Saturday Morning Rounds July 11, 2020 - Residency interviews in the age of COVID

Posted by BossB, MD on July 11, 2020

Saturday Morning Rounds

A weekly round-up of career & negotiation content for women physicians

What got our attention

In speaking with a number of MS4s recently to get input on our forthcoming Residency Interview Guide, we've heard one common message loud & clear:

2020 is a year of terrifying uncertainty

The med students we've spoken with:

  • Have no idea what impacts COVID will have on the interview & match process
  • Feel abandoned by a lot of the institutions they would usually look to for clarity
  • Worry that virtual interviews and lack of clinical rotations will just exacerbate any disadvantage an applicant might already have (or perceive themselves to have)

Which gave us an idea. We - not BBMD alone but this whole community writ large - can help fill the gap for them. And the way to do so? Get the info directly from the source - ie program directors!

So here's the plan. We're gonna create and distribute a short survey for program directors about what's changing this year, what's staying the same, and how med students should adjust their strategies. Then we're gonna distribute the results to med students for free.

In order to do so, it would be great to have a couple of 1:1 conversations with program directors beforehand so that we can make sure we're asking the right questions.

So if you know any program directors who'd be willing to chat with us for 15min this week to help shape the survey, please forward this email to them or put us in touch some other way. Thanks!!

Who we're following 

We're huge fans around here of what you might call "pluck"

Pluck /plək/ (Noun): Determination, persistence, spiritedness, courage, resilience, adaptability

Taking your problems head-on instead of waiting for someone else to come solve them shows a lot of pluck

And this week we were impressed with the pluck that one osteopathic med student demonstrated on Twitter in response to the scarcity of clinical rotation opportunities:

In this Tweet, Melissa Few (@MelissaFew) - an aspiring family physician - showed more than just pluck; she also demonstrated humor, humility, and a good bit of creativity to boot. This kind of well-designed, personalized, virtual "hand-raise" is an idea that a lot of other med students could benefit from, and it's definitely earned her a follow from us. Best of luck Melissa!

BBMD tip of the week

All these conversations with MS4s recently has reminded us of a core truth about the world in general and interviews + negotiations specifically that's easy to forget.

It's lonely at the top

Most of the MS4s we've talked to speak about program directors as if they're some all-powerful, gatekeeping Gods whose wrath makes them all but unapproachable.

And while those who seem to have the "power" in an exchange - whether because of a leadership position or an informational advantage or scarcity or social/political capital or any number of other reasons - are certainly in a privileged position and are often gatekeepers, they're also human. Which means:

  • They have fears and goals, just like you
  • They likely have someone in a position of power above them, just like you
  • They have informational gaps and uncertainty, just like you
  • They want to be empathized with and have positive interaction, just like you

They're powerful yes, but more times than not they actually want you to approach them - if you have something of value to offer.

In terms of their goals, people decisions are the most important decisions the majority of institutional leaders make. Hiring a great person can literally be everything to a program, and hiring the wrong person can be a catastrophe. Yet women will only apply for a job if they meet 100% of the requirements, while men will do so if they only meet 60%. Kanye West is running for president for God's sake. If you're a good fit for a role, you're doing them a favor by letting them know.

In terms of their fears, public-facing risks like a lawsuit or bad press are what keep institutional leaders up at night. So empathize with that, express how you can help minimize that risk for them, and all of a sudden you'll be a name rather than a number.

It's all about humanizing - humanize your counterpart and the organization they serve, and they in turn will humanize you (you can also humanize yourself in many ways, one of which is employing humor like in the Tweet we highlighted this week).

Do that, and in the minds of these leaders you'll go from:

"Potentially sufficient candidate 642"

to

"<INSERT YOUR NAME HERE> WHO WE JUST HAVE TO HAVE I DONT CARE ABOUT THE BUDGET JUST GIVE HER WHATEVER SHE ASKS FOR AND MAKE IT HAPPEN!"

We teach more specifics about this in the "Finishing School" portion of our curriculum:

Quote we're contemplating
 "Loneliness is the penalty of leadership" - Ernest Shackleton

 

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PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds June 27, 2020 - Where to focus your attention when there's so much coming at you (just say "NOP")

Posted by BossB, MD on June 27, 2020

First, a quick request

We're currently creating a resource to guide med students through the residency discernment and interview process, and we could really use your input to ensure that it's as helpful for them as possible. We only have a few quick questions:

  • What did you do that worked really well?
  • What do you wish you'd known or done that you didn't?
  • We design our solutions around the people who will use them - do you know any MS4s or early-stage residents that we should interview 1:1?
  • What else we should ask that we haven't?

If you'd prefer to take this as a survey instead of just responding to the email, you can do so here. Thanks!!

What we're reading

If you're anything like us, you're consuming a lot more news than you usually do.

And if you're consuming more news than usual lately, you're probably also noticing that the pace and emotional pitch of the news have gone up exponentially.

This creates a tension.

On the one hand, it's important to stay informed of what's happening - especially during times like these when EVERYTHING IS HAPPENING and it is all truly important and the stakes are high and there's real work to be done.

On the other hand, simply keeping up with the news has inadvertently plugged us into a 24hr cortisol drip - it's an exhausting effort that's been shown to cause increases in anxiety, depression, helplessness, stress, and pretty much everything else you don't want.

So we've got a devil's brew of high stakes, real-world consequences, infinite information to sort and process, rapid pace, and volatile emotions. 

You know what else shares those qualities? Negotiations. And luckily for us, the strategy for both is the same.

It's all about deciding where to direct your attention BEFORE you're in the mix.

Our "tip of the week"  will address that question when it comes to business conversations, but when it comes to your informational diet, the process is the same:

  • Narrow - Choose just 1 trusted general information/news source
  • Organize - Every input by a simple yes/no question: "is it actionable?"
    • If so, proceed the next step
    • If not, resolve to skim it quickly and move on
  • Perform or Plan
    • Perform - If it is actionable and takes <2min, just do it right then and there (for the news, this might mean sharing the article, signing a petition, etc)
    • If it is actionable but takes >2min, immediately plan a time for it on your calendar so that you'll (a) avoid it rattling around your mental to-do list, (b) avoid having it fall through the cracks, and (c) realize in the process that it's probably not as essential as you might have thought

We like shortcuts and acronyms around here, and this handy little one is easy to remember by thinking "just say NOP (Narrow, Organize, Perform or Plan)."

Which is the polar opposite of its close homonym and the default operating system of most this newsletters' readers, "just say Knope"

Who we're following 

If you're ready to narrow down your new sources, it can be difficult nowadays to find one that's high in data and low in opinion or spin. Our current favorite is Quartz (@qz), specifically the Quartz Daily Brief. The daily newsletter shines in our opinion because it is:

  • More impartial and data-driven than anything we've seen
  • More globally focused than most sources
  • Easily digestible in just a minute or two each morning

Their daily email generally opens with headlines from around the world, progresses on to curated summaries of that day's best thought/interest/opinion pieces (with links if you wanna dive deeper), and then ends with something fun or interactive. We love it - and they didn't even pay us to say that - so if you're currently looking for a news "home," we definitely recommend you check them out.

BBMD tip of the week

We've learned how to "just say NOP" to too many news sources, but how do we do so to the deluge of information and emotion that can so easily overwhelm us during a negotiation?

We're glad you asked.

  • Narrow - Your focus down to just your counterpart
    • We call this being "other-centered," and it's the place from whence all good comes in a negotiation because your counterpart is (a) the most important source of information in that moment and (b) the person you most need to influence in that moment to maximize your outcome
  • Organize - Every piece of information for its effect on 2 things:
    • Informational Advantage - Can this help you to gain a piece of pertinent information about your counterpart that your counterpart doesn't yet know about you (ie what they're willing to pay vs what you're willing to accept - you want to know their number first)?
    • Emotional Resonance - Can this help you increase the feeling of "vibing" with each other (ie can you use this piece of information to create a sense of promise, excitement, and mutual goodwill)?
  • Perform or Plan - Whether to dive down each rabbit hole as it presents itself
    • There are a lot of distracting thoughts that come up in consciousness during a negotiation, and most of us just dive into them immediately because we don't know better - so next time, take a moment to pause and actually decide whether something is worth exploring and will add value to the conversation; if not, just write it down so you can get it out of your head, note it as something to maybe come back to, and then return to step one by re-narrowing your focus back on your counterpart
Quote we're contemplating

“What is your heart worth?
What about your time?
What holds your heart, holds your attention.
What holds your attention, holds your time.
What holds your time, holds your life."

- Eric Overby

 
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PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds June 20, 2020 - Black joy, music, and Juneteenth

Posted by BossB, MD on June 20, 2020

What we're reading

Happy Juneteenth!

The holiday, which celebrates the emancipation of slaves in the US, has been celebrated more widely than usual this year - inviting black joy to share center stage in the nation's consciousness and headlines alongside the black suffering that's been in the spotlight these past few weeks.

And while that might feel full of tension or even downright contradictory, we're reminded of the wise words of Carl Jung:

"Only the paradox comes anywhere near to comprehending the fullness of life." 

Or, as this article in The Atlantic poignantly states:

"Despite the numerous ways to honor Juneteenth, one thing about the holiday endures throughout generations: the paradox of black people’s lived experiences. How could they at once celebrate freedom and acknowledge that the residue of slavery continues to influence their lives?"

So, while the work of education, advocacy, and anti-racism is far from over, black joy is what we'd like to amplify and give thanks for today.

Black joy, specifically as expressed in musical form, is one of America's greatest cultural gifts to the world, and it's made a huge impact in our lives personally. BBMD is run primarily by a husband/wife duo, and if our relationship had a soundtrack it would be comprised of at least 80% motown and soul - specifically Sam Cooke (seriously - Carlton actually sang Nothing Can Change This Love for Jess at their wedding). 

And while we're not really church-going folk ourselves, we created this gospel-adjacent playlist - which we listen to almost every Sunday morning - to help replace the sense of joy, transcendence, and gratefulness that worship music is so uniquely good at cultivating.

The playlist is short, features only a few artists, focuses primarily on gospel and hip-hop, and varies from songs that bring us to our knees to ones that make us wanna get up and dance. We hope that you enjoy it, and that it brings even half as much joy to your day as it does to ours :)

Who we're following 

Speaking of black joy & black music, today we're using this section to highlight LaShyra "Lash" Nolen (@LashNolen), who is, in her own words, "a jubilant young woman on a mission to fight injustice through healing and education." She's also:

  • The Harvard Med class of 2023 president
  • A Fulbright scholar
  • Got flows (i.e. can rap really well)

She's clearly on the path to do great things and make a massive positive impact - give her a follow if you haven't already so that you can watch and support her journey as it unfolds!

BBMD tip of the week

Above, we highlighted the power that worship music can have to cultivate states of awe, transcendence, and gratefulness.

However, music is a powerful tool across the board for affecting any state-change one might want - and as we've said before, state is the single most important thing you can focus on for interview & negotiation success.

So our tip of the week is simple. Make 2 playlists for yourself:

  • One to pump you up if you're feeling self-doubt or low energy - think upbeat, powerful drums and bright sounds, anything to get you into a confident, powerful, self-actualized state
  • One to calm down you if you're feeling anxious or jittery - think andante (walking-pace), soothing, not exactly put-you-to-sleep but something to make you feel centered and single-minded

And then USE THEM, depending on what you need, before going into your next meeting!

Quote we're contemplating

"I'm at war with my wrongs

I'm writin' 4 different songs
I never forged it or forfeited

I'm a force to be reconciled
They want 4 minute songs
You need a 4 hour praise dance

Performed every morn
I'm feeling shortness of breath

So Nico grab you a horn
Hit Jericho with the buzzer beater

To end the quarter
Watch brick and mortar fall

Like dripping water ugh!"

- Chance The Rapper

  ---
 
PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds June 13, 2020 - The difference between liberals and conservatives, and how you can use it in negotiations

Posted by BossB, MD on June 13, 2020

What we're reading

We really should re-name this section because of all the videos we feature here. This week's featured content is a TED talk about the moral roots of liberals and conservatives.

It would be well worth the 18 minutes to watch anytime, but it feels especially important in today's charged political environment. And don't worry, this way of looking at people's values carries HUGE insights for how to succeed in negotiations - we'll connect those dots for you in our "tip of the week."

The lecture in this video is built upon a foundation of research which shows that there are 5 foundational moral values:

  • Harm/care
  • Fairness/reciprocity
  • Ingroup/loyalty 
  • Authority/respect
  • Purity/sanctity

Liberals have a 2-channel morality that focuses almost exclusively on harm/care and fairness/reciprocity.

Conservatives, in contrast, have 5-channel morality that values all of them more equally.

 

Great! We can stop reading because we finally have a research-backed explanation for why "the other side" is the woooooorrrrssssst, amiright?!

Not so fast.

In the words of the TED talker himself:

"If our goal is to seek a deeper understanding of the world, our general lack of moral diversity here is going to make it harder, because when people all share values and morals, they become a team. And once you engage in the psychology of teams, it shuts down open-minded thinking."

This quote was an especially salient moment, because just before it he had established (a) that liberals are generally far more open-minded, and (b) that in the TED room where he was giving this talk, there were hundreds of liberals, a couple dozen libertarians, and only about 10 conservatives.

Which takes us back to the 5 values, specifically ingroup/loyalty:

  • We're prone to it - "Tribal psychology is so deeply pleasurable that even when we don't have tribes, we go ahead and make them because it's fun"
  • It's counter-productive to our goals - "You can't just go charging in saying 'you're wrong and I'm right' because everyone thinks they're right, and a lot of the problems we want to solve require us to change other people."

This idea of there being an "other side," of there being teams at all, is one of the biggest impediments to actually creating the change we want to see.

At the same time, there are real moral problems that need solving and real malicious, bad-faith actors in the world whom we need to oppose.

So what to do?

Step outside the moral matrix - even if for just a moment - to get a 30k-foot view.

How?

First, understand that liberals and conservatives essentially exist to form a balance with each other on change vs stability, and that they're both right:

  • "Liberals speak for the weak and oppressed, they want change and justice" 
  • "The great conservative insight is that order is really hard to achieve, it's really precious, and it's really easy to lose" 

We like to think of it in terms of an analogy: imagine that humanity is all in one big car, together.

Liberals are trying to drive to the destination - equity and justice and our species' highest calling ("the progressive march of history") - as quickly as possible.

Conservatives are trying to keep the car from flying off the road at high speed so that we actually make it in one piece.

Same destination, different roles.

 

According to the TED talk, now that we've established the necessarily dualistic nature of this eternal dance, we can take a cue from the great insight that most asian religions share with us:

Not only are the two sides necessary parts of the same system, but one cannot see that system in its wholeness unless one zooms out from their respective "side" and takes a proverbial "30,000-foot view."

 
 

And "seeing the system in its wholeness" is the first step to changing it, because it allows us to come back into the system and change the people therein.

Who we're following 

Today's featured "TED talker" is none other than Jonathan Haidt (@JonHaidt). Haidt is a social psychologist who studies morality and business ethics at the NYU Stern School of Business. His mission "is to use research on moral psychology to help people understand each other and to help important social institutions work better." He's authored a number of spectacular books (including our very favorite primer on positive psychology), and is just an all-around good faith public intellectual - a category of person that we could use a lot more of in today's world.

BBMD tip of the week

So what can all this research about value systems and talk of moral dualism teach us about negotiation?

A lot, as it turns out.

See, the foundational pillars of our negotiation system share a lot in common with Haidt's recommendations. For long-time readers of this newsletter, these ideas might feel like review, but it's mastery of the basics - as opposed to advanced technique - that separates a negotiation expert from a novice in any field, and negotiation is no exception. So, here are the basics:

  • Be Other-Centered: Try to think about the other person first - understand their goals and fears, frame things in terms of what's in it for them, and generally keep them in the center of your attention because as Haidt said, "a lot the problems we want to solve require us to change other people."
  • "Grow The Pie" > Zero-Sum: In a zero-sum game, there is a winner and a loser. However, in a dualistic system we're both fulfilling our necessarily contrasted roles in order to get to the same destination. And in such systems, a win for one the is palatable for the other is therefore balanced, making it a win for all. We like to use the analogy of growing the entire pie rather than focusing solely on the size of your slice.
  • Assume Best Intent (and Intelligence): Whenever you find yourself at odds with someone, ask yourself this simple question: "how could an intelligent and well-intended person come to this conclusion?" This will help you to paint your counterpart in the best light possible, thereby strengthening your counterpoint when you present it, and even more importantly avoiding defensiveness in them.

Develop these as habits of interpersonal interaction, and we guarantee that you will go a lot further and faster toward your destination that would otherwise be the case.

Quote we're contemplating

“If you think that moral reasoning is something we do to figure out the truth, you’ll be constantly frustrated by how foolish, biased, and illogical people become when they disagree with you.” - Jonathan Haidt

 
 
 
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PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds June 6, 2020

Posted by BossB, MD on June 6, 2020
June6

 

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Saturday Morning Rounds May 30, 2020 - Where does your time REALLY go?

Posted by BossB, MD on May 30, 2020

What we're reading

Productivity Skills to Help You Gain Time Back

We don't have to tell you that time is the scarcest of all our resources - being a woman physician is a masterclass in time scarcity and time management.

We also aren't here to give you more pithy "productivity-hacking" tips - the internet is full of those and if you really want our takes on which ones are actually useful, email us and we'd be happy to share some of our favorites.

What we do want to point out, however - and what this article does a great job of highlighting - is that not all tasks are created equal, and that we all should have SOME kind of system for determining which ones get (a) the best of our hours and (b) the most of our hours.

This article has a great graphic that offers such a system by breaking down tasks by their respective hourly values, going from $10/hr-$10,000/hr:

Now it's almost certain that your most important tasks are not the same as the ones in this graphic, so in our "tip of the week" section today, we'll give you some tools to recreate something like this for yourself that actually reflects your goals, values, and priorities.

Who we're following

America is hurting. And this particular pain is one that stems from a cancer that's been in our system since the founding of this nation - racial inequity.

When it comes to healing hurt, increasing empathy, cultivating a sense of shared humanity, and enhancing our understanding of the interplay between race and medicine - or even just race and everyday life - Dr. Kimberly D. Manning, MD (@gradydoctor) is by far our favorite follow on Twitter.

 

If you don't already read damn near everything she writes, you should. Here are a couple of recent examples as to why:

BBMD tip of the week

As we mentioned above, your most important (ie $1,000/hr and $10,000/hr) tasks are probably not the same as the sales & marketing tasks highlighted in this video.

Matter of fact, they probably fall into a number of different buckets, each replete with their own vast array of sub-buckets. So we're not going to try and give specific advice on how to maximize your effectiveness in any particular bucket - we're going to give you a tool to use on all of them to ensure that how your time gets spent aligns with your values, goals, and priorities.

And that simple, handy, and in our experience unbelievably impactful tool is called the Eisenhower Decision Matrix:

The core of this system's usefulness comes from the observation that urgent tasks tend to get the lion's share of our time because they make the most attentional "noise."
 
But most urgent tasks aren't actually important. And most important tasks are not at all urgent. And as a rule, almost all of us spend way too much time on urgent, non-important tasks, and way too little time on non-urgent, important tasks.
 
Sounds pithy and simple, yes - but that's exactly what makes it so useful for quick decision-making. If you want to combine it with the dollars per hour concept from today's reading and do a time/value alignment exercise, we recommend you block off 30-60 min and conduct the following steps:
  • List no more than 5 time buckets (ie self, family, work, volunteer efforts, friends)
    • Order them in terms of priority
  • Now create no more than 5 sub-buckets (or task types) for each of those original 5
    • These task types should be a blend of which ones you spend the most time on and which are most important (even if you don't spend time on them yet)
    • Assign each task type a dollar per hour value
    • Assign each task type a quadrant in the Eisenhower decision matrix
  • Then, track your time in 15min increments for a week
    • Many ways to do this but the easiest in our experience is to list all the tasks on paper or a note-taking app, set a silent alarm to vibrate every 15min as a reminder, and then just use tally marks to track the 15min increments spent
    • Compare how your time is actually spent with what the dollar values and importance levels you assigned the respective tasks at the beginning of the week

We've never had a client actually do this exercise without having some foundation-shifting realizations about where their time goes. Those realizations almost always result in monumentally positive changes.

We do this practice ourselves AT LEAST once a year and it's always incredibly illuminating.

Even if you're not ready to hop into this now, or if your current time expenditures look so different from your baseline that it doesn't seem worthwhile, we can't recommend strongly enough that you come back to this when you have a relatively "typical" week lined up and give it a try.

Quote we're contemplating

 "What gets measured, gets managed" - Peter Drucker

 
 
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PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds May 23, 2020 - What Michael Scott from The Office can teach us about negotiations

Posted by BossB, MD on May 23, 2020

What we're reading (or in this case, watching)

We've been ending most days lately by watching a quick episode of something comedic - nice way to finish on a light note, highly recommend it. The Office and Parks & Recreation comprise most of our rotation.

We were pleasantly surprised this week when, expecting some lighthearted entertainment, we actually stumbled upon a masterclass in negotiation tactics!

If you can read between the lines to get to the core motions of what's happening in this negotiation, there's a lot to learn. We'll break those lessons down for you in our "Tip of the week."

Quick aside - did you know Idris Elba guest starred in like 5 episodes of The Office?! 5th season, starting at episode 20. You're welcome.

Who we're following
Dr. Angela Duckworth, PhD ( @angeladuckw) is a researcher, author, teacher, Founder & CEO of The Character Lab ( @TheCharacterLab) and all-around badass + great human being. Her life's mission is to use science to help kids thrive, and in pursuit of that goal she's uncovered a number of truths about human nature and success that all of us can apply.
 
She's also got one of the most interesting, enriching, and just all-around uplifting Twitter feeds of anyone we follow. Here's an example - a gift her teenage made her for her birthday that both warmed our hearts and reminded us of some very important things that can be easy to lose sight of:
BBMD tip of the week
So in the clip we're breaking down this week, Michael Scott, the manager of a paper company, leaves that paper company to start his own competing paper company, and has a great deal of quick success, thereby putting his former employer in jeopardy.
 
The clip in question is the scene in which his former employers (specifically the CFO) negotiate to buy him back. Here are the motions:
  • Before the CFO can even present the first offer, Michael tells him to give him their second offer because he "never accepts the first offer"
    • We rarely give advice that has a "never" in it, but this it pretty solid (especially given that a significant portion of the gender pay gap can be attributed the fact that women are 8x less likely to ask for anything AT ALL in a negotiation than men are) - obviously don't actually say this the way he did though
  • The CFO's second offer is $12,000; Michael responds to this offer by focusing on emotion "are you kidding me - that is insultingly low" rather than the money itself
    • Where you focus during a negotiation is the single most important thing you can control, and the money itself is almost never the place you should be focusing - maximizing emotional resonance between you and your counterpart is one of the most important places to focus, and letting them know that they're jeopardizing that and breaking faith with their low-ball offer can be a great tactic
  • Next, the CFO tries to back Michael into a corner by pointing out that his fledgling business is a new company, that they can't keep operating at their current margins, and that they're probably scared - Michael flips this right back on him by pointing out that there's an investor meeting coming up at which the CFO will have to explain how Michael's departure has put the company's most profitable branch in the red, which will jeopardize the CFO's job, and that therefore Michael is really the one with time on his side
    • This is the singly most brilliant moment in the whole negotiation, when the tables actually turn and Michael realizes he can pretty much name his price - things are never about numbers themselves, they're about what the numbers mean to the individuals involved and to the organization itself
In   our curriculum, we call this "thinking like your boss." And it all boils down to understanding that no matter how seemingly important, every human has a role that you can orient toward, and no matter how seemingly powerful and well-run, every organization has a goal that you can orient toward:
Quote we're contemplating
Surprisingly effective:

“Whenever I’m about to do something, I think, ‘Would an idiot do that?’ And if they would, I do not do that thing.” – Dwight Schrute

 
  ---
 
PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds May 2, 2020 - How to lead (even if you don't have authority)

Posted by BossB, MD on May 2, 2020

What we're reading

Leadership and the One Minute Manager by Ken Blanchard

We don't have to tell you that women are massively underrepresented in medical leadership positions.

What we might need remind you of, however - what we all need to be reminded of on occasion - is that one doesn't need authority to be a leader. Leadership isn't about a title or decision-making power - it's about influencing others, preferably for the better.

Now scoot in close cause we're gonna let you in on a little secret. The authority and titles and decision-making powers that we all want to see more women in medicine hold? Well, they tend to find their way into the hands of those rare few who intentionally study and master the art of positively influencing others, of leadership - regardless of gender.

Which means (a) that you can always lead wherever you're at, (b) that there are a lot more things in your sphere of influence than you likely realize, and (c) that the path to authority and title and decision-making power is a predictable one that you can reliably speed your progress on, should you so choose. 

And this book - in our opinions one of the very best books on leadership ever written - is a great guide for how to do so.

Leadership and the One Minute Manager is:

  • Simple - Almost to the extent of being kitschy
  • Short - Only 134 pages of really large type w/lots of white space
  • Story-Based - It tells the story of a female entrepreneur learning about leadership through a series of interactions with a mentor

It is also, pound-for-pound, the most highly applicable, effective, and tactical leadership system we know of. And the essence of that applicability and effectiveness lies in what the authors call "Situational Leadership" - the idea that different people, different tasks, and different moments call for different leadership styles.

Here's the essence of what the book has to teach in a single image:

The essential argument here is that people have two components that drive how they engage with any task or role - competence and commitment.

And that leaders have two types of behaviors they can offer those they lead to improve how they engage with any task or role - directive behaviors and supportive behaviors.

Now this all might seem painfully simple, and that's because it is. Which is exactly why it's so effective - because you can use it in almost any situation, especially when you don't have a lot of bandwidth because emotions are running high.

Let's give it a spin real quick to show you what we mean. Think of a leadership interaction that you've seen go wrong, preferably one in which you were the leader. Really, get it in your head - envision it, transport yourself to that moment. Now, imagine that before the conversation the leader had diagnosed where those they were leading were at in their development level. Imagine that during the conversation the leader had shown some range and flexibility, meeting those being led where they were at, with what they needed in that moment to either understand the task better, to feel better about the relationship or their place in the organization, or both.

We'll bet that the scenario you just played out went a lot better than the original one did in real life, and that's why we love this book.

Who we're following

It's impossible for us to talk about women in medical leadership without giving a shoutout to the American Medical Women's Association (@AMWADoctors). The "about" section from their website says it better than we ever could:

"For nearly a century, the American Medical Women’s Association (AMWA) has been committed to the advancement of women in medicine. Although the number of women choosing careers in medicine has grown substantially, there has not been a commensurate increase in the percentage of women in senior leadership positions. To redress this situation, AMWA has carried out ambitious advocacy efforts including research, constituency building, mentoring, leadership development, and policy reform to enable environmental and institutional transformation."

AMWA is one of our most valued partner organizations, and we're actually currently running our personal finance and entrepreneurship webinar series with them! Become a member today and email us your confirmation if you'd like to be attend the final webinar of that 3-part series and get access to the recordings :)

BBMD tip of the week

It's easy to say that one can lead from wherever one is at today, regardless of title and authority. It's another thing entirely to believe it and to do so. 

That's what our tip of the week is about.

If you've been reading this newsletter for any amount of time, you'll know that we're fans of simple systems because they're more likely to work for you in the moment. And this is one of our favorite little ways of thinking about leadership.

Essentially, you can always lead. The way you do so depends on where you are in one of three contexts:

  • Leading from In Front: This is what we think of when we usually think of leadership - the one in the front of the room with the talking stick and the authority.
  • Leading from Beside: This is being a leader amongst one's peers and colleagues - sharing best practices, supporting each other, celebrating their wins, and actively seeking opportunities to add value.
  • Leading from Behind: This is what we like to call "managing up" - the way you lead those who are in authority above you, the art of being a good follower. Skills used in this context include supporting your leader's success, communicating well and often, trying to make them and the whole team look good, and the like.

Once we reframe "being a leader" as something we do at all times rather than some far-off goal that's hard and unlikely for us to attain, we become one, de facto.

And this little spatial framework is an easy mental shortcut to help us recognize and embody whatever the best version of our inner leader would be doing in any given situation, thereby believing even more that we are, in fact, leaders, thereby leading more effectively, and so on and so forth.

Now go ride that positive feedback loop all the way to the top of wherever it is you wanna go.

Quote we're contemplating

"Leadership is a series of behaviors rather than a role for heroes." -Margaret Wheatley

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PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds April 25, 2020 - Creating your own independent revenue streams

Posted by BossB, MD on May 2, 2020

What we're reading

"Everyone knows that timing is everything. But we don't know much about timing itself. Our lives are a never-ending stream of "when" decisions: when to start a business, schedule a class, get serious about a person. Yet we make those decisions based on intuition and guesswork.

Timing, it's often assumed, is an art. In When: The Scientific Secrets of Perfect Timing, Pink shows that timing is really a science.

Drawing on a rich trove of research from psychology, biology, and economics, Pink reveals how best to live, work, and succeed. How can we use the hidden patterns of the day to build the ideal schedule? Why do certain breaks dramatically improve student test scores? How can we turn a stumbling beginning into a fresh start? Why should we avoid going to the hospital in the afternoon? Why is singing in time with other people as good for you as exercise? And what is the ideal time to quit a job, switch careers, or get married?"

While the entire book is spectacular and definitely worth a full read, that "switch careers" bit at the end of the description is especially interesting to us. 

A majority of our clients first come to us at a crossroads. "Should I stay or should I go" is sometimes the question they're asking - but more often than not, it's "how can I <increase my salary/fix this professional relationship/get promoted>?" and we have to answer that question with another one: "do you even want to?"

In When, Pink includes a "Time Hacker's Handbook" at the end of each chapter to help us put theory into action. And he concludes his chapter on Endings with a succinct guide about when to quit a job. If you answer no to two or more of these questions, it might be time to start planning an exit:

  • Do you want to be in this job on your next work anniversary?
  • Is your current job both demanding and in your control?
  • Does your boss allow you to do your best work?
  • Are you outside of your three-to-five year salary bump window?
    • We would rephrase this to ask, "are the tangibles of this job providing what you want, and if not what are the odds that they ever could?"
  • Does your daily work align with your long-term goals?

If you're feeling a little unsettled by your answers to those questions, don't worry. We offer free 30min intro calls designed to provide some clarity and next steps for exactly those kinds of situations, and we're going to go over some options that are a little more creative than "give two weeks' notice" in today's tip of the week.

Who we're following

For those who've been reading these newsletters for a while, it will come as no surprise that we're huge fans of Pink (@DanielPink).

He's got that rare combination that so many non-fiction topics beg for - the communication and storytelling prowess of a world-class writer, blended with the incisive, data-driven perspective of someone who's spent an entire career trying to separate signal from noise. His ability to communicate primary research to a lay population is world-class, and his Twitter feed is a reflection of that.

That's why we've featured his work before, it's why Carlton uses his books as required reading for 2 of the business classes he teaches, and why we're recommending you give him a follow!

BBMD tip of the week

It's a sad truth that regardless of how you answered Pink's "should you leave your job" questions, in the near-term you're not likely in a position to actually do anything about it.

That's because most of us are beholden. To debt. To a lifestyle. To showing up at a specific time and place to make money so that the wheels don't fall off of whatever life we've built for ourselves.

This week's "tip" is all about how to break free of those shackles that bind, or at least to begin the process of loosening them.

And we've got good news! We're going to do so not by becoming a miser, or living with less, or faking your death and escaping to an island nation that doesn't extradite because you can't bankrupt out of student loans in the USA (not like we've ever thought of that or anything, of course).

No, we'll do it by creating new, independent revenue streams for ourselves so that we have OPTIONS.

Last week, we asked you to take the 10 business ideas you'd generated the week prior, and then score and sort them based on the following qualities:

  • Monetary investment to establish and maintain (think of this as a reverse-coded question - 0 for a high monetary investment because that's bad, 10 for a low monetary investment because that's good)
  • Time investment to establish and maintain (again - 0 for high, 10 for low)
  • How much the idea capitalizes upon YOUR UNIQUE gifts/talents/skills/assets (0 for not at all, 10 for completely)

Now that you've done that, it's time to put your list into action!

And to do so, we're gonna transition out of our heads and into our guts, away from our numbers and toward our intuition, and most importantly out of our own experience and into that of our potential customers (all businesses have a customer, after all).

