Peak Performers & the Vertical Learning Curve

One of the hallmarks of peak performers is that they are acelerated learners.  They reframe what others might label as mistakes or failures as "learning opportunities".  They are constantly and voraciously learning. 

Most of us arrive in medical school because we ARE peak performers.  Being a peak performer is the price of entry. But something seems to happen between the end of school/training and mid life.  I'm not sure whether we get tired of learning or we just get so busy that its easier to fall back on what we already know, or perhaps there's so much learning to do to keep up with advances in clinical medicine that we sometimes feel maxed out and just give up.

Regardless of the reason, as an industry, we are now paying a heavy price - specifically in our unwillingness to learn to use technology.  And until we buck up and embrace technology, we will continue to pay. 

The American College of Physician Executives (ACPE) did a survey last year on physicians and technology.  Read the article entitled Survey Reveals Physicians' Love Hate Relationship with Technology by David O. Weber from The Physician Executive, March-April 2004 pp. 4-10.  The results are enlightening and I highly recommend it.

There's an excellent article in the latest edition (March-April 2005 p.40) of The Physician Executive entitled Professionalism in Medicine:  The New Authority by Dr. Anthony Oliva.  This article, published exactly one year after the article above points out how physicians are losing ground as a result of our slow adoption of technology.

Oliva starts off by describing how the medical profession struggled to create and confer professsional authority over a period of many years.  But now our authority is being quickly eroded by forces in the marketplace like consumerism, performance information (now dissimenated electronically in the form of "best doctor lists") and marketing by pharmaceutical companies and other entities.

Oliva stresses the importance of physicians taking a leadership role in securing our professional authority for the next generation of healthcare practitioners rather than allowing the marketplace to usurp it.

Barriers to our success (roughly paraphrased from the article) are:

1. We have failed to set our own standards (allowing the marketplace to set them for us).
2. We lack the technology infrastructure to document and evaluate performance.
3. We do not have the systems in place to hold ourselves accountable.
4. We have not even begun to allow for the transparency needed to create the cultural shift.

We must, as a profession embrace technology - but even more basic still, I think we should be looking deeper for what might potentially be an even greater problem.  Even though our young physicians are graduating with great savvy in technology, will there just be some other disruptive phenomenon that comes along when these physicians are in mid-life?  Will they be as resistant to change as we physicians in mid-life are now?

Because acelerated learning is so critical to the success of peak performers, if physicians are to thrive as peak performers now and in the future, perhaps we should be teaching young physicians not just how to use technology (which in my mind is just content), rather we should be teaching them how to learn.

Comments

[Jane Thilo, MD, MS]

Thanks for your comment Erin. I agree that Emotional Intelligence (EI) is an underlying factor here. Self-confidence is one of the competencies under the EI domain of Self-Awareness. The other two competencies are Emotional Awareness and Accurate Self-Assessment.

Learning requires that I be willing to try new things even at the risk of making a mistake, not doing it perfectly or even "failing." In medical school students learn that it's not cool to make a mistake lest they be judged negatively and all too often, when they do, they are put on the spot (see my earlier post Still Pimping...). Eventually they lose some of the self-confidence required for learning.

Being fair to docs, we do lead VERY busy lives and it is difficult to find the time to learn an entirely new lingo and skill like typing if its not something you've ever done before. But there are plenty of ways to learn in a non-threatening environment. For example - try sending email to your kids, grandchildren or friends, join online discussion groups and make short posts, type short memos to your staff, use the computer to type your own to-do lists. If you at least try these types of things, before long, you'll be using your computer and the Internet like a pro. You'll be amazed at how fast you can learn when you're doing something fun, interesting or useful and technology can be all three of these things.

Teaching medical students how to learn...now that's an entirely different topic. I think we need to revamp the way we teach in medical schools - get rid of pimping and make sure that we are graduating doctors who are solidly grounded in the Emotional Intelligence domain of Self-Awareness.

Thanks again for reading and commenting!
Jane

[ErinB]

I agree and thank you for your thoughtful post.

Technology really could assist us in effecting positive change in the way we deliver care to people if we immerse ourselves in it. I think that one barrier for many physicians is needing to learn a new language - intimidating for many without a helpful guide (see below - IT support). Doing so seems to become more difficult, though certainly not impossible, with increasing age.

I would add the obvious - teach medical students and new physicians how they learn new information and then use that information to change their behavior (in this case, adopting new technology). Some people are renegades, almost fearless, who want every new gadget immediately while others need to wait and watch. Others are in between those first two groups and still others could wait forever without a considerable amount of coaching and coaxing. Based on other pieces I've read on your blog, I think that this kind of self-knowledge fits well with emotional intelligence. Both approaches - knowing how we learn and how we feel - require an inner journey that many physicians (as well as folks from other walks of life) have spent many years successfully avoiding. A more advanced step - knowing how we lead - would be a natural extension of this newfound self-knowledge and would allow us to spread the word about technology in medicine.

I think that employing IT experts who are also at ease in the world of medicine (they wouldn't have to be physicians but need an intimate understanding of nuances of medical communication - both physician-to-physician and physician-to- patient) would help us to move a long way down this road.

Please pardon the long comment - apparently I was inspired.