Feature Article:

Resolution: Why Developing Personal Competence Enhances Resolve

By Shelley Simon, RN, DC, MPH, EdD
Founder, Beyond Practice Management

Doctors who make New Year?s resolutions do so for the same reasons everyone else does — because the turn of the calendar brings with it a sense of hope. It?s a time when things feel possible. It?s a new beginning, a fresh start, and an opportunity for change. You resolve to get organized, be a better leader with your staff, ask for referrals, grow your practice, and put your finances in order. Then, one day toward the end of January, you realize you?ve lost your enthusiasm and that you?re no more organized or successful than you were this time last year.

Or, instead of making resolutions, perhaps you sign up for a practice management program, complete with a three-day-weekend kick-off seminar in a warm, sunny city. By the final morning of the seminar you?re so pumped up and excited about your potential for success you can barely contain yourself. Being with colleagues who share your enthusiasm is intoxicating. And then, within a few weeks, you?re wondering if you accidentally left all that optimism and energy poolside. Your goals feel impossible to implement or achieve.

Here is a truth you can take to the bank: you?re not alone. The age-old tradition of New Year?s resolutions, the myriad seminars, and the fool-proof systems don?t ultimately work because they are missing an essential component for a successful, sustainable change effort — you.

This January issue of Practice Your Way is the first in a three-part series where we will explore what it means to advance successful, sustainable change in your practice and in your personal life. In this first newsletter, we explore the first of three ?R?s? — resolutions. The focus of this issue is how to make resolutions become realities by paying careful attention to your intentions, along with targeted personal development efforts and measurable, actionable steps toward your goals. In the second part of the series we?ll discuss resistance, how to work with and learn from this all-too predictable aspect of human growth and change. And in the third and final part we?ll address how to build and maintain resilience, another important factor in creating sustainable change and reaching goals.

The words resolution and intention are often used interchangeable, and rightly so. They are not as concrete as a goal, but are instead statements of resolve or aim. An intention is a determination to act in a certain way — to do or achieve one?s purpose or goal. A resolution may feel or sound more like a pledge or a promise to one?s self. Examples of resolutions or intentions include: I will contribute to my retirement plan; I will put my finances in better order; I will be more conscious about how I spend and invest.

A goal is measurable and has a deadline associated with it. Example: I will add $20K to my retirement fund by the end of this year. This is quantifiable. At the end of the year, you need only look at your account to see if you?ve achieved what you set out to do.

Intention can also be understood as where you focus your attention most of the time. I encourage my clients to become increasingly mindful of where their attention and intentions lie, especially during challenging times. This requires cultivating both self-awareness and self-management skills, the two major components of personal competence as defined in the Emotional Intelligence (EQ) literature. (See the October 2006 issue of Practice Your Way for details on personal competence, specifically in the domain of EQ).

Unclear intentions may lead to mixed results or less than optimal outcomes. What you habitually think about — positive or negative — very often becomes your reality. So, for example, you can have an intention to increase your referrals but if your attention is constantly on your lack of new patients you are limiting your own success. If you?ve ever experimented with affirmations, you already know that this technique is only effective to the degree that you can hold an authentic belief around your chosen affirmation.

The tradition of New Year?s resolutions can be traced all the way back to early Rome, to a mythical King Janus (after whom the Romans named the first month of the year). Janus, the god of beginnings and the guardian of doors and entrances, is always depicted with two faces — one looking forward, one looking back. This ancient symbol for resolutions tells us that Janus looked back to reflect on the old year and also looked forward to the new one. An important step in embarking on a resolution is to first reflect on past successes (and failures) so that you can incorporate important lessons and insights as you move into the coming year.

Everyone has experienced setting out to change something about themselves or their business, only to be disappointed when they don?t follow through or achieve their desired outcome. In the face of failure some individuals place blame, dismiss their goal as having been unimportant, or rationalize why they were not successful. Others look inward, but in an unproductive way — blaming themselves for not having enough willpower or determination.

There may indeed be external reasons that change efforts fail, and, sometimes, internal lack of determination is the culprit. In many cases, however, there is an overlooked element or minimized variable that is often essential to any successful change plan. Sustainable change requires changing ourselves — our behaviors, our skills, and level of self-management and personal development. Your intention may be to increase new patients or build a high-performance team, and you have scripts, procedures, and an endless list of the actions appropriate to your goals. Yet, actions without attention to how you are taking those actions will likely result in disappointment and unmet resolutions.

If you could make significant change and reach your most important goals by using willpower and positive affirmations alone, you?d need only to trot off to another seminar. Or, you would effectively respond to the advice of your coach who says simply that you need to ?get out of your own way? or that you should ?just do it.? While this might work for Nike and is a great call to action (at least to buy some new athletic gear), it might not work for you. If, instead, you?re ready for change at a deeper more sustainable level, then it?s time to look inward and ask yourself: ?Who do I have to be to see the change I desire?? This is the developmental question that must be answered on an ongoing basis, especially when you are trying to keep resolutions and achieve goals.

What?s missing for most practitioners is not good ideas or a sincere yearning for something different. More likely, it?s a higher level of personal competence — accountability, professional development, self-awareness, and self-management strategies to sustain efforts even during challenging times. These are the competencies that, when coupled with clear intentions and goals, produce results. To illustrate, I offer three short examples. See if you can relate to one of these:

Doctor A has a strong desire for a stable staff. She?s tired of constant turnover and training. She thinks that hiring an office manger, paying more, and setting up a bonus system is the answer to her problems. Some of those actions may be useful, but what she really needs is more empathy, better communication skills, trustworthiness, and/or the ability to accurately self-assess, along with updated leadership skills.

Doctor B is easily annoyed when patients don?t agree to the treatment plan he recommends. He believes that if only he had better persuasion tactics, patients would follow his lead. In fact, what he needs is more emotional awareness, including the ability to handle disappointment and rejection without personalizing or withdrawing. Instead of tactics, he should focus on becoming more service-oriented and improving his listening skills.

Doctor C needs to build his practice and knows that referrals are the best source for quality patients. Repeatedly disappointed by affirmation attempts, positive thinking techniques, and on-again (off-again) monthly healthcare classes for new patients, he attends seminar after seminar looking for the latest tactic, trying to improve his ?pitch,? or searching for the perfect script to request referrals. Unfortunately, seminars and scripts won?t help him until he builds his social awareness (emotional intelligence), initiative, self-confidence, and communication skills.

Developing personal competence is the single most important factor in keeping resolutions and achieving goals. While developing personal competence is definitely a process—and, as such, requires continued effort, time, and commitment—it will impact your level of success and change efforts far more than any tool, trick, script, or seminar.

So, you have a resolution you?d like to keep, an intention you want to become a reality, or a goal you are determined to achieve. A critical question is: are you ready?

Perhaps you believe that change only occurs in response to pain, crisis, or chaos. Certainly, those conditions (along with feelings of dissatisfaction, hopelessness, and desperation) may prompt an individual to take action. However, change is not always born out of the negative. The impetus for change can also come from a compelling positive vision, new idea or possibility, or a positive state of readiness.

You may, for example, be doing quite well with your current practice marketing plan, but you?re curious how much more efficient or effective you could become, and if there is a higher or different level of service you could provide. Or you?re not altogether unhappy with how your financial future is shaping up, but you wonder what would happen if you worked your financial plan with a bit more finesse and attention. When individuals approach change from a place of strength and inquisitiveness, they tend to be receptive to new ideas and fresh ways of looking at their practices, their finances, or some other domain they want to improve. They?re ready to do the work necessary to reach a new level of excellence or potential, even though their current satisfaction level is reasonably high.

In terms of readiness, it?s important to be able to distinguish between a plan that you will carry out and one that you won?t. Every day, practitioners challenge themselves to keep up with paperwork, market their practice, deal with a chronic staff problem, spend more time with their families — and then they don?t follow through. They promise themselves, ?I?ll do it tomorrow.? If you tend to make the same resolutions and set the same goals year after year and then fail to follow through, it?s time to take a deeper look at the issue. Ask yourself these questions:

1. Are the resolutions, intentions and goals I set out to achieve really important to me?
2. If they are important, what are the obvious obstacles (internal and external) that get in the way?
3. To what extent does achieving the goal or keeping the resolution depend on someone or something else changing?
4. When I fall short or fail, what is my typical reaction (dismiss, deny, blame, rationalize, learn?

An important element people often leave out of their change equation is the counter-pull of resistance. You want to make a change, but you hold back. You want to achieve a specific goal, but you?re fearful of where your efforts might lead. You want to take those first steps toward success, but you procrastinate. We will discuss resistance in part two of this series. For now, just know that it?s something you?ll likely encounter.

After you have reflected on your resolutions, intentions, and goals and are ready to take action, the next task is deciding on first steps. You need a concrete plan — one that you can visualize yourself doing — including the when, where, and how. Having the first few steps of your goal mapped out will dramatically increase your likelihood of success.

First steps allow you to see early results. This is important because while you may not have a completed goal for weeks, months, or even longer, you will be taking steps toward your goal, staying focused on your plan, and growing your confidence. When you can see incremental progress, you?re more likely to follow through even when definitive results are not immediate.

Study this chart for a quick recap of what we?ve covered so far in this article. The examples given will help put the theories and concepts into perspective. Simply keeping on task and doing the appropriate actions steps may achieve many of your intentions and goals. If, however, you are consistently falling short of your objectives and can?t follow through on resolutions, then assess your personal competencies. Keep in mind that the developmental competencies and skills listed below are options; most practitioners would not work on all of these at once, but would instead choose carefully from among the options.

When you?ve completed your first steps, pause to appreciate and acknowledge your progress. Sometimes our own expertise and natural talents are so foundational that we minimize our achievements, forget to congratulate ourselves on results, and instead spend all our time focused on what we?ve yet to do or accomplish. If you?ve slipped behind on some of your action steps, this is the time make a plan to get back on track. Then, map out the next steps you need to take on your way to your goal. Throughout this process — from the first glimmer of a resolution to seeing your goal come to fruition — remember to give proper attention to the developmental skills you need to learn or build along the way.

Assuming that at least some of what you?ve read here has captured your attention, I?d like to leave you with a gentle challenge for this New Year. Let 2007 be the year you take yourself and your goals seriously. Make the effort and take the steps — including the important personal development steps — necessary to have a successful change effort this year and achieve the results you want. Ask yourself these questions:

• What matters to you?
• What are your resolutions, intentions, and goals for this year?
• What personal development competencies are lacking or need your attention?
• How ready are you to change?
• What are your first measurable steps?

If you have clear answers already in mind, you are likely well on your way to a successful 2007. If you are not 100% clear on your resolutions, intentions, goals, personal development needs, and first steps, then spend some time with the questions in this article. Do further reading and find the support you need to achieve the success you envision for this year — the year you take yourself and your goals seriously.

Client's Corner:

Five Tips for Successful Change

1. Set goals and make resolutions that are realistic and achievable. Break them into small steps so that you can see progress quickly.
2. Get into action — now. Don?t wait until you feel motivated or inspired. Start acting immediately on the first simple steps toward your goals. Inspiration and momentum will follow naturally.
3. Avoid perfectionist thinking. You don?t have to have all the answers to get started. Striving for perfection leads to procrastination.
4. Find a way to remind yourself in an ongoing way why the goals you?ve set are important to you. Ultimately you have to keep yourself motivated internally. No one cares about your goals as much as you do.
5. Get support so you?ll be accountable to achieve what you say you want.

Introductory Consultation:

Make 2007 Your Year for Success

Are you committed to taking yourself and your goals seriously this year? Focusing on developing and enhancing personal competence may be the most important thing you do in 2007. If you?re ready to move beyond short-term tactics and learn self-management skills that will to help you achieve your most important goals, then don?t wait — act now, while it?s on your mind. Click here to request a free consultation with Shelley Simon and get the support you need to have a truly great year.

Upcoming Issues:

Part two and three in three-part series: Three ?R?s? for Successful, Sustainable Change:

February: Resistance
March: Resilience