So, here's what we want you to do:

  • Pick whichever idea from the top 3 in your list has the most energy/draw/attraction/excitement for you - Trust your gut, your intuition in this step
  • Commit to trying to make at least $1 off that idea in the next month - It's even easier than it sounds, but also one of the most fundamentally gratifying and exciting and encouraging things most entrepreneurs ever do; presales are your friend ;)
  • Create a crystal-clear (first draft) vision of your perfect customer
    1. Read this short essay
    2. Watch this 2min video on customer personas 
    3. Watch this 3min video on the customer adoption curve and try to think about who your "innovators" and "early adopters" will be
    4. Brainstorm about the demographics, psychographics, motivators - and really anything else you'd find interesting or helpful (preferred brands, favorite color, favorite season, etc) - of your perfect customer, then edit and crystallize it into something that's easily digestible and memorable for you
    5. Give the customer a name (extra points for alliteration ie "Soccer Sarah", extra points for attaching an image)

And now you've got a better start than most successful businesses out in the world today even had! 

There's a lot more to this entrepreneurship/side-hustle/multiple-revenue-stream game than we could fit into even months' worth of newsletters, and we don't wanna bore you if this isn't up your alley. So, if you ARE interested in learning more about the topic, please fill out this super-quick survey or reply to this email to let us know!

Quote we're contemplating

 "Know what your customers want most and what your company does best. Focus on where those two meet." - Kevin Stirtz

 
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PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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Saturday Morning Rounds April 18, 2020 - How to spot a millionaire, and what that teaches you about how to become one

Posted by BossB, MD on April 18, 2020

What we're reading

The senior partners in Jess' practice gifted this book to her when she first joined - a tradition they uphold with any physician who becomes a part of their team. And there's a great reason why.

This book isn't just considered canon in the world of personal finance, it's a cornerstone. Its authors are two business professors who spent years interviewing as many millionaires as they could to learn what path each took to reach the point of $1M+ ($3.7M, on average) in net worth.

The results were anything but intuitive. 

They found that the actual average American millionaire is probably a lot different from what most peoples' image of a "millionaire" might look like. For example, the average millionaire:

  • Didn't receive an inheritance
  • Never went to a private school (but does have a college education)
  • Lives in a middle-class area, has lived in the same house for 20+ years
  • Drives an old, used vehicle
  • Invests 20%+ of their pre-tax income

This book is especially valuable to Jess' practice and this newsletter's readers because it includes a number of cautionary tales about physicians and how common it is for them to NOT end up in the "millionaire" group - despite incomes that should be almost guaranteed to land them there (and yes we're factoring student loan debt into that statement).

Wealth accumulation is really quite simple at its core, and it's driven by an equation that we went over last week.

But we don't want you to get the idea that delayed gratification and miserly frugality are the only way to get there. Just that every dollar you spend should be driven by a series of intentional, clear-eyed choices based on a system you create before you spend that dollar.

The bad news is that you don't get to write the rules of wealth accumulation. They are what they are, and this book is one of the shortest, most effective ways to learn them.

The good news is that you do get to create a system that reflects your priorities and values - and the webinar series we're almost done creating is designed to be one of the shortest, most effective ways to help you do so.

Who we're following

Dr. Carrie Reynolds, MD (@HipHustlePod) is, in her own words, a "Peds GI doc by day and podcaster and side-hustler by night." She's the "founder and producer of the Hippocratic Hustle Podcast- a podcast for women physicians," and she also just happens to be one of our favorite contributors to the physician finance space. If you're interested in all this stuff, we strongly recommend giving her a follow!

BBMD tip of the week

Remember those 10 ideas for how you could increase your income (or better yet add entirely new sources of income) that we asked you to come up with last week?

Well this week, we're going to put some meat on their bones!

Pull out your list, and give each one of those ideas it own 0-10 scores in the following 3 categories:

  • Monetary investment to establish and maintain (think of this as a reverse-coded question - 0 for a high monetary investment because that's bad, 10 for a low monetary investment because that's good)
  • Time investment to establish and maintain (again - 0 for high, 10 for low)
  • How much the idea capitalizes upon YOUR UNIQUE gifts/talents/skills/assets (0 for not at all, 10 for completely)

Next, calculate the blended average for each idea and re-order the list based on that score, highest to lowest.

Then, if you feel like it, email them to us for some free feedback!

Lastly, make sure you read next week's newsletter, in which we'll share how you can put this newly prioritized list of ideas into action.

Quote we're contemplating

“Money should never change one’s values…. Making money is only a report card. It’s a way to tell how you’re doing.” - Thomas Stanley, PhD (author of The Millionaire Next Door) 

 
 
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PS - If you were forwarded this email and enjoyed it, subscribe here to make sure you don't miss out on future ones!
 
PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to  @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!
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