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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher.

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Oh, let's start again.

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Just make sure that my audio is where it needs to be.

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The sound is exactly where I want it to be.

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Yep.

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Hello, hello.

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Hello, hello.

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It absolutely is.

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All right, let's get started.

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Hello, everyone.

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Welcome to the Clinician Researcher podcast.

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I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you today.

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Today I'm going to be talking about one of the five keys to your success in 2024 and

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for your entire life.

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And today it is decisions, your decisions.

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Last week we talked about your thoughts, and today we're talking about your decisions.

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And I'm excited to talk to you today about the importance of your decision making, which

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I think you know is important.

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But I'm going to just talk to you about five ways to think about it.

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I think that, I don't know about you, but when it's getting to the end of the day, those

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are the most challenging times to make decisions.

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And to be honest, it looks as if emails are always flowing into my inbox daily.

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And the email that has 324 complexities to it flows into the inbox right at 430.

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And it's the kind of email that you don't want to turn off your email and turn off your

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computer and go to bed and like think about that email all night.

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You want to address it right there and then, but you're exhausted, you're tired, it's not

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the right time to be angry or to be making your decisions.

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Yeah, decision fatigue is real.

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And that's why today I'm going to be talking about five strategies, five things to think

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about actually as you are making your decisions.

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So the very first thing I want to talk about is the importance of analyzing your decision

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framework.

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And okay, so there's a whole discipline around decision making, and I'm not necessarily going

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into any of those, but these are thoughts that I've had and I just want to share with

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you.

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So the first thing I'm talking about is really analyzing your decision framework.

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And without going into any like specifics, I really am just thinking about what has driven

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your decisions in the past.

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Like go back to the decisions you've made, especially the major life decisions you've

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made and think about what has driven, what has been the driver for those decisions.

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What has been the driver for those decisions?

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For example, you went to medical school and you chose a medical school.

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So okay, even if in residency and fellowship, we say you had no choice, it was the match.

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You always have choice and to some extent you made choices, but let's go to medical

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school where you actually did choose the school and say, what got you to that place where

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you made a decision to go to that school?

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Who was involved in the decision making?

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What were the feelings that you had in making the decision?

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What led you to that big decision as to where to take a medical school?

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And for some of you, when you go to medical school, for some of you, you'll say, well,

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I was desperate.

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They were the ones who took me.

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That's why I went.

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And that's the decision that you made that you only had one option and you took that

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one option because you also made a decision to go to that option.

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You didn't make a decision to say, you know what, I'm not doing this medical school thing.

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I'd prefer to hold out for a different medical school.

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You didn't make that decision.

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You've made certain decisions over time.

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And what I'm saying is in analyzing your decision framework is to go back and say, well, what

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were the strategies I used to make decisions up until I've used to make decisions up until

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this point?

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And for some people, maybe you don't have a decision framework.

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You just are like, well, I don't know.

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I don't know what it is.

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Well, you have one because you're clearly making decision and the results that you've

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produced in your life are a result of the decisions you've made.

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So even if it's not a decision framework that's explicit to you, it exists.

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And that's why the very first thing I think that's important is to really go back to your

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major decisions.

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How did you choose who to be a partner with?

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How did you decide that you were going to have children or maybe you didn't decide and

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life decided for you?

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I don't know.

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What are the major life decisions you've had and how did you get to those decisions?

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And the reason why it's important to analyze your decision framework is that there is a

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pattern in your life for decisions being made.

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Going back to the example of going to medical school, like even the decision to become a

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physician, for some of us, those were decisions that were made by our parents before we even

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started life.

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It was just, hey, your grandfather was a physician.

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I'm a physician.

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Guess what you're going to become?

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For many of us, that was the decision.

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A parent made a decision for us.

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Whether that was implicit or it was explicit or there was just an expectation that you

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grew into.

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There are some of those decisions that you can trace back to authority figures or even

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coming closer, because so many of us are so far from medical school, coming closer to

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residency.

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How did you choose where to apply for residency?

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How did you choose finally what program to be in or how did you choose what the final

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residency program would be?

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There are decisions that you've made in making those decisions or even in the decision as

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to where to practice, where to pick a specialty, where to go as an academic faculty member,

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what your area of specialization as far as research is concerned.

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There are decisions you've made.

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And if you go back and look at those decisions, you have a sense of who is making these decisions

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for me?

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What are the drivers of the decisions?

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What are the authority figures that I defer to in my decision making?

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When have I made decisions that I was not happy with?

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You have that feeling in your mind that you're like, oh, I don't want this thing, but you

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don't want to upset the person beside you.

