BossB, MD

BossB, MD

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Saturday Morning Rounds August 1, 2020 - President Obama's eulogoy for Rep. John Lewis, and what it can teach you about influencing others

Posted by BossB, MD on August 1, 2020

Saturday Morning Rounds

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

What got our attention

President Obama's eulogy for Rep. John Lewis

The speech is ~40min, but well worth the listen regardless of which side of the aisle you inhabit. Plus, President Obama is just about the only speaker that you can listen to at 1.5x without missing anything.

More on that, and a few other things you can glean from this speech to make yourself more effective at influencing others, in our "tip of the week" below.

Who we're following 

They say it takes a village to raise a child

They also say that writing is an act of creation, a "labor of love"

So if what "they say" is true, does that make President Obama's former speechwriter, Jon Favreau (@jonfavs) an OB/midwife/doula?

We're not sure, but we do know that his Twitter feed delivers (see what we did there??) a consistently interesting and thoughtful perspective.

BBMD tip of the week

There's a lot that can be learned from President Obama's speech, but we're going to highlight 3 skills today that he modeled especially well.


We made a joke about how you can listen to Obama at 1.5x and still absorb everything, and we're not the only ones - SNL, every comedy news show, and every White House Correspondent's Dinner act during his administration made a lot of much better jokes about his speaking cadence over the years.

It's unique and sometimes funny, yes, but it also works. And it's something we practice A LOT with out clients.

See, it's often the case that when we slow down our speech or let a silence hang for a beat, we feel awkward. We worry we might seem like we don't know what we're talking about. We worry like might seem weak or unsure of ourselves.

Most of us are incredibly uncomfortable with silence - especially silence while discussing an already-uncomfortable topic - which happens often during business conversations.

So we talk fast, we use vocalized pauses ("um, like, ya know"), and we hamstring ourselves by undercutting the strength of whatever we said before the silence with a bunch of qualifiers to make others feel more comfortable.

Not any more.

We offer a reframe - silence is not a sign that you're weak or don't know what to say, it's a sign that you're thoughtful and worth listening to. It's a sign that your word means something, that you're a serious person, and that you respect your counterpart's time and attention, and expect the same in return.

Once you can think of a silence like that, you can use those pauses to command a conversation the way a conductor commands an orchestra. You can hang in the balance and take a moment to be intentional with what you want to say next. And you can be pleasantly surprised by what your counterpart will concede just in order to break the silence that's made them uncomfortable, but that you can sit with.

As always, practice makes perfect.

Write out a script for some kind of business conversation - any kind will do, but the more uncomfortable or potentially confrontational the better - and then practice it in a mirror. Time your first attempt as you would usually speak it, then try as hard as you can on your second go-round to take at least 150-200% that amount of time to say the same words. You'll blow yourself away with how much more expressive you can be and how much more worthy of being taken seriously you'll sound.

Be Other-Centered

We talk about this concept a lot, and for good reason. 

It's no secret that President Obama is a Democrat, and the Democratic party is well-known to be more secular and specifically to advocate more strongly for the separation of church and state than Republicans. This is an important core value in the Democratic party. However, here are a few pull quotes from Obama's speech:

"James wrote to the believers..."

"Like John the Baptist preparing the way, like those Old Testament prophets speaking truth to kings..."

"As The Lord instructed Paul..."

Obama probably wouldn't have said those things if he was giving a speech in most other contexts - he almost certainly would have actively avoided them if he was speaking in front of, say, the ACLU.

But during this speech, he was in a church. So, he made an active attempt to be other-centered. Obama read the room and spoke to his audience.

And so should you.

To provide a more applicable example, we just had a call yesterday with a client who's been passed up for consideration to become a partner in her private orthopedic practice after two years of employment with them. Their bullshit excuse is that COVID has made money tight - really, they probably just wanna profit off her efforts for another year.

