Overcoming the resistance to same day appointments

This past weekend I spent time relearning some life lessons.

On Saturday, I picked up a couple screens from the hardware store to reinstall them after they were nearly destroyed by our neighborhood bear. The bear seems to think she will find the birdfeeder that used to hang nearby, so she stands on our deck and leans on whatever is nearby (our screened porch) while she looks for it. Then she heads into our small orchard, stands on her hind feet, and paws the branches for apples (wrong season!)

What does this have to do with acceptance? Well, it’s all about how I react to this unwelcome change in my life. I wasted a good hour searching Amazon.com and other websites for bear repellent devices. I quickly discovered there is quite an arsenal available: strobe lights, sirens, electric fences, and even the advice to introduce neighborhood hunters to your backyard bear!

So the life lesson and how I came to it. I recently read an article in the New York Times about physicians in Kentucky who don’t accept the new “customer service” approach to office scheduling, offering same-day service. As an advocate for open access scheduling, I found myself thinking “what’s the matter with these guys, why can’t they accept change? To be successful in health care we need to accept what our patients want!”

And then I broke out into a big smile and internally laughed at myself. Why can’t I accept that there is a bear in my neighborhood that I can’t control unless I turn my yard into a fortress? Maybe I could breathe and even enjoy the occasional glimpse of this big animal.

Our neighbor has a tire swing and told my wife and I this weekend that the bear has 2 cubs and they actually figured out how to get on the swing! Maybe I should enjoy my new neighbor instead of trying to electrify and fence my border. I bemoan the building of fences between Israel and Palestine or the US and Mexico, but I’d consider doing the same thing in my yard? My doctor colleagues resist changing their schedules just like I resist the bear enjoying my yard.

So what can we do to be better at accepting change?  Zen Master Leo Babauta offers a few suggestions:

  • We cannot keep things the way we want them to be, it’s better to accept them the way they are.
  • Be self aware; you can’t change things in your head if you are not aware of them. Asking for feedback, or listening, can improve awareness. That’s not so easy, but it helps. My wife looked at me surfing electric fence designs (battery, solar, or should I run power out there underground?) and gave me that “Really?” look. I hate to admit it, but that helped me realize the absurdity of what I was contemplating.
  • Realize I cannot control others.  As someone who takes on leadership roles at work, this one is hard. People will only do stuff when they decide it’s in their interest to do so. Yeah, we can change incentives, but carrots and sticks only work for a limited time. Engaging something more fundamental, like passion for the doctor-patient relationship, brings true change.
  • Breathe — this one is so easy and it’s physiologic — it does relax us.

So how do I help my colleagues see the absurdity of their resistance to customer satisfaction with access, just as I realized the absurdity of resisting the bear in my yard?

In my last job, open access scheduling by primary care doctors came only after one early adopter family doc tried it. He had a friend in another state who said he liked it. After shifting his schedule he became the poster boy for open access scheduling: a very busy primary care doc who told all his friends, “you won’t believe how much better this is. I go home on time, and it’s really fun working in an office where everybody is happy!”

It’s time to stop resisting change that is inevitable. Make peace with the bear.

Mark Novotny is chief medical officer, Cooley Dickinson Hospital, Northampton, MA.

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