Has Medicine Become a Retail Experience?

April 13, 2018

I have an enormous regard for the pressure that physicians face when trying to balance patient care and time constraints. Patients have done their homework on their illness and their physician and want to heard. They expect an excellent customer experience and look for excellent technical skills as well as honed people skills. The traditional hierarchical model is being questioned and we are looking for a guide on the side. Satisfaction scores are being used for all sorts of decision making ranging from reimbursement, bonuses and hiring/firing.

The impetus for writing this article was to find a way to say thank you to the team of doctors who went above and beyond in their care. It started me down the path of thinking about communication and customer satisfaction and it developed into a seminar on the topic. Although this is designed for physicians, the same communication principles such as likability, show empathy, know your audience, anticipate concerns, etc. apply to all situations.

I recently had an article “Communication Will Enhance the Doctor-Patient Relationship” published by Physicians Practice. Below is the link to the article: http://www.physicianspractice.com/patient-relations/communication-will-enhance-doctor-patient-relationship.

Here’s to thinking of the patient as a valued client and thinking of the physician as a trusted adviser as we look to reach our health goals.

Changing Another’s Behavior

April 7, 2018

My friend Dian wrote this article and it gives us a tool for what we thought would be almost impossible…to change someone’s behavior. Thanks, Dian.

By our fifties, we’ve learned to cope with all kinds of personalities. Divorce, death & retirements further alter relationship dynamics & new communication skills are required. Most advice says we can only change our own behavior, this isn’t 100% true. This powerful technique can alter another’s behavior without confrontation—whether a partner or anyone else.

Think about the behavior you want another to change. Examples could be to drive slower; help with housework; be more attentive; increase intimacy; give you more space— whatever. To begin the transformation, start complimenting the other person sincerely for what they AREN’T doing. Here’s how it will unfold.

Suppose you want someone to listen more closely when you’re speaking, but they’re not. So, you start visualizing that they are. When you’re together, you start peppering the conversation with compliments about their behavior and say, “I just want you to know how much I appreciate that you’ve really been listening to me. It makes me feel really good. Thanks.” The other looks at you & wonders: “What are they talking about?” They may say: “I didn’t do anything.” But at this point you say, “You’ve really been great. I used to think that what I said wasn’t important to you because you didn’t seem to be interested — but lately I feel like you’ve really been listening. I just want you to know I’ve noticed.” The other will likely shrug or say thanks. But then, things start to change because conflicting thoughts cannot exist simultaneously. The other is now considering what they may have been doing that you favorably noticed! They’ll start wondering: “What could I have been doing that made him/her think I was listening better?” Now, they are fully engaged in thinking about changing.

The more we find ways to compliment a behavior we want to positively reinforce, the more we get the results we want–which benefits everyone’s happiness!

During this shoot, I kept telling the pigeons they were beautiful & well behaved…and they really were! My hope was they’d behave in line with my gentle words & not poop on me. They didn’t! Proof of this principle in action! Let me know how it works for you!

By Dian Griesel

Instagram @SilverDisobedience

A Brief Grief Manual for Living, Dying and Dating

July 11, 2017

Recently an acquaintance of mine lost her husband. I suspect many of us struggle in this situation with what to say as well as how and when to say it. Call? Email? Text? Send a card? Visit? Take them out? Now? Later? Reach out? Let them be? There are two things I wanted to share with her. 1. I wanted her to consider that everyone grieves differently and moves on differently and that she will find her own way in her own time. 2. I wanted to prepare her that even with the best intentions, people will say things that are not helpful and maybe even painful. Remember they mean well. Often, they are dealing with their own emotions; this loss may trigger memories of other losses they’ve had, and frequently at this time, people fear their own mortality and say things to help soothe themselves.

#1. Everyone grieves differently and moves on differently

When people hear your husband died unexpectedly, it often triggers primal reactions such as pity, (you poor thing) or freeze (what do I say?). After the initial shock, opinions may be offered about your timetable and readiness to find a partner. People may remember hearing or reading that it takes one year of grieving for every year you were married. Let’s not generalize. True for some, not all. (BTW all divorces aren’t the same and divorced people move on differently, too). In answer to “Are you really ready?” Ready? For what? Heartbreak? Loss? Intimacy? Sharing? Caring? Exploring?  If you lost someone to death or even divorce you deeply understand there are no guarantees. And if you had a great marriage or partnership, you know what is possible.

I feel so lucky that my friends and family are guided by what I think is right for me and they cheer me on. (Maybe I’ve trained them well.) Here is what I know. You are ready for a new relationship when you can put yourself out there with an open heart and open mind with no expectation to replace or replicate your mate. I know I’m ready to share things that can best be shared only with an intimate partner. Bring it on. Enough said.

#2. People mean well and yet sometimes say things that are not so helpful.  At least to me.

Below are some of the things that I suspect are rather common bromides, said by well-meaning acquaintances, friends, and colleagues who want to reach out and ease the pain. I know they spoke from the heart.  Maybe it will help others who have the best intentions and struggle with what to say, to know how these words landed for me. One communication principle I teach is that the meaning of a communication is how it was RECEIVED not how it was INTENDED.

“He’s in a better place.” Really? A better place would be right here, right now.

“I sense his aura around you protecting you.” Yikes. I don’t, nor do I want to.

“If you talk to him it might help.” I don’t talk to dead people and they don’t talk to me.

“You will be reunited someday.” I don’t believe there’s some hotel in the sky that I will check into with my side of the bed waiting. Perhaps this comforts some. Not me.

From well-meaning widows:

“It’s 3 years later and I still cry every day.” That’s really sad. Too bad.

“I didn’t take my wedding ring off for 5 years.” Oh, what a hussy I am.

“There are no men out there for us.” Not my experience or belief.

“You’ll never find anyone as good as your husband again.” And this is helpful how?

“You were cheated. Robbed. You should have had many more years together.” Actually, I think I was blessed with the time that we did have together. People who didn’t experience the unconditional love I had are the ones who were cheated and robbed.

The feeling of being blessed for what I had and deeply knowing that phase of my life is over, is the driver that allows me to move on. I never felt like a victim and no one would be a louder cheerleader for my continued happiness than my husband. SO, BRING IT ON!

What was most helpful in the process was knowing that I was surrounded by people who cared about me and shared the loss. Just being there and telling stories that made me smile was the best medicine. And yes, cooking for me or bringing my favorite foods felt very nurturing. Most of us get through grief and go on quite nicely. My hero in this journey, Sheryl Sandberg, whose husband also died suddenly and unexpectedly, met a new great guy. She’s on the talk circuit with her recent book and I heard her speak passionately about resilience and moving on. YAY!  Good for her! Here’s to resilience, and with a little luck and timing thrown in I will have my own new story too.


How I Learned to Keep My Options Open

July 9, 2017

My mother was into full disclosure, or truth in advertising and/or managing expectations. Or maybe she just didn’t want any returned goods after the sale. That is why she felt the need to tell all of my serious boyfriends about my second grade assembly that she and many other mothers attended.

Each child walked across the stage, stopped, and recited their Three Wishes. I seem to recall in those days they lined you up by height so I was in the middle, towards the back of the line. (I think even then I noticed how sing-song everyone’s voice was -some early awareness and preparation for a career in public speaking.) When it was my turn, I walked to the center of the stage, stopped and proudly declared, “I only have one wish. I want the whole wide world.” Then I moved on, proudly.

Now had my mother been different, she might have smiled, turned to another mother and said, “She will grow up to be President.” But alas, no. She was mortified. She admonished me later, something about why didn’t I follow the rules like everyone else. I think she wanted sympathy for her plight in raising this very willful child.

Lest you think I wanted the whole world because I was greedy, I distinctly remember it was about keeping all of my options open. The thought was, how the heck did I know what I wanted or was going to want? I was only 7 years old.

The strategy paid off. Not that I’ve gotten the whole wide world; but I knew early on that I could explore, invent, and reinvent and I delight in continuing to keep figuring it out. I still keep my options open with the same curiosity, wonder and appreciation I had at 7 years old.

Life and Death Lessons

May 17, 2016

Thank you, Sheryl Sandberg, for having the courage and grace to speak from the heart to the graduates at UC Berkeley. Your words of wisdom were profound and wise.  And, thanks to all of you who feared I might miss or might listen to (or read) her comments and forwarded the link to her graduation speech.

It’s another reminder of how similar and yet how different we all are. She and I share grief, heartbreak, and loneliness, and, as she calls it the “brutality of loss” for husbands who died suddenly of unexpected heart attacks. We share gratitude. Sheryl found deeper gratitude and appreciation after her husband Dave’s death. She also discovered the depths of her resilience. I felt gratitude to be unconditionally loved, moment to moment, day to day and year after year. I learned from my husband’s life about kindness and grace.