So, how can you speak to your audience and be other-centered in such a situation? Well, Orthopedics is a male-dominated field well-known for being the "jocks of medicine," so we asked if that was true of her counterparts and she said yes. 

This lead to us building a strategy together that hinged on an analogy - we named it the "put me in coach" approach. 

We'll spare you the details of the analogy other than to say that the idea is for her to frame this to them as the feeling of being passed up for varsity your junior year but not knowing why.

Such an analogy works because it:

  • Connects  to a context that's meaningful to her counterpart
  • Humanizes her by highlighting the pain and unfairness she's feeling in a way they can empathize with
  • Humanizes them as coaches who have to make a tough call, thus avoiding the shame/blame/defensiveness game just enough to make space for a productive conversation

Never pass up an opportunity to maximize connection with your audience.

Reject Zero-Sum Frames

One of our favorite quotes from the speech was:

"We don't have to choose between protest and politics - it's not an either-or situation, it's a both-and situation"

So many conversations hit a stalemate because someone frames things as zero-sum, as win-lose. That's an "either-or" construction, and it's almost always a logical fallacy and a trap (often an unintentional one - just a reflection of that person's fear/scarcity/deficit mindset).

This often takes the form of "squabbling" over how big of a "slice of the pie" each party gets.

Instead, we always always always want to focus on growing the whole pie for everyone. That's a "both-and" mindset - it's also the reality of any productive business relationship, a great way to get on the same side of the table/on the same team as your counterpart, and the best quickest most effective shortcut to maximizing your outcome in a negotiation.

Quote we're contemplating
"We are hard-pressed on every side, but not crushed
Perplexed, but not in despair
Persecuted, but not abandoned
Struck down, but not destroyed"
- 2 Corinthians 4:8-9 (also, President Obama)
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 July 25, 2020 - How medicine became the stealth family-friendly profession, and how to make it moreso by negotiating better parental leave; also, #MedBikini

Posted by BossB, MD on July 25, 2020

Saturday Morning Rounds

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

What got our attention

How Medicine Became the Stealth Family-Friendly Profession by Claire Cain Miller in the NYT Upshot.

This article captures the current-state of work-life integration for women physicians better than any other we've read - and we've read a lot.

The title, we'll admit, is deceptively cheery when compared with the reality that many women physicians face today. However, the author does a good job of balancing her celebration of the wins that have been tallied to-date with her coverage of the structural imbalances that still need to be addressed.

Overall, it's a pretty short read that's densely packed with good information - we highly recommend you scan it fully for yourself. Some of the main themes touched upon are:

  • The importance of flexible, predictable hours for shrinking gender pay gaps (this applies to all professions, not just medicine)
  • The transition from small private practice to large group practice or hospital employment as the driving force for this change, a "happy consequence" of which being more flexible arrangements for women physicians
    • There are a lot of downsides to this as well, which are not addressed in this article and which make many of the more lucrative work arrangements in medicine more punishing toward women than they are toward men even if their family planning decisions are the same. The biggest example of this is in how a lack of equitable parental leave policies financially punishes women physicians and hurts families by forcing male physicians to go back to work sooner than would usually be optimal after the birth of a child - we will cover this more thoroughly in our "Tip of the week"
  • Women & work hours
    • "Female doctors are paid 67 percent of what men are, but much of the gap is because they work less. After considering their hours, their specialty and the years they’ve been doctors, the gap shrinks to 82 percent"
    • "There’s a downside when women cluster in certain specialties: In general, when a field becomes female-dominated, its pay and prestige drops"
    • "One possibility — which could help alleviate this problem — is that more men will also choose less time-intensive specialties and ask for predictable hours. There’s evidence that’s happening. This year, 80 percent of male medical school graduates said work-life balance had a strong or moderate influence on their choice of specialty (up from 70 percent a decade ago, when the question was first asked)"

Who we're following 

Less of a who, and more of a what, this week - and that what is the trending #MedBikini controversy

Long story short, the Journal of Vascular Surgery published a "study" in which 3 male researchers created fake social media accounts, searched the Vascular Society's database to find member physicians on social media, and then shamed physicians they deemed to be "unprofessional" for wearing a bikini or holding a beer in their personal social media profiles.