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And for that reason, you're like, okay, I'm not going to make that decision because I

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don't want people to be mad.

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And those are all parts of your decisional framework.

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And so the first thing to do is just to figure out, hey, what kind of decisions have you

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been making and what is the driver for them?

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And that brings me to number two, which is to visit the root of your decision making,

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your decisional biases or your decision making.

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You want to visit those roots because for some of us, the roots are in the fear of missing

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out.

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Like, well, all my friends were going to med school, so I said I wasn't going to not be

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the one to go.

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And that's how you ended up in med school.

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And that's how you're a physician.

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You've kind of been going with the flow all along.

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And that's important because what it helps you to recognize is that you are someone who's

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greatly influenced by the people around you.

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That's so important because if you don't like the choices that you have made in your life

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up until this point because of the decisions you've made, and you can trace it back to

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the community that has led you in that way and how strongly affiliated you are with your

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community, how much affinity you have such that you are willing to put your life in a

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challenging place just so that the community is happy with you, that's important.

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Because then the question is, does it make sense to upgrade your community or does it

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make sense to put in boundaries so that the community is only so much involved in making

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decisions for you?

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And so that's one of the things that is helpful in going back to the root of your decisions

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to understand what are the drivers for my decision making.

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Let's use another example.

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Let's say for example, you're like me or you're like I used to be.

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Actually, I'm still kind of working through it where I have grown out of a people pleasing

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place.

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I like to make people happy and I feel so bad if people are not happy with me even when

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they're being happy with me means that I'm being hurt.

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And I think it's a socialization thing for many people who identify as women or who identify

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as underrepresented in the academy.

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I think there's this sense of you move forward because people like you and they like you

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when you behave a certain way.

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And the more of that you produce, the more like you get.

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And so maybe many of your decisions are based on people liking you.

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And that has been a big challenge for me and some of the work I've needed to do and to

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be honest still continue to do is really in saying, am I making this decision because

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I want this person to like me?

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And it's so important because it helps me.

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It means every time I'm going to make a decision, I pause and I ask the question, wait a minute,

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is this your decision or is this a decision you're making to make somebody else happy?

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Because every time you are when you're aware of your decision making habits, when you're

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aware of your decision or biases, then it allows you to stop and question your decisions.

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And that's important because otherwise you're an autopilot.

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Otherwise my autopilot has to say yes.

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And so when it's someone I really like, oh my gosh, it's so hard for me to say no, because

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I'm like, oh, what if this person won't like me again?

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And it's so subconscious.

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I'm not even always aware of it.

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It's just this feeling that I have and I am in decision paralysis.

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And I don't recognize that that's what's going on until I pause and say, well, why is this

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decision so hard?

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Clearly the answer is no.

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So anyway, so you want to understand the root of your decisions, what's driving them, and

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you may be able to change them as in changing the community or at least expanding your community

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so that one community is not the most dominant.

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Or it could be that you are making changes and maybe moving into another community or

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decreasing the pull of a certain community.

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So ultimately revisiting the root of your decisions helps you because it allows you

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to become intentional as far as how you address those roots and how they're driving your decision

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making.

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So that's number two.

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Number three is to upgrade your information sources.

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And that comes from the fact that we have certain biases and that kind of speaks to

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the root of our decision making.

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And those biases, and you know that having a bias doesn't mean you're a bad person, right?

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It just means you're human because all of us have grown up with a certain worldview.

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We've grown up with a certain perspective and those inform our biases.

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So we're all biased in some way, but it's recognizing what are the sources of information

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that drive the bias.

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For example, when I was growing up, I had and do have a beautiful smile.

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And people would look at my smile and they would say, wow, your smile is so beautiful.

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You should become a flight attendant.

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And this is nothing against anybody who's a flight attendant.

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It's just saying that in that pool of people, and these were my teachers in school actually,

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there were a lot of them that would say this, in that pool, there was just the sense of

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like, well, this is the direction for you.

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This is it.

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I mean, there wasn't even like, oh, you could be a flight attendant or you could be a police

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person or you could, there wasn't a list of options.

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It was just, oh, that smile is the smile of a flight attendant.

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And so that was one community, my teachers at school, my parents didn't, I don't think

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they associated my smile with being a flight attendant.

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So that was not something that was reinforced for me at home.

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But I bring that example up to say that, you know, for whatever reason, my teachers, or

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at least this group of teachers that felt so strongly that I needed to become a flight

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attendant, had a bias as to what a woman with a beautiful smile looked like.

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And it doesn't mean their recommendation to me was wrong.

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I mean, I'm glad I knew and understood that there were many, many options to me, including

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being a flight, becoming a flight attendant.