Sheryl and I are both familiar with Seligman’s 3 P’s and how important resilience is in processing negative events. The first P.  Personalization. She found her husband. I would still be inconsolable if that happened to me. I would have lived with the feeling that I could have done something then and there to save him -medical knowledge be dammed.  As odd as it sounds, I am so grateful that my husband died (4 very long months ago) as we lived. He felt a burning in his chest as he was exercising (at home) and his last words were, “I think I’ll sit and watch the swans”. For a man who loved nature, living in his dream house, watching the birds, wow. There was only the slightest gasp (he was a quiet and gentle person, never wanting to call attention to himself). I rushed over, pushed him off the chair, did the TV version of CPR and knew instantly that I got his last breath and he got mine. I knew he was gone. Forever. EMS came rapidly and could not resuscitate him. We were one of those goofy Siamese twin couples who liked to always do everything together. I am so grateful for our ending. There always has to be one. And we were together.

This is making me too sad to go through the other P’s, but suffice it to say, the real point is that everyone grieves differently. I am grateful for family and friends who have always been and continue to be there for me. Sheryl Sandberg’s courage lead me to this public tribute, to my husband, Roger. A sterling example of a life well-lived. I miss you. I love you, too.


Don’t Ask What You Can do to Help

November 25, 2015

It’s my nature to extract something that I can learn and perhaps pass along to others when stuff happens. It’s not a list. It’s only one thing. When someone is going through a tough time, DO NOT ASK THEM WHAT YOU CAN DO TO HELP.  Sure, send cards that say you are thinking of them, knock yourself out with prayers, think kind thoughts. No problem. Asking what you can do to help may make you feel better, but it doesn’t help them at all. They are not going to ask you for help, may not even know what they need and don’t need the extra burden of inconveniencing people they know are busy.

You know your audience otherwise you wouldn’t be in the loop of information or updates at this difficult time. Think. What might they need? Do it or don’t do it. Most of us are pretty independent and not used to asking for help.

I dipped my toe into the ‘I could use some help water’, asking someone who asked me to let them know how they could help for some assistance with transportation on a certain day. Their response was, “If I’m around that day I will be happy to help.” For me, that ended the possibility of asking this person again. Alas, I needed some help and I actually scripted what I was going to say to a dear friend since it was really hard to ask. I know how busy everyone’s life is! Of course, my loving friend said, “No problem” and showed up graciously and went above and beyond.

Friends know when we wait at a doctor’s office or at hospital for potential bad news it’s difficult. If you ask them if they want company, most likely they will say “no.” There have been times when friends showed up unexpectedly and lovingly, even though I said, “It’s not necessary” when they asked. I didn’t want to inconvenience them. It was a great distraction and I am so grateful they overrode my protests.  Other friends, who know my freak out around food and cooking, lovingly prepared meals when necessary.  They didn’t ask how they could help they just did it and I was so appreciative of their thoughtfulness and kindness!  And the notes, texts and emails sharing good wishes and do mean a lot. Just don’t ask what you can do to help!

So what I’ve learned, painfully, is that I too, have been part of the “Please let me know how I can help brigade”. Now I know to just do something or not but don’t ask. There. Now I feel better, and I’m just fine. Thank you for asking.

Mindfulness? Nah! Just Pay Attention

October 27, 2015

This week my son-in-law was at a stop light and rear-ended by someone texting going 30 miles an hour. Her car was totaled, she has some physical injuries and he is sore and the car has a dented back end.  My brother swerved to avoid getting hit by a woman texting who ran a red light.

I wrote the article below, “Woulda Coulda Shoulda”, in what seems like kinder, gentler times. It was published in the local paper. All we had then was a cell phone to distract us. The lesson is still the same.  Many of us are on the Mindfulness/Meditation bandwagon to learn to focus.  Claims of this helping productivity and creativity abound. Let’s stop being so mindful, and just pay attention. Especially when driving.

Woulda Coulda Shoulda

Two weeks ago on Saturday afternoon I was driving up the Post Road from Main Street. It was a beautiful day and I was surprisingly, not rushing, not on the cell phone, not checking my make-up in the mirror and not changing the radio station.

Right at about Compo Road, on the sidewalk, I saw a guy and a girl each about 15 riding their bicycles. The boy looked at the car then at me as if he recognized me, perhaps thinking that I was one of his mom’s friends.  We made eye contact with a look that might have said, “Don’t tell my mom I don’t have a helmet”.

In that second of eye contact, he lost control of his bicycle, went skidding off of the curb and he and his bicycle landed one inch from skidding under my front wheels.  No, there was no slamming on of brakes or running out of the car, or a crowd of people gathering.  The girl started laughing at her friend who had fallen off of his bicycle, and he picked up his bike and signaled that he was okay, got back on his bicycle and road off.