Same bullshit, different day.

Med Twitter recently discovered the article, and the outpouring of rage + swimwear photos that has become #MedBikini has successfully gotten the journal to retract the article and publish a formal apology. Good on y'all for showing that being a doctor and being a human aren't mutually exclusive.

That being said, we have a responsibility as your de facto career consultants to point out that a lot of organizations do informal social media reviews like this without publishing them, and while we look forward to the day when such social media posts don't disproportionately punish women, that day has not yet come. We're not gonna preach to you about what's professional or unprofessional or make any specific recommendations, but we will encourage you to (a) intentionally draw that line for yourself and (b) generally err on the side of caution.

BBMD tip of the week

Parental leave, the gender gap, race and intersectionality, politics - all of these topics share a common theme: they're very charged.

What do we mean when we say a topic is charged?

  • Opinions about charged topics are often strong and entrenched
  • Emotions about charged topics often run high
  • Discourse on charged topics tends to quickly escalate or quickly shut down

But more importantly, what do we DO when a topic is charged?

The first question we should ask ourselves is whether it's worth the fight in the first place. If you (a) can't change the outcome and (b) aren't likely to change an opinion, yelling into an echo chamber or at an unreceptive counterpart is only likely to make things worse.

However, there are many topics - parental leave being one of the most important among them - that we can't afford to ignore.

So how do we wade into this dangerous territory in a way that's productive? The key is to:

  • Avoid defensiveness at all costs - in both yourself and your counterpart
  • Humanize, humanize, humanize - again, both yourself and your counterpart

Defensiveness is the single most counterproductive emotion in any exchange, and becoming sensitive to it in both yourself and others is a communication superpower.

Humanizing your counterpart and yourself is like putting guardrails on the conversation that keep it on the road and headed in a productive direction. It increases empathy and puts everyone's focus on solving the problem at hand rather than "winning" a fight against an opponent.

What can you tactically do to avoid defensiveness and increase humanization (I think we made that word up)? Ask yourself a simple question:

  • "How could a well-intended and intelligent person come to that conclusion?"

We talk a lot in our curriculum about how important it is to assume best intent - it provides the clearest path forward and maximizes the emotional resonance of your interactions.

In this case we also add the assumption of intelligence because it helps us to more effectively see things from our counterpart's perspective and to understand their priorities. Doing so greatly increases our chances of actually changing their position.

In the specific area of parental leave and career perceptions, one great way to do this would be to actually have an open conversation with the decision-maker(s) at your institution about the topic. Transparent conversations about charged topics can be incredibly effective if you follow this outline:

  • Start on the Right Foot - It's key to start the conversation with something like "I know that you are dedicated to creating an equitable workplace and that the studies I'm about to show you don't reflect the kind of institution you want to run." We call this tactic "preemptively saving face" for your counterpart - it avoids defensiveness and gives them an occasion to rise to; a positive vision of themselves to live up to.
  • Express Your Concern - Proceed to lay out your argument in clear terms, preferably with data to back it up. Share the article above, print out a study about the gender gap, tell an anecdote about what happened to a friend. Then make it personal by again reiterating that "I know this institution would never intentionally do something like that, but I'm still concerned about becoming one of those statistics."
  • Create Space for Them - After you drop a line like the one above, STOP TALKING. Let them squirm in silence for a few seconds. You'll be amazed at the kinds of commitments people will make to avoid a little interpersonal discomfort. And even if they don't commit to fixing the problem in that moment, you'll gain an informational advantage over your counterpart if you outline the problem in clear terms but then let them start to talk about solutions. There's usually very little to lose and a lot to gain by "not going first" in a negotiation.

