Practicing Like an Eagle—Not an Emu

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AUTHORS:
Neil Baum, MD; and Neeraj Kohli, MD, MBA

Neil Baum, MD, is Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, LA, and author of Marketing Your Clinical Practice-Ethically, Effectively, and Economically, Jones Bartlett Publishers.

Neeraj Kohli, MD, MBA, is Director, Division of Urogynecology, Brigham and Women’s Hospital, and Assistant Professor, Department of Ob/Gyn, Harvard Medical School, Boston, MA.

The eagle—our national symbol—is an exalted bird that lives on the mountain tops and has such keen eyesight that it can spot a 3-inch mouse from a distance of 446 feet in the air, which is 2.24 times better than the human eye. The emu, on the other hand, does not fly, but runs on the ground and buries its head in the sand when it wants to escape.
 
There are more extraordinary characteristics of eagles that are worth noting. Some eagles live up to 70 years. Half-way through their life span, they go through a significant midlife “transition.” They grow new beaks and replace their talons with a new razor sharp pair. When eagles are in their 40s, their beaks become too bent and talons too soft to pick up prey. At the same time they also completely lose their fresh feathers, resulting in a challenge to fly. They are left with one of two options: to die or go through a painful 150-day process in which they sit in their nest atop the mountain and self-extract their beak by beating it against a rock. The eagle will wait for a new beak to grow and then pull out their talons; when new talons grow, the eagle will use them to remove its aged feathers. After 5 months, the eagle is reborn and lives for approximately another 30 years.
 
Like the eagle, we as physicians, have the opportunity to reinvent ourselves and our practices each and every day. In today’s business world, if you are not growing, then you are shrinking. Many doctors use the very same skills that they learned during their training and practice in the same office setting that they set up decades ago. It is possible for us to shed our feathers, grow a new beak and talons, and develop a fresh new look that will be more attractive to our patients.
 
We have been around the block a few times working to help practices with different issues. Day-in and day-out, we communicate with doctors and their staff, and a simple fact is that their biggest problem, roadblock, and adversary is the person in the mirror. As we grow up, we are conditioned and affected by many negative influences that, as adults, we are too often putting up stop signs, smacking us in the face. We have learned that the choice is ours—for good, for bad, and every place in between. There is no one else to blame and no need to worry. If you have control over something, you can change it. And if you do not have control, there is no need to worry because you cannot change it.
 
Change, significant improvement, and transformation of your practice all titrates down to taking action. All the motivation, systems, goals, innovative ideas, new systems, and staff training means little to nothing if you do not take action, make sustainable changes, and keep this momentum going. This takes time, focus, and energy, but the payoff is incredible. The return-on-investment will ultimately save time and energy, increase joy for life, reduce stress and craziness, result in better patient outcomes and satisfaction, increase blessings, and you can all make more money. Just like a shark, if it does not move at all times, it dies.
 
We knew the only way to change the practice was to change our paradigm (discussion of paradigm below) and make a commitment to changes no matter how crazy, how uncomfortable, or how they contradicted the “rules” we adhered to. We are very proud to say that the practice has grown exponentially in all aspects, with financial being the least important, although this area has thrived (so appreciate the wisdom and much of success in this transition.)
 
Change will necessitate breaking your self-induced rules—the rules blocking you from change, improvement, and growth. This is supposed to hurt and feel uncomfortable; otherwise there cannot be significant change. Keep reminding yourself that what you are doing is not working (not saying that you do not have a very successful practice, we merely reference your desire for improvement and change). Little to nothing will change unless you change the way you view and approach things.
 
Definitions of Paradigm:

•A philosophical and theoretical framework or a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated
•The generally accepted perspective of a particular discipline at a given time
a theoretical background
•A system of assumptions, concepts, values, and practices that constitutes a way of viewing reality
•A set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline.
 

What is a Paradigm Shift? 

•A paradigm is our perception of reality, our view of the world. It is our interpretation of events based on previous teaching we have received. If our paradigm is based only on input from the media of conventional newspapers, magazines, radio, television, Hollywood films, public education, etc, then may God help us, for we will only see things the way the elite and wealthy rulers of this world who control these sources of information, want us to see things! This is often the opposite of the truth. A paradigm shift means to have a sudden change in perception, a sudden change in point of view, of how you see things. Hopefully this change will be in the right direction. (Based on Stephen R. Covey's definition in The 7 Habits of Highly Effective People)
•A dramatic change in methodology or practice. It often refers to a major change in thinking and planning, which ultimately changes the way projects are implemented.
•A fundamental change in approach or underlying assumptions
Just like for the eagle, change for you may feel uncomfortable and scary. But without constant (and sometimes significant) change and growth. survival in today’s healthcare climate will be a challenge. You must to change your paradigm and have a paradigm shift; this is an absolute, for without this I guarantee you will not achieve what you are looking for. Post a little sign with the phrase “Paradigm Shift” in your office and another place where you will see the sign often. By all means, we can control our destiny in practice if we focus on taking control of the things that can be changed and stop worrying about the things we cannot control.
 
Bottom line: We have reached a fork in the road; we can chose to soar like an eagle and make incremental changes that improve the care we offer our patients or we can behave like an emu and hope the problems that we all face will go away. The choice is up to us. Which bird will you “emu”late: the eagle or the emu?