It took me several hours to talk about this and several weeks to write it down. “WHAT IF was all I could think about.  I wasn’t doing anything wrong, nor was the boy (in fact I’m not even sure if he had a helmet on or not, it was just the look he gave me).  In a different second his life, his family’s life, my life and my family’s life, could have been changed forever.

PLEASE take this as a lesson for all of us.  All of us have seen the bad driving of “others” on cell phones.  People talking, who stop or slow down when the light is green, or pull out without looking. How many of us can say, “That’s never me?” It is that ONE SECOND of not paying attention that can change everything, and that one second when you are paying attention that can change everything as well. This is not only about angels and miracles, it is about paying attention when we drive so it’s not your kid or my kid, or spouse, or friend, or………..

What’s a Map?

September 14, 2015

Talking to a millennial friend, I used the expression, “He/she sounds like a broken record”.  He asked me to explain what that meant. I said it describes someone who keeps repeating the same thing over and over again.  “Oh, you mean they sound like a corrupted MP3 file?” Yeah, sure, that’s just what I meant to say.

It struck me recently that many millennials may have never have used (or even seen) a paper map. It raises the question of whether they think there is a reason to look beyond where they are and where they are going. When we rely on a GPS to take us from here to there we don’t have much need to see the big picture. We decide if we want the fast route, the toll route, or the scenic route as we go from point A to point B to point C.  We don’t see all the possibilities there are and to quote Dr. Seuss, “All the places we can go”. We don’t see relationships or how point A relates to point C.

I wonder if we are we losing the context and perspective of a larger world as we become more and more self-referential.  Our perspective becomes limited to the route of a destination rather than considering all that is available on the journey.  Our coordinates are limited to here is where I am and here is where I want to go.  I’m not sure if there is a larger meaning or any societal implications, or if I am I just tired because my GPS didn’t get a signal and I couldn’t get from here to there faster.

Are You Cast-raphobic?

February 20, 2015

It was a perfect day to be skiing in Utah. Just like the commercials say.  Temperature was in the 40’s, snow conditions perfect, my ski’s didn’t cross, there wasn’t any ice, no one cut me off, I was carving turns nicely and then, boom, I’m down.  But not out.

Despite the golf ball size swelling of my thumb joint, I chose to keep skiing, without poles, of course, for the rest of the week.  Back to NYC and the freezing weather.  My dad used to say that everything gets better in about 2 weeks.  So I waited 3 before I went to the doctor.

A client cancelled, there was a snow storm, and surely I thought, there must be a hand surgeon with a cancellation who can fit me in. He’s just going to look at my hand and say, “Give it time” and give me a band-aid. We trucked across Central Park with the wind blowing and the snow pelting to the orthopedic surgeon.  And actually he did say, “Give it time?”, however, he added, “Are you nuts?” The x-rays showed torn ligaments.  Apparently there is a 3 week window where they can still surgically reattach the ligaments.  After that, they have to remove a tendon (Who knew we happen to have a spare tendon in our wrist).  Cockeyed optimism did not serve me so well this time.

Anesthesia, surgery and a cast.  This is when I realized that I am CAST-rauphobic.  Perhaps it was a combination of the pain meds and the anesthesia wearing off, but in the middle of the first night  I freaked out and ran around looking for a hammer yelling, “Get this blank blank blank blank thing off of my hand, now”.

Other Lessons learned:

  1. Skier’s thumb is pretty common. The pole gets planted quickly in the snow and the impact causes the strap to pull your thumb back.  Next time, I won’t put my hands through straps and this can’t happen.
  2. Seek medical attention sooner rather than later. (Sunk cost fallacy prevailed).
  3. Removing a cast is traumatic. The noise of the saw will get you no matter how many times they reassure you they won’t slash your wrists and you won’t bleed to death. And, if you wait too long for surgery, as a bonus, you get a 2 inch pin put into your thumb that you may not know about until it yanked out with pliers after 3 weeks.
  4. It is no fun to be dependent on others for months. After three weeks when the cast comes off, you get a hand splint and still can’t use your hand. (Appreciate and thank your partner who takes on many new chores willingly. It’s no picnic for them either).
  5. The thumb is the most important finger. Without it, small motor anything is almost impossible. Writing, eating, buttons, zippers, etc.
  6. Have lots of compassion for people who have accidents or illnesses who need help who aren’t lucky enough to have someone to ask for help.
  7. Patience. Not a huge strength of mine.  Still need practice. Please no more casts to learn this lesson.
  8. Everything takes longer than you think. To eat, to dress and to heal.
  9. When people see a cast they want to know what happened to you, and also to tell you about what happened to them when they had a cast.
  10. Be grateful that you can type even if you can’t hold a pen.

Note to self: There are people with real tragedies, buck up.

Lose Your Mind and Find Your Answer

November 6, 2013

Think about those big leaps you’ve taken in your life.  Those times when you trusted your gut…you went for it….even when logic may have guided you towards restraint.  The inspiration for the action probably came suddenly, out of the blue, more as an instinct and less from a process of working hard and trying to find the answer. Our subconscious is our data base that stores everything.  It does a beautiful job of processing, and quickly delivers a clear, simple, often brilliant idea.  This amazing deep well holds all of our experiences, feelings, learning and teachings.  And the best news is, it’s always available to us, always ready to bubble up and help, just for the asking.  And, this amazing free gift was factory installed in each of us when we were born.

How often do we tap into the supercomputer of our mind to let it guide us in the moment?  Not often enough.  Why?   Because we’re addicted to looking outside of ourselves, searching for the answer on Google instead of tapping into our innate wisdom.  Or we think someone else’s database is better than our own so we consult our panel of experts instead of our waiting for own pool of answers to bubble up.

Here’s the irony. We don’t need logical proof to justify or believe those things we hold deeply.  We just know. We’ve seen time and time again that we have an innate resilience and ability to solve problems-when we don’t over-think a situation.  However, to get to your heart, your soul, your gut, you’ve got to by-pass the brain, and this doesn’t always seem logical and feels scary and unfamiliar.  In business, we bring in consultants to get us thinking about disruptive innovation and how to unleash our creativity.  The great consultants and coaches I know, use their innate wisdom and the storehouse of all of their data and experience to ask great questions that lead to new thoughts and solutions.

Okay, for the disbelievers, I will take the conventional route and start top down, head first, with some research to calm your active mind.

A recent article in the Atlantic talked about a course at Harvard on Ancient Chinese Philosophy (third most popular course) that “promises to change your life”.  Professor Michael Puett teaches that the heart and the mind are inextricably linked, and that one does not exist without the other. Whenever we make decisions, from the prosaic to the profound (what to make for dinner; which courses to take next semester; what career path to follow; whom to marry), we will make better ones when we intuit how to integrate heart and mind and let our rational and emotional sides blend into one. Americans tend to believe that humans are rational creatures who make decisions logically, using our brains. But in Chinese, the word for “mind” and “heart” are the same,” says Christine Gross, the author of the article.

 Wynton Marsalis recently did a piece for CBS, Symphony and Scrimmage, with Tom Brady (QB of the Patriots) and Alan Gilbert (Conductor NY Philharmonic).   The analogies of leadership were spectacular. So was the importance to each of them that the role of emotion plays, yes, even in football.  This should be viewed for endless reasons and is required in my course on Management Communications. (http://www.cbsnews.com/video/watch/?id=50158465n).

 Christopher Chabris, in The Hidden Gorilla says, “Appeals to emotions are more effective than appeals to logic.  Not because people are stupid, but because the mind is designed to use logic for supporting our beliefs rather than for changing them”. 

Even Aristotle knew that no appeal to logic is ever as successful as an appeal to emotion. Facts alone are not sufficient to persuade. Logis, Ethos, and Pathos were his holy triumvirate.  Simply said in business language, data dumps aren’t motivational and don’t drive behavior.

 An alternative model is to start with an emotional connection and then back it up with data.  Emotional connections are infectious and engaging.  Think about the people in your life that have profoundly affected you, or some speakers and presenters that touched you.  My guess is what made them memorable and effective is they integrated stories along with the facts to lead you gently to their conclusion. They engaged you at an emotional level.

 The conventional model, whether it’s presenting at a staff meeting, giving recommendations to a client or presenting at an industry conference is typically to load the deck or the slides with lots of data.  The goal is to get the information from one head into the other, bypassing the heart and gut completely.  I do see a sea change out there.  CEO’s, leaders and managers are getting more comfortable sharing personal stories and even showing some vulnerability. Slides have more pictures and visual images.  We are moving from conference calls to webinars so ‘all of us’ has to show up and we see you and hear you. Thought leaders are streaming videos, and of course the magic of TED.com puts us in touch with fabulous presenters who engage and educate simultaneously.

 Listen to your gut. Put it top of mind. Cherish it. Hold on to those moments of pure instinct, pure intuition, pure joy and engage, excite and emote your way to better decisions!