Tag Archives: Noom

Commit and Flex

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NaBloPoMo 2021:  Do Good, Kid

How do you see the relationship between commitment and flexibility? 

Son submits college applications in the coming weeks. I worry that he puts too much pressure on himself to choose the ‘right’ school (I assume that he will have choices), as if so many permanent things depend on this one life decision. In truth, this door swings two ways, not just one way. He is thoughtful and self-aware, and will make a conscious decision. Then I hope he immerses himself in his chosen school, goes all in with classes, clubs, culture, and people. There is always the risk that it won’t be a good fit, despite all of his efforts and intentions. And it will be okay; he can change schools, take a year off, study abroad—so many options!

Two friends in medical school graduated at the top of our class and matched in general surgery residencies.  They both hated it.  One is now a neonatologist, the other a pathologist.  My residency classmate left in the middle of our intern year because her husband’s job required them to move.  They all committed and flexed.

In science and medicine, we often think we know something.  We study, analyze, discuss, and conclude.  We sometimes make sweeping changes in decision making based on the evidence to date (think hormone replacement therapy, cancer screening, and baby aspirin, for example).  But we don’t stop monitoring.  We keep asking questions.  Sometimes what we thought we knew turns out to be wrong, and we must step back and change direction.  It’s not because we were stupid, or because we had some nefarious intent.  We simply can’t see the whole picture sometimes, and still have to act, so we do the best we can with what we have.  And we must be willing to change both our minds and our actions when we learn and know better. 

In The Infinite Game, Simon Sinek discusses the idea of existential flexibility, which he defines as “the capacity to make a dramatically huge strategic shift in an entirely new direction to advance our cause.”  We flex in actions while maintaining steadfast commitment to our purpose and mission. He gives examples of companies who did this successfully (Apple), and who did not (Kodak). 

For myself and so many of my patients, we must constantly commit and recommit to our health habits and practices. The method I used to lose 25 pounds in 9 months when I was 34 does not feel feasible now that I’m 48. I recently read a Noom article on decision making that resonated deeply (I have no interests in this business). “Make a choice and move forward with conviction. Prepare to be wrong. Be ready to pivot. And be willing to make a different decision. You can always make a different choice.”

Whether it’s suffering, fun, college, residency, clinical guidelines or mindful eating, we get to choose.  Doing the same thing over and over again is totally okay, and so is changing.  It’s just much better if we are actually choosing either, and that we know why.

The Value of Comradery

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I’m having a party!

Well, not really.  I’m inviting colleagues to convene on video in the name of professional community and connection, so it’s almost a party.  It’s also my homework!

These six weeks I get to take Stanford’s inaugural online Physician Well-Being Director Course, along with over a hundred other physician leaders.  What a privilege and pleasure!  I’ve already learned so much, and we’re only one third of the way through.  I may have made a new friend—we bonded over our shared tendency to stress eat, and that we are both using the Noom app to overcome it.  It happened during a breakout session to sample a Comradery Group.

Turns out there is clear evidence that community building, done intentionally and purposefully, promotes clinicians’ overall well-being.  “Well, duh,” you might say (I have).  Why did this have to be studied formally?  But I get it now.  When there is objective evidence for direct benefit and a positive cascade (well physicians tend to have higher engagement, higher patient satisfaction, happier teams, and systems that thrive—relationally as well as financially), healthcare organizations are more likely to invest resources to execute the well-being programs shown to work. 

In a Comradery Group, the objective is more than just venting.  It’s about finding meaning, fostering growth, and supporting one another through empathy, querying, and sometimes even challenging—all in a psychologically safe environment.  Groups meet to discuss particular topics and are admonished to stay on task.  There is usually a facilitator.

I have always found communing with colleagues nourishing—particularly across specialties.  More and more, we toil in silos.  Advancing technology accelerates complexity of both diagnostics and therapeutics at breakneck speed in almost every field.  Everybody can barely keep up with their own work, let alone understand what’s happening in anyone else’s.  And with in-person conferences and other professional gatherings banned for the past year, our sense of community wanes further and faster.  Our disconnection propagates insidiously, and we will all pay in the end, physicians and patients alike.

So what better moment to tend and strengthen our connections?

I have a few colleagues from internal medicine, OB/gyne, ophthalmology, and orthopaedics ready to gather in meaning on Microsoft Teams.  Can’t wait can’t wait!  The first rule of Comradery Group is that what’s said here stays here; holding confidence is key to connection and trust.  We can set other rules at our (first) session.  The homework assignment is only to experience a group once, but my secret hope is that my colleagues will get enough from this meeting to consider doing it again (and again!). 

I’ve proposed some sample topics below.  I’d love to discuss any of them, and I’m sure my friends will suggest others.  Take a look—how could you adapt these questions to your own profession?  How are you and your colleagues at risk for burnout, and how do you imagine Comradery Groups could help?

Here’s something new for the blog:  If you answer one of the questions in the comments, I’ll share my own answer to the same in reply (or a separate post!).  Please also feel free to offer a different question, one that holds meaning and importance to you.

Times are hard and complicated.  We humans are social creatures.  The better we can maintain and strengthen our ties to one another, the less we will suffer—no—the more we will flourish. 

Onward, friends.  We are all we have.

  1. How has doctoring the past year through a global pandemic impacted your professional and personal outlooks?
  2. What lasting lessons from the past year do you want to keep front and center?
  3. What do you want most from your colleagues in other specialties?
  4. How would you change medical education?  Why?
  5. How have you seen medical culture evolve over your career, for better and/or worse?  How has this impacted your personal experience of your work?
  6. What concrete changes have you made to the way you do things, over the years and the past year?  What do you miss and not, about the way things used to be?
  7. What makes a hard day at work?  An easy day?  A good day?  A bad day?
  8. What is your preferred leadership style, as both a leader and one who is led?
  9. What is the value of DEI initiatives at work?  What are the barriers?  Pitfalls?
  10. What’s foremost on your mind right now for your own well-being?  How are you upholding it?