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But you know, for them, it was very much like, this is it, this is it.

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And that's based on their biases, right?

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And even now, I think about, you know, society, societally and the things we think, you know,

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women should do or shouldn't do.

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And it's still funny to me, my name is a unisex name, if you don't know.

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My full name is Uluwa Toyosi.

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And actually, Toyosi is unisex as well.

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It's Yoruba from Nigeria.

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And you can't tell by looking at my name, whether I'm male or female.

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You know, there are some names that are more, there are some names that are more commonly

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associated with women than men.

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But you can't tell my name, and it's actually intentionally unisex.

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But even in the United States, since I moved here, people look at my name and see that

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there's a doctor before my name, and they immediately assume I am male.

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Immediately, like there's just no question.

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And so many times I've had conversations by email with people who I end up recognizing

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that they were calling me he all along.

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I guess this is why it's very important to clarify your pronouns, right?

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Because people can't tell on even no matter what your name is, right?

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Whether it looks like it's a name for one or not, they can't tell.

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So anyway, I think I say that to say that there are certain biases people have as to

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who are the doctors, right?

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Who are, especially if it's not obvious to them, whatever obvious means, there are biases

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that people have.

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And you have biases too.

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I have biases too.

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And there are some biases that are unconscious and some biases that I am aware of, fully

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aware that I think that people who are Nigerians are the best and the brightest.

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Okay.

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Yes.

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Coming back home.

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So I'm just talking about like, I'm aware of some biases that I have, but I'm not aware

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of all of them.

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But my biases are driven by the information sources that I've had growing up.

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And same for you.

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Even if you went to wherever you went to school, you have biases driven by where you went to

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school, where you grew up, what your parents believed, what your family of origin believed.

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And the more information you get, the more you can directly address some of those biases,

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at least the ones that are more conscious.

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But the ones that are subconscious, you probably do need to do a little bit more work to get

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them out.

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And that's why the more information you get, the more opportunities you have to be exposed

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to people who are of different backgrounds and diverse.

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And the more you approach people respectfully, because I think that sometimes you can be

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exposed to people of diverse backgrounds and come away still feeling as biased as ever.

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And some of that is really approaching learning from other people in a way that is respectful

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so that you can upgrade your information sources.

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Where you're like, oh, I didn't know that all tall guys didn't play basketball.

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Okay.

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I am now informed.

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Okay.

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But upgrading your information so that you upgrade the source of the information that

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drives your decision making.

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We're still talking about decision making, not so much biases.

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But yes, you want to make sure that you upgrade your decision making.

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All right.

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Number four, automate your trivial decisions.

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And so maybe trivial may not be the right word to use, but automate decisions that are

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not the most important, most critical.

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For example, I will give you an example.

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I wear dresses all the time.

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For people who've noticed, they're like, is this a religious decision?

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When somebody asked me once, I was like, religious decision?

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Really to wear a dress?

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I'm clearly unaware of some of these things.

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But anyway, but I do consciously only wear dresses.

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And the reason I do is because it's a very easy decision.

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There's no mixing and matching, no pairing.

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It's just one decision.

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I'm wearing that dress and I don't necessarily wear a jacket over my dress.

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Sometimes I do, but I have very limited numbers of jackets compared to the clothes that I

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have, the dresses that I have.

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So for me, it's an automated decision.

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And if I take it a step further, actually, I don't take it a step further, but someone

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I know who's very dear to me takes it a step further where she'll lay out the clothes for

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the week.

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Like Monday, this is what I'm wearing.

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Tuesday, this is what I'm wearing.

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Wednesday, this is what I'm wearing.

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And you know, just for the whole week, she's got the dresses laid out.

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She's not making decisions on Monday morning about what to wear.

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She saves herself time.

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And so is it a trivial decision to decide what to wear?

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I would think not, but she's automated those decisions.

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She did it earlier, earlier in the week so that she doesn't have to think about it anymore.

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And so in just thinking about your life, where can you automate decision making?

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Maybe it's in how much you save every month, how much you put towards retirement.

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Don't decide every month how much you're going to do.

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Just decide upfront and then automate it.

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If you're thinking about, okay, I'm submitting a journal, a manuscript or a journal, and

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this is my top tier dream pie in the sky journal and a couple of, you know, and you know that

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there's a high chance of rejection because it's a really high impact journal, automate

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the decision as far as what the next journal will be.

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Don't wait until you get the rejection and then you're like, ah, I really want to get

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in there now.

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Where will I go?

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Just have a plan.

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Just have a plan of at least three journals, maybe even five to say, okay, it doesn't get

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in this one.

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This is where we go next.

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And it just, it automates the decision.

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So when the rejