06:51,880 --> 00:06:54,200 And like you can't believe anyone lived like this. 113 00:06:54,200 --> 00:06:59,480 And everybody may be whining and complaining about it, but they don't get to become the 114 00:06:59,480 --> 00:07:01,760 way they are by accident. 115 00:07:01,760 --> 00:07:07,360 Your clinic and the way it runs inefficiently did not happen by accident. 116 00:07:07,360 --> 00:07:14,000 Your academic system and the way tenure and promotions happen did not happen by accident. 117 00:07:14,000 --> 00:07:18,960 The challenges that people experience in being underrepresented in the academy, those are 118 00:07:18,960 --> 00:07:21,960 things that don't happen by accident. 119 00:07:21,960 --> 00:07:25,300 They happen because they serve a purpose. 120 00:07:25,300 --> 00:07:28,880 Systems are the way they are because they work for some people. 121 00:07:28,880 --> 00:07:33,320 And usually they work for people with enough influence that going against the grain is 122 00:07:33,320 --> 00:07:36,340 usually not safe for other people, right? 123 00:07:36,340 --> 00:07:39,440 Systems are the way they are because they work. 124 00:07:39,440 --> 00:07:41,720 They serve a purpose. 125 00:07:41,720 --> 00:07:42,720 Systems work. 126 00:07:42,720 --> 00:07:46,760 They may not work in a way that seems functional to you, but they are the way they are because 127 00:07:46,760 --> 00:07:48,040 they work. 128 00:07:48,040 --> 00:07:55,480 And the reality is the moment they stop working for the majority, then they change. 129 00:07:55,480 --> 00:08:00,240 But you are frustrated about systems that have been in place sometimes for 70, 80, 90 130 00:08:00,240 --> 00:08:01,240 years. 131 00:08:01,240 --> 00:08:04,520 Some of you have institutions that are older than old. 132 00:08:04,520 --> 00:08:06,960 They've been around for a few hundred years. 133 00:08:06,960 --> 00:08:07,960 Wow. 134 00:08:07,960 --> 00:08:14,820 That's a lot of tradition, a lot of bias, a lot of just whatever it is that skews the 135 00:08:14,820 --> 00:08:19,040 culture of an environment has been going on for so long. 136 00:08:19,040 --> 00:08:23,360 You have to recognize that they are there because they work. 137 00:08:23,360 --> 00:08:24,760 You may not feel like it works. 138 00:08:24,760 --> 00:08:26,720 You may not feel like it's functional for patients. 139 00:08:26,720 --> 00:08:29,120 You may not feel like it's functional for your career. 140 00:08:29,120 --> 00:08:32,280 I'm not going to argue that, but they work. 141 00:08:32,280 --> 00:08:33,280 That's why they're still there. 142 00:08:33,280 --> 00:08:37,520 And the moment they stop working for the majority, they get overturned. 143 00:08:37,520 --> 00:08:39,920 And so I want to just emphasize that. 144 00:08:39,920 --> 00:08:45,400 So you recognize that even though you're super frustrated, even though you feel like something 145 00:08:45,400 --> 00:08:50,920 should change, there are people who would prefer that things remain completely unchanged 146 00:08:50,920 --> 00:08:55,400 because the way the system is suits them just fine. 147 00:08:55,400 --> 00:09:01,840 For example, I remember a time that I was trying to get a badge at the VA, at the VA 148 00:09:01,840 --> 00:09:05,760 hospital, the Veterans Administration Hospital, and I went to line up. 149 00:09:05,760 --> 00:09:07,200 I forget if this was fellowship. 150 00:09:07,200 --> 00:09:14,880 I think this was fellowship because I had a VA that I was connected with for clinic 151 00:09:14,880 --> 00:09:15,880 for my fellowship. 152 00:09:15,880 --> 00:09:21,320 And I went to go get a badge because I think my badge was expiring. 153 00:09:21,320 --> 00:09:22,760 And so I get there. 154 00:09:22,760 --> 00:09:26,000 It's probably like, I mean, it's after clinic now and I make it. 155 00:09:26,000 --> 00:09:27,240 I'm just in time. 156 00:09:27,240 --> 00:09:29,840 It's like 10 minutes to 12. 157 00:09:29,840 --> 00:09:31,040 And there's nobody in line. 158 00:09:31,040 --> 00:09:32,960 Can I just tell you that there's nobody in line? 159 00:09:32,960 --> 00:09:33,960 OK. 160 00:09:33,960 --> 00:09:36,160 So I'm waiting because I'm next. 161 00:09:36,160 --> 00:09:37,240 And there's nobody in line. 162 00:09:37,240 --> 00:09:42,440 This person who's working keeps working until it's 12 o'clock, then gets up, puts a sign 163 00:09:42,440 --> 00:09:45,320 outside the door saying off to lunch. 164 00:09:45,320 --> 00:09:46,320 And that was it. 165 00:09:46,320 --> 00:09:47,320 The whole place is shut down. 166 00:09:47,320 --> 00:09:52,360 I got there 10 minutes earlier, 10 minutes before lunch hour. 167 00:09:52,360 --> 00:09:53,360 Still didn't matter. 168 00:09:53,360 --> 00:09:58,600 The whole place shuts down at noon and then it's over. 169 00:09:58,600 --> 00:10:03,320 I say to myself, do I go back without this ID or do I wait for them to come back from 170 00:10:03,320 --> 00:10:04,320 lunch? 171 00:10:04,320 --> 00:10:05,800 And I decided to wait. 172 00:10:05,800 --> 00:10:08,640 I waited the whole hour sitting outside the window. 173 00:10:08,640 --> 00:10:13,040 I mean, sitting outside the office and finally got my ID. 174 00:10:13,040 --> 00:10:14,040 Eventually. 175 00:10:14,040 --> 00:10:15,480 It took a long time. 176 00:10:15,480 --> 00:10:19,320 But you know, if you've ever had experiences with VA hospitals, and again, that's been 177 00:10:19,320 --> 00:10:22,940 several years and at least a decade since I worked in a VA hospital. 178 00:10:22,940 --> 00:10:25,040 So clearly, I'm sure things have changed now. 179 00:10:25,040 --> 00:10:30,800 But I'm just saying that things work the way they work because they work. 180 00:10:30,800 --> 00:10:33,480 Because it's the culture, right? 181 00:10:33,480 --> 00:10:37,960 The culture of a place is just the collective experience that everybody is having. 182 00:10:37,960 --> 00:10:41,560 And different people experience a culture differently, but everybody comes together 183 00:10:41,560 --> 00:10:43,240 to create the culture. 184 00:10:43,240 --> 00:10:47,020 And so the culture we have serves a purpose, even if it's a bad purpose. 185 00:10:47,020 --> 00:10:49,920 It serves a purpose and that's why it's persisted. 186 00:10:49,920 --> 00:10:51,200 That's why it hasn't gone anywhere. 187 00:10:51,200 --> 00:10:54,680 So you just got to understand that this problem is older than you. 188 00:10:54,680 --> 00:10:57,560 Whatever problem you're frustrated by is usually older than you. 189 00:10:57,560 --> 00:11:01,120 In fact, it may be older than several generations of your family members. 190 00:11:01,120 --> 00:11:06,320 You just got to recognize that because here you are coming trying to, in a sense, fight 191 00:11:06,320 --> 00:11:12,960 against a pillar of your institution, a pillar, like a structural cultural pillar. 192 00:11:12,960 --> 00:11:13,960 That's what you're trying to come against. 193 00:11:13,960 --> 00:11:17,320 So you just want to recognize the impossibility of that task. 194 00:11:17,320 --> 00:11:22,440 Okay, number three is that you want to decide what's most important to you. 195 00:11:22,440 --> 00:11:25,840 I mean, the issues that we're bothered by are big issues. 196 00:11:25,840 --> 00:11:29,960 A patient wasn't seen, a patient wasn't treated appropriately, someone's treated disrespectfully. 197 00:11:29,960 --> 00:11:33,560 You heard about there's so many things and they are all important. 198 00:11:33,560 --> 00:11:34,560 They are. 199 00:11:34,560 --> 00:11:37,240 You have to decide what is most important to you. 200 00:11:37,240 --> 00:11:38,540 What are you here for? 201 00:11:38,540 --> 00:11:42,640 This is so important, especially for people who are underrepresented in the academy. 202 00:11:42,640 --> 00:11:43,640 Why are you here? 203 00:11:43,640 --> 00:11:46,360 It's so important to clarify. 204 00:11:46,360 --> 00:11:49,440 I mean, and sometimes we feel like, oh, we're here to build community. 205 00:11:49,440 --> 00:11:50,440 We're here to do this. 206 00:11:50,440 --> 00:11:53,280 And it's like, yeah, you could do all those things anywhere else. 207 00:11:53,280 --> 00:11:54,760 But why are you here specifically? 208 00:11:54,760 --> 00:11:58,760 Like, what did you come to get from here that matters to you? 209 00:11:58,760 --> 00:11:59,760 What is it? 210 00:11:59,760 --> 00:12:03,640 I mean, this is really important because you want to be very clear on why you're here, 211 00:12:03,640 --> 00:12:05,400 why you're in this place, why you're in the system. 212 00:12:05,400 --> 00:12:06,400 What did you come to get? 213 00:12:06,400 --> 00:12:11,160 For example, sometimes, let's say, you know, one of my fellows will be like off on a crusade 214 00:12:11,160 --> 00:12:14,600 and it's like, wait a minute, wait a minute, why did you come again to fellowship? 215 00:12:14,600 --> 00:12:18,440 I came to be certified, to be board certified in this area. 216 00:12:18,440 --> 00:12:19,440 Okay. 217 00:12:19,440 --> 00:12:20,440 Does this help you get that certification? 218 00:12:20,440 --> 00:12:23,360 I mean, you just want to be clear. 219 00:12:23,360 --> 00:12:25,520 Like, does it help you get to your goal? 220 00:12:25,520 --> 00:12:26,520 You want to be clear. 221 00:12:26,520 --> 00:12:29,320 It's like, well, no, I want to make sure it doesn't happen like this for someone else. 222 00:12:29,320 --> 00:12:32,080 It's a problem that's older than you. 223 00:12:32,080 --> 00:12:35,000 And after you leave, this problem will still be here. 224 00:12:35,000 --> 00:12:39,920 But you, you may leave without the certification you came for if you're not able to finish 225 00:12:39,920 --> 00:12:42,600 the work that you're actually supposed to do. 226 00:12:42,600 --> 00:12:47,840 And so it's just really important to clarify your goals for any environment. 227 00:12:47,840 --> 00:12:48,840 And we always have a goal. 228 00:12:48,840 --> 00:12:51,800 We always have a goal in our interaction in any environment. 229 00:12:51,800 --> 00:12:54,560 It's very rarely that we don't have a goal. 230 00:12:54,560 --> 00:12:58,720 And patient care, it's part of that experience, but it's not our primary. 231 00:12:58,720 --> 00:13:00,480 It's not our only goal, right? 232 00:13:00,480 --> 00:13:06,560 Or solving the problem of unhappiness in medicine is a great goal, but may not be your primary 233 00:13:06,560 --> 00:13:07,560 goal. 234 00:13:07,560 --> 00:13:11,240 It would be nice to do your work, get your outcome and make everybody happy. 235 00:13:11,240 --> 00:13:15,360 But if you have to choose, you want to know which takes precedence. 236 00:13:15,360 --> 00:13:16,840 And that's important. 237 00:13:16,840 --> 00:13:18,680 What is most important to you? 238 00:13:18,680 --> 00:13:22,600 Peace of mind, joy, harmony, all those things. 239 00:13:22,600 --> 00:13:28,680 You just got to recognize your values and nobody can tell you what those are. 240 00:13:28,680 --> 00:13:33,120 You'll be happy to work with you and help you figure it out. 241 00:13:33,120 --> 00:13:38,400 But you want to know that you know what's most important to you so you can clarify how 242 00:13:38,400 --> 00:13:43,880 much energy and investment you really want to put into handling or changing your frustration 243 00:13:43,880 --> 00:13:44,880 with the system. 