107. Physician Leadership Job #1 - STOP Solving Problems, do THIS Instead

In this episode, I'm going to show you the single most misused word in the physician leadership lexicon. This is true for all leaders, not just doctors. Every time you hear this word, it's wrong — maybe one time out of 100 when you call something a problem, it's actually a problem. But the key is that in order to be a good leader, you actually have to stop using the word "problem," stop trying to solve problems, because 99% of the time what you're facing isn't a problem in the first place. I'm going to show you how to identify the real underlying issue and quickly organize your team around addressing things effectively. It all starts when you stop solving problems. Check it out.

Hello and welcome to the latest episode of the Stop Physician Burnout podcast, a physician leadership podcast where you will learn the skills so that we can join together and lead the charge to physician well-being, skills to earn the respect of your colleagues on the frontline, skills to exercise true influence in the C-suite, and take back your job, your practice, your career, and your life. All of these tools have been proven effective in my 40,000-doctor physician coaching and training practice. And if I know one thing, I know you're super busy. So let's get started.

Now, this isn't even specifically for physician leaders. It's for anybody in a leadership position. Ninety-nine times out of 100 when you use the word "problem," it's inappropriate — not because you don't face challenges, not because there aren't things that you need to address, but because the use of the word "problem" is inappropriate, as what you're facing doesn't meet the definition criteria of the word. The word "problem" comes from mathematics. It's actually quite specific. By definition, a problem has a solution, and if I apply a solution to a problem, what should happen to the problem? It should go away. Problems are things that are fixed in a single step. You apply the solution, and the problem goes away.

The challenge is, as a leader, you never see problems. This word is a form of magical thinking on the part of leaders. They see a challenge, hope that you can just do one thing and fix it, and pray that it's a problem. They call it a problem and ask you to find a solution, which is never, ever going to work. Let me give you just a quick example. How about physician burnout? That's a real problem, isn't it? No, it's not. It doesn't meet the definition criteria. Let's think about it for just a little bit. Physician burnout is an issue that all healthcare delivery organizations have to face.

However, is it a problem? Is there one thing you can do one time, and you never have to worry about burnout again? Just think about it for a second. Do you think hiding somewhere we haven't found yet because it's in a secret layer, like Austin Powers' lair, there's this one thing you can do one time inside your organization, and you'll never have to worry about physician burnout again because you've solved it? Do you think that's true? Of course not. That's because physician burnout isn't a problem. What it is, is a dilemma.

Problem. Dilemma. Problem's the wrong word. Dilemma is the right word. And when I say "dilemma," what I mean is a never-ending balancing act. In this case, it's a lot like a teeter-totter.

On one end is the amount of energy an individual doctor burns in their practice and their larger life, and on the other end is their ability to recharge the energy they burn in order to maintain a positive energy balance in all three of their energetic bank accounts. This balancing act is something that you can manage. You can strike a balance and keep your energy positive, but it's not with a solution. You have to use a different "S" word. Got it yet? The word is "strategy," right? Strategy. And what's the difference between a solution and a strategy? Well, think about it for a second. It's actually extremely simple. The difference between solution and strategy is simply the number of steps. Solution is one; strategy is more than one.

When I'm working with a burned-out doctor as a coach, and we help them recover from their burnout, typically, they will take three to five new actions. They have to be new actions if you want to get new results, and they'll turn them into habits. Those new habits will help them hold a positive energy level and help them recover from physician burnout. Now that you understand the difference between a problem and a dilemma, just notice that dilemmas are everywhere, but we almost always call them problems. How about this: your personal physical fitness. Now you might say to me, that's a real problem. Is it? Is there one thing you can do one time, and you never have to worry about being fit again? Well, that's just crazy talk. How about your net worth? Problem or dilemma? It's a dilemma. You need a strategy. You have to put several things together in order to address it successfully.

In any leadership position, but especially as a physician leader in healthcare, you never see a problem. Why? Because the problems get fixed on the way to your desk. If it had a solution, it would have been applied a long time ago. Every single thing on the agenda of your next leadership meeting, I guarantee you, is a dilemma, and the team is being called out for a solution because the leader is misnaming the issue you're facing as a problem.

See, "problem-solution" is a trap. If I keep calling something a problem, and I say, "Dike, we need some solutions here; you've got to be a solution guy for me," I trap people in an impossible set of circumstances. And if you have things on the agenda, month after month, year after year, that you keep calling problems but can't solve, two things will happen. People will start to doubt your ability to lead effectively, and they will start to doubt their own abilities.

So here's the mantra: any problem you can't solve is not a problem. Think of anything that's persisted, that's been an issue for you in your personal life or for your teams at work. Any problem you can't solve is not a problem. What is it? It's a dilemma. And here's the way you get your team to focus on strategy. It goes like this: let's say that the issue we're talking about is staffing — getting the right amount of staff in the right slots to make sure all the positions are covered in the coming month. It's an ongoing issue that you've been calling a problem. Wrong. There's not one thing you can do one time and take care of staffing forever.

So next time you're with your team, say, "Hey team, you know what? I've been doing some education. I just realized one of the problems that we're having — one of the challenges that we're having — is that we're trying to solve the staffing issue, and it's not a problem. It hasn't got a solution. It's actually a balancing act. Getting the people and the slots matched effectively every month is a balancing act. So rather than try and do one thing one time and fix it, which is impossible, let's get some ideas on the table about what are one, two, or three tactics we can string together into a strategy, so we make sure all the slots are filled every month. What are some ideas?"

What you'll notice is when you identify a dilemma, eliminate the thought of a solution and switch to multiple steps — several steps, just three to five — get your team focused in that fashion, what will happen is they'll quickly come up with a really usable strategy for you.

In my experience, 99 times out of 100, effective leadership is not solving problems, simply because the issues you face are not problems, especially in healthcare. As a matter of fact, you know the cover sheet on a chart? The cover sheet on a chart is called a what list? It's called a problem list. I'll tell you that on a patient's problem list, there are no problems. Example: a person comes in with a boil, and I fix the boil — that was a problem, and I solved it. Would you put "boil" on their problem list? Yes or no? The answer is no. The reason you don't is because you were able to solve it in one visit. The reason you don't put it on the problem list is because it was a problem. Are you seeing this?

What is on the patient's problem list? All the things you can't solve. So even the problem list isn't a list of problems; it's a list of dilemmas.

So let's review. Any problem you can't solve is not a problem; it's a dilemma. Focus your own actions and your team's on strategy — two to three to four simple tactics that will allow you to reach the balance point that you're seeking — and watch how everything gets so much easier.

This Stop Physician Burnout podcast is just 10 minutes on Tuesdays and Fridays, giving you useful tools just like this. If you've enjoyed this lesson, please go out and find the dilemmas your team is dealing with and focus them on strategy. And go ahead and subscribe to this podcast wherever you get your podcasts. Until the next episode, keep breathing and have a great rest of your day.