Taking the toxicity challenge
jonathan_medverdYes, I know, when you file a blog entry from the banks of a lagoon in the South Pacific, you run the risk that people might think you are not really covering the RBMA meeting in Orlando. But they would be wrong. I am just letting my unconscious primed mind do the work. It's OK, just ask Steve Bedwell, MD, who regaled the RBMA crowd with a highly entertaining talk that had a very important message: in this very challenging time, at this juncture in the evolution of U.S. health care, it's the stuff we don't see and the stuff we make up that will kill us. The next time you are perplexed, angry, or fogged in on a particular a subject, apply Bedwell's psychological blueprint for seeing clearly and letting go of frustration. Bedwell first demonstrated the problem. Using tongue depressors on a foot-square felt board, he arranged them in a shape and asked the audience what number it represented, repeating the question each time he rearranged the tongue depressors. In spite of offering numerous clues (like, if I show you zero, I will drop the board), it took a long time for anyone to figure out that the numbers related to the number of fingers he displayed on the board while holding it up. "If we stay focused on the tongue depressors, no amount of logic will solve the problem," he says, but by then, we all understood. "If we just stare at what we've seen we are not likely to see the unexpected. Here is a better way: focus first and foremost on changing your point of view." Here's how to address that first problem, the stuff you miss. Step Number One. Reframe the problem itself. Look at it from different perspectives, staff, patient, physician, technical or emotional. Step Number Two. Presuppose multiple solutions, and by all means, don't latch onto the first answer and risk missing clues to the best answer. Don't let a good solution distract you from a great solution. "This is something that physicians have codified into a differential diagnosis'" notes Bewell. "However, it is rare to find a physician who will apply the differential diagnosis approach to solve administrative or personal problems." Step Number Three. Let it go, walk away, relax, live in the moment, and trust that your brain will find the solution for you. "When we do, we are distracting our logical extrovert and letting our creative introvert take over." Sweating the nonexistent stuff What about the stuff you are making up? Think about it: when we don't get the reaction we want or expect, when we hang in limbo--whether waiting for a vote, a phone call, or a response--we make stuff up in order to resist our drive for closure. And it's never good stuff. "Whenever we face a situation that is unresolved it creates a tension, and in order to reach closure, we make stuff up and the stuff we make up tends to be negative. We are masters at taking a speck of information and creating a massive pessimistic scenario." Bedwell believes we are hardwired to do this, but that it is possible to learn to recognize our toxic inventions. "If you recognize them as stories you don't need to argue with them, you can just let them go and that is the power of recognizing and labeling your stories," he advises. "We spend too much time thinking about what the world should be," warns Bedwell. While you are at it, banish those absolutes from your vocabulary, because always, never, completely, do not allow for shades of gray. Bedwell says face it, the stuff we miss cripples our thinking, and the stuff we make up fuels toxic feelings. So get rid of it, poolside, if that's what it takes.