244 00:13:44,880 --> 00:13:47,520 Okay, you've decided what's important to you. 245 00:13:47,520 --> 00:13:50,840 You're like, yes, this is something I really want to intervene in. 246 00:13:50,840 --> 00:13:52,480 Physicians are no longer happy. 247 00:13:52,480 --> 00:13:56,960 I'm going to do this initiative that's going to make all physicians happy. 248 00:13:56,960 --> 00:13:59,120 So decide on your intervention. 249 00:13:59,120 --> 00:14:02,400 It's one thing, you know, everybody can complain. 250 00:14:02,400 --> 00:14:05,080 I mean, oh my goodness, who doesn't love a good complaint? 251 00:14:05,080 --> 00:14:09,520 You sit down, you gripe, you're all angry, you all get so mad and then you can miss a 252 00:14:09,520 --> 00:14:11,520 rate because you're all experiencing the same thing. 253 00:14:11,520 --> 00:14:12,960 So everybody feels so good. 254 00:14:12,960 --> 00:14:13,960 Oh, yeah. 255 00:14:13,960 --> 00:14:15,160 I mean, so amazing. 256 00:14:15,160 --> 00:14:16,160 So awesome. 257 00:14:16,160 --> 00:14:17,160 So sweet. 258 00:14:17,160 --> 00:14:23,500 But you're in leave complaining and determine what intervention do you want to champion? 259 00:14:23,500 --> 00:14:28,440 What is the answer to the problem of not enough providers to see too many patients? 260 00:14:28,440 --> 00:14:30,720 What is your answer to that question? 261 00:14:30,720 --> 00:14:31,720 Great. 262 00:14:31,720 --> 00:14:33,600 How do you determine to solve it? 263 00:14:33,600 --> 00:14:38,640 Oh, you have a plan, an incentive plan for all physicians who see more patients than 264 00:14:38,640 --> 00:14:39,720 they're supposed to. 265 00:14:39,720 --> 00:14:41,640 Good for you. 266 00:14:41,640 --> 00:14:42,640 Figure out the intervention. 267 00:14:42,640 --> 00:14:47,680 It's so important because I think so many people get stuck in griping that they haven't 268 00:14:47,680 --> 00:14:51,840 determined what intervention they want to see or what intervention they want to champion. 269 00:14:51,840 --> 00:14:53,880 And you can make change happen. 270 00:14:53,880 --> 00:14:54,880 Absolutely. 271 00:14:54,880 --> 00:14:59,880 If you're very clear about what that change brings you, what gift it gives to you and 272 00:14:59,880 --> 00:15:03,480 what the intervention is that you have to make a difference. 273 00:15:03,480 --> 00:15:04,480 Okay. 274 00:15:04,480 --> 00:15:07,200 So determine after you decide what's most important to you. 275 00:15:07,200 --> 00:15:10,760 You're very clear about your goals for your stay here. 276 00:15:10,760 --> 00:15:11,760 Determine the intervention. 277 00:15:11,760 --> 00:15:12,760 So it's measurable, right? 278 00:15:12,760 --> 00:15:16,520 I made this intervention and this is the outcome that I got, right? 279 00:15:16,520 --> 00:15:20,360 Now in going to implement your intervention, whether that is you're trying to influence 280 00:15:20,360 --> 00:15:25,600 somebody else who's a decision maker, or you're trying to make a proposal to get people to 281 00:15:25,600 --> 00:15:31,400 buy in, whatever it is, it is important for you to decide upfront what you can and cannot 282 00:15:31,400 --> 00:15:32,400 live with. 283 00:15:32,400 --> 00:15:34,060 This is important. 284 00:15:34,060 --> 00:15:43,920 For example, one of my mentees had a situation where she really was frustrated by the way 285 00:15:43,920 --> 00:15:45,320 her clinical environment was. 286 00:15:45,320 --> 00:15:46,320 I mean, she was so frustrated. 287 00:15:46,320 --> 00:15:48,280 She was like, they don't do this, they don't do that. 288 00:15:48,280 --> 00:15:49,280 There's not enough support. 289 00:15:49,280 --> 00:15:53,680 It was a litany of complaints. 290 00:15:53,680 --> 00:15:59,760 And so at some point you have to decide, okay, wow, this, you know, I've been complaining 291 00:15:59,760 --> 00:16:01,040 since the day I got here. 292 00:16:01,040 --> 00:16:04,520 This is the way it seems to always be. 293 00:16:04,520 --> 00:16:05,720 What can I live with? 294 00:16:05,720 --> 00:16:07,480 What can I live without? 295 00:16:07,480 --> 00:16:09,320 What can I live with? 296 00:16:09,320 --> 00:16:10,320 Right. 297 00:16:10,320 --> 00:16:13,360 So you're making the decision that's too well, oh, okay. 298 00:16:13,360 --> 00:16:16,000 I guess this is just the way they work here. 299 00:16:16,000 --> 00:16:18,840 Can I live with it or can I just not work like this? 300 00:16:18,840 --> 00:16:23,760 And it's so important because the moment you recognize that you cannot work in a clinic 301 00:16:23,760 --> 00:16:28,200 where MAs are not available to support you, it's good. 302 00:16:28,200 --> 00:16:33,760 You now know what you can and cannot live with. 303 00:16:33,760 --> 00:16:36,040 What if you're like, it doesn't matter that there are no MAs. 304 00:16:36,040 --> 00:16:41,000 I'll work with one of the nursing staff who's not an MA, right, or one of the nursing staff, 305 00:16:41,000 --> 00:16:42,000 right? 306 00:16:42,000 --> 00:16:45,920 MAs are not nursing staff, but they're sometimes on their way to becoming nursing staff. 307 00:16:45,920 --> 00:16:49,240 So you decide that, oh, okay, I can't do this. 308 00:16:49,240 --> 00:16:52,200 Or you decide, well, you know, that's not such a big deal. 309 00:16:52,200 --> 00:16:56,560 You're the only one to decide what you can and cannot live with because the reality is 310 00:16:56,560 --> 00:17:02,220 that it is more likely that this problem that preceded you is going to succeed you. 311 00:17:02,220 --> 00:17:03,960 It's just more likely than not. 312 00:17:03,960 --> 00:17:09,720 I'm not trying to be pessimistic here, but you want to say to yourself, if change will 313 00:17:09,720 --> 00:17:14,400 never happen no matter what I do, to what extent am I prepared to live with things if 314 00:17:14,400 --> 00:17:16,160 this is the way they always will be? 315 00:17:16,160 --> 00:17:18,800 But you just want to make a decision. 316 00:17:18,800 --> 00:17:24,760 If your decision is no matter what they do, I'm going to stay, that's important. 317 00:17:24,760 --> 00:17:28,200 But if you're like, you know what, I cannot live like this. 318 00:17:28,200 --> 00:17:30,920 This is not the way I've envisioned my clinic experience. 319 00:17:30,920 --> 00:17:34,400 I don't want to do this. 320 00:17:34,400 --> 00:17:39,840 You want to make sure that you decide which pieces you can do, which pieces you would 321 00:17:39,840 --> 00:17:42,040 prefer not to have to do. 322 00:17:42,040 --> 00:17:43,040 Okay. 323 00:17:43,040 --> 00:17:49,960 The next thing is to set a time with which to see the intervention through because the 324 00:17:49,960 --> 00:17:53,200 thing about interventions is that they can take a long time. 325 00:17:53,200 --> 00:17:58,600 They need an awful long time for you to see it through, but you've got to decide, okay, 326 00:17:58,600 --> 00:18:02,160 I have 12 months for this intervention or I have three weeks for this intervention or 327 00:18:02,160 --> 00:18:04,080 I have two weeks. 328 00:18:04,080 --> 00:18:06,600 Whatever your timeframe, set it, set it. 329 00:18:06,600 --> 00:18:10,080 This is how much it's kind of like when you think about making an investment in the stock 330 00:18:10,080 --> 00:18:13,800 market, actually, to be honest, this is more like gambling with slot machines because I 331 00:18:13,800 --> 00:18:18,280 told you you can't change anybody, but we're just going through emotions here. 332 00:18:18,280 --> 00:18:19,920 It's like a slot machine. 333 00:18:19,920 --> 00:18:24,000 You put in a lot of coins, eventually you're going to hit, eventually. 334 00:18:24,000 --> 00:18:27,840 But you may lose a lot trying to hit this one round, right? 335 00:18:27,840 --> 00:18:32,760 So you just have to decide, it's like, I'm just going to do X number of dollars. 336 00:18:32,760 --> 00:18:35,420 In the moment you get to the X number of dollars, you're done. 337 00:18:35,420 --> 00:18:38,240 Even if it's like, I bet the next one's going to be it. 338 00:18:38,240 --> 00:18:41,600 Even if that's how you feel, you just say, oh, that's enough. 339 00:18:41,600 --> 00:18:42,600 It's the same thing. 340 00:18:42,600 --> 00:18:45,040 You're going to set the time with which to see your intervention through and you're going 341 00:18:45,040 --> 00:18:48,480 to say, no matter what, no matter how close I am, three months from now, seven months 342 00:18:48,480 --> 00:18:51,280 from now, two years from now, I'm going to be done. 343 00:18:51,280 --> 00:18:55,560 And you want to make sure to set the time so that you can really make the investment 344 00:18:55,560 --> 00:18:57,400 push as hard as you want. 345 00:18:57,400 --> 00:19:01,040 And then turn around and decide, you know what, the time I set for it, it didn't work. 346 00:19:01,040 --> 00:19:02,520 No thank you. 347 00:19:02,520 --> 00:19:07,840 And the final thing is be okay with quitting. 348 00:19:07,840 --> 00:19:09,400 In medicine, we struggle to quit things. 349 00:19:09,400 --> 00:19:12,960 We just feel like, nope, we must see it all the way through. 350 00:19:12,960 --> 00:19:17,120 We don't want to not do our obligation. 351 00:19:17,120 --> 00:19:20,320 But you know what, when you get to a place where you're like, you know what, people are 352 00:19:20,320 --> 00:19:22,200 hard to change. 353 00:19:22,200 --> 00:19:23,800 And I've done all the best that I can. 354 00:19:23,800 --> 00:19:24,800 I've created an intervention. 355 00:19:24,800 --> 00:19:26,080 I've seen it through. 356 00:19:26,080 --> 00:19:27,840 And wow, nothing's changing. 357 00:19:27,840 --> 00:19:30,600 It's okay to quit the crusade. 358 00:19:30,600 --> 00:19:32,720 It is okay to quit. 359 00:19:32,720 --> 00:19:34,360 And you may not quit medicine. 360 00:19:34,360 --> 00:19:36,320 You may not say, I'll never practice again. 361 00:19:36,320 --> 00:19:39,560 Or you'll never say, you may not say, oh, I don't want to do this clinical research 362 00:19:39,560 --> 00:19:41,240 thing anymore. 363 00:19:41,240 --> 00:19:45,160 Whatever it is, you don't have to quit the whole thing. 364 00:19:45,160 --> 00:19:48,600 But be okay with saying to the crusade, I've served you enough. 365 00:19:48,600 --> 00:19:50,920 It's time to move on. 366 00:19:50,920 --> 00:19:55,440 And it's important to do that because if you think about how much energy you expend trying 367 00:19:55,440 --> 00:20:00,840 to fight for what should already be yours, or trying to make people see reason, or trying 368 00:20:00,840 --> 00:20:05,560 to make them come around to your way of thinking, it's a lot of energy. 369 00:20:05,560 --> 00:20:09,800 And it's energy that you are not spending doing things that actually move you forward. 370 00:20:09,800 --> 00:20:16,520 You are stuck in, to some extent, the past of what could be you or how people might respond 371 00:20:16,520 --> 00:20:21,460 instead of really moving forward into your space of creativity, whatever that looks like. 372 00:20:21,460 --> 00:20:24,720 And so it's important to quit so that you're released. 