The above method might not solve the gender gap overnight, but we've seen it change entire institutions' policies more quickly than any legislative action ever dreamed.

As an example, one of our clients works for a very large, well-known academic institution on the east coast. With our help, she negotiated an increase from 6wks of unpaid to 12wks of paid maternity leave. A year later she called to let us know that the mere existence of her contract had catalyzed an institution-wide policy change to match everyone's parental leave offer to hers - not just on the medical side of things but throughout the whole university!

Change comes most often from inside an organization itself, and you can be the most powerful force to make it happen for both yourself and others.

Quote we're contemplating
 "When you learn to see the world as it is, and not as you want it to be, everything changes." - Shane Parrish


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 July 18, 2020 - How to help MS4s during COVID & talking about money during your interview

Posted by BossB, MD on July 18, 2020

Saturday Morning Rounds

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

What got our attention

As we mentioned last week, a lot of our time and attention right now is being directed toward helping MS4s with the residency interview and match process - particularly helping them to know how they should adjust their approach in light of COVID-19.

To do so, we've created a quick (<5min) survey for program directors that will help to provide some clarity around:

  • What changes programs are making in their process because of COVID-19
  • What's staying the same
  • How med students should adjust their approach this year

If you're a program director, PLEASE take this survey. If you know a program director, PLEASE forward this to them.

Every medical student we've spoken to feels incredibly uncertain and "in the dark" about what to expect this year. If we can get enough responses to this survey to actually provide some clarity, it will make a huge difference.

Obviously, we will make whatever results we receive from this available to anyone who wants to see them, free of charge. We will also scrub the responses of any identifiable information so as to protect the privacy of respondents and their programs.

Who we're following 

One of our favorite Tweeps, Dr. Kemi Doll, MD MS (@KemiDoll) JUST GOT PUBLISHED IN THE NEJM 🙌👏🎉

What's more, the paper - "Structural Solutions for the Rarest of the Rare — Underrepresented-Minority Faculty in Medical Subspecialties":

  • Got desk rejected twice before being accepted
  • Strikes a perfect balance between telling a powerful story and providing concrete recommendations for action
  • Was written & accepted in December before this issue got a lot of the attention it currently has

Dr. Doll has been on a helluva roll lately, and if you're not following her yet, you should be.

BBMD tip of the week

We had a call with a client this week who is about to interview for partner in her private practice. She's been employed by them over the last 2 years, and during that period she has:
  • Built her practice up from nothing with very little support
  • Made them 2x more money than they paid her
If your jaw is not currently on the floor from reading that last point, it should be.
One of the biggest red flags we highlight in   our curriculum  is if a private practice won't show you their books. This creates an incredibly lopsided power dynamic, takes away your ability to build a profitable practice, and most importantly hides from you the essential knowledge of whether they're running a solvent business.
And if you're in academics or are hospital-employed and thinking this doesn't apply to you, think again.
You don't need to self-teach an MBA curriculum overnight, but you should always understand the basics of how your employer makes money, how you'll fit into that equation, and what you can do to ensure that you're getting a piece of any profit you generate. Here are a few tips on how to do so:
  • Private Practice - During the interview and well before you even consider an offer, ask to "see the books" and have their accountant + business manager walk you through everything thoroughly (esp % of revenue that goes to overhead and how overhead is distributed)
  • Hospital/Academic - During the interview and well before you even consider an offer, ask "how does this institution make money?" - spend time with the administrators to fully understand where funding comes from and how you as an individual physician will engage with that system
  • Ask, "if I generate a profit for the institution, where does that money go?" - there should be some financial incentive for you to do so and this is often a place where you can negotiate some huge pay increases for yourself because it's a no-risk situation for the institution (they're already in the green) 
Quote we're contemplating
“Money is the opposite of the weather. Nobody talks about it, but everybody does something about it.” – Rebecca Johnson


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 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"



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


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 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

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.


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

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


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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

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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