Aspirations for an Ideal Future in Medicine: Implementation and Pivoting

This week, we’re adding the final touches to your action plan for transitioning into your ideal practice of medicine. So far, we’ve:

- Explored perspectives on the future of medicine

- Defined goals and visions for your practice

- Addressed mindset obstacles, including limiting beliefs              

- Transformed challenges into strategies   

- Prioritized and calendared your plan

Now, it’s time to move into implementation and tackle the inevitable obstacles that will arise.

How are you feeling as you look at your plan on the calendar?

Take a moment to reflect. Yes, even in action weeks, mindset and emotions are key. (You’re not surprised, are you? 😉) This is key to persevere. 

Emotions like confusion, doubt, fear, and overwhelm can stall your progress. Despite your best intentions, these feelings are normal as your brain tries to keep you safe, avoid discomfort, and preserve energy. The good news? You have a prefrontal cortex to step in and clean up your mindset, so you don’t sabotage your plan.

What emotions energize you?

Which ones naturally lead you to take action?

- Motivated

- Energized

- Curious

- Determined

- Committed

- Willing

- Disciplined

- Excited

- Empowered

- Hopeful

For many of us, courage is also an essential emotion, even though it’s not always pleasant. It drives us to act consistently, even when discomfort arises.

What thoughts or beliefs fuel these emotions for you?

- "I’m made for this."

- "I will practice medicine on my own terms." (Borrowing Dr. Una’s phrase)

- "I can serve patients in a way that aligns with my core values."

- "I will find a way to enjoy life and thrive in my career."

- "My family, patients, and staff deserve this."

- "I deserve this."

- "I refuse to give up."

Take some time to brainstorm: Which thoughts and beliefs will you focus on to drive the emotions that propel you into action -

• Keep your appointments with yourself
• Work through your plan step by step
• Stay committed to your timeline.

Overcoming implementation inertia Dr. Amelia Bueche, a dear colleague, shared these essential steps, which I’ve slightly adapted: 

1. Tune in. Listen to the needs of stakeholders—including yourself. Ask questions, gather details, and explore your options.
2. Trust yourself. Remind yourself of your experience and capability to figure things out, even hard things (confidence). Create something that aligns with your mission, vision, and values (clarity). Be selective in your feedback from others and be compassionate yet objective with your feedback to yourself (curiosity).
3. Try it out. Every new practice has a first edition. Start by getting started. Set your intention, observe the impact, and allow space for innovation.

Additional frameworks for implementing change.

-  Logic Model for systems changes. Start with the end in mind. (As taught in my CHARM GME Wellbeing Leadership Course.)

- Kotter’s 8-Step Change Model for team-driven change.

- MedEd Model for medical educators using Kern's 6 steps focusing on curriculum development.

Expect discomfort—it’s part of the journey. As Brooke Castillo, Master Certified Coach, says, “Discomfort is the currency to fulfill our dreams.” You’ll either experience short-term discomfort while working toward your dreams or long-term discomfort from not aiming for them. Choose wisely.

And know this: things won’t go perfectly according to plan. This is when you use the mental flexibility you’ve been cultivating. Review outcomes, adjust your process, and keep moving forward. It’s essentially a multi-PDSA cycle (Plan, Do, Study, Act). This is where the “Done is better than perfect” mindset really helps.

Remember Dr. Una’s analogy: The first iPhone wasn’t perfect. They launched it, learned from it, and continued refining it. Your plan will evolve, and so will you. Embrace the learning process. This is what Amy Edmonson terms “Quality Failures” – they are necessary for mastery.

One last very cool outcome about the process: as you navigate this journey, you’ll experience what Dan Sullivan calls “strategic byproducts”— learning, growth, and transformation that will make you a better version of yourself.

Enjoy the journey!

Next week, we will get a running start into the new year to optimize your well-being. 

Have a joy-filled week,  Tonya

Looking for an external coach to partner with you on your journey to your ideal practice? Set up a time to chat.

Original March 2023, updated December 2024