373 00:20:24,720 --> 00:20:29,200 It takes too much energy trying to convince people to do things that they actually don't 374 00:20:29,200 --> 00:20:30,460 want to do. 375 00:20:30,460 --> 00:20:35,360 So when you have seen your intervention all the way through, you set the right time, the 376 00:20:35,360 --> 00:20:40,680 time frame that feels authentic to you, and you don't, if you don't achieve it, then you've 377 00:20:40,680 --> 00:20:42,520 got to be okay with saying, you know what? 378 00:20:42,520 --> 00:20:43,520 Okay, I quit. 379 00:20:43,520 --> 00:20:45,520 You don't have to quit everything. 380 00:20:45,520 --> 00:20:50,840 Remember, you just have to quit the one thing, that one thing that's really frustrating, and 381 00:20:50,840 --> 00:20:51,840 you want it to champion. 382 00:20:51,840 --> 00:20:56,760 You have to be willing to say, okay, maybe not me, maybe not me. 383 00:20:56,760 --> 00:21:00,000 If you struggle, if you struggle, definitely reach out to me. 384 00:21:00,000 --> 00:21:06,120 Let's talk about which of our programs may be a fit for you, and definitely reach out 385 00:21:06,120 --> 00:21:08,360 and let me know how I can support you. 386 00:21:08,360 --> 00:21:12,160 Again, remember that we have a webinar coming up December 20th at 12 p.m. 387 00:21:12,160 --> 00:21:17,920 When you have no research mentor, please sign up on our website, clinicianresearcherpodcast.com. 388 00:21:17,920 --> 00:21:23,320 You can also sign up on our coaching website, www.coedcoach.com. 389 00:21:23,320 --> 00:21:28,440 All right, to summarize how to handle frustration with the system, number one, recognize that 390 00:21:28,440 --> 00:21:30,160 you have no power to change others. 391 00:21:30,160 --> 00:21:35,920 Number two, remember, assistance are the way they are because they serve a purpose. 392 00:21:35,920 --> 00:21:39,640 They work, even though they may not work to your benefit. 393 00:21:39,640 --> 00:21:43,120 You want to decide what's most important to you, why you're really here, making sure you're 394 00:21:43,120 --> 00:21:48,880 not losing sight of what you really came to do in this environment. 395 00:21:48,880 --> 00:21:49,880 Determine the intervention. 396 00:21:49,880 --> 00:21:54,880 Don't just sit and complain, and decide what you can and cannot live with, set a time within 397 00:21:54,880 --> 00:21:59,280 which to see the intervention through, and finally be okay with quitting the crusade. 398 00:21:59,280 --> 00:22:04,760 All right, somebody needs to hear this episode, please share it with one person today. 399 00:22:04,760 --> 00:22:06,280 Just one person. 400 00:22:06,280 --> 00:22:11,840 Let's transform the lives of clinicians, scientists everywhere, one clinician scientist at a time, 401 00:22:11,840 --> 00:22:14,360 or one aspiring clinician scientist at a time. 402 00:22:14,360 --> 00:22:16,440 All right, it's been a pleasure talking with you today. 403 00:22:16,440 --> 00:22:17,880 Thank you so much for listening. 404 00:22:17,880 --> 00:22:29,400 I look forward to talking with you again the next time. 405 00:22:29,400 --> 00:22:34,760 Thanks for listening to this episode of the Clinician Researcher Podcast, where academic 406 00:22:34,760 --> 00:22:40,320 clinicians learn the skills to build their own research program, whether or not they 407 00:22:40,320 --> 00:22:41,560 have a mentor. 408 00:22:41,560 --> 00:22:47,680 If you found the information in this episode to be helpful, don't keep it all to yourself. 409 00:22:47,680 --> 00:22:49,400 Someone else needs to hear it. 410 00:22:49,400 --> 00:22:53,480 So take a minute right now and share it. 411 00:22:53,480 --> 00:22:58,920 As you share this episode, you become part of our mission to help launch a new generation 412 00:22:58,920 --> 00:23:18,960 of clinician researchers who make transformative discoveries that change the way we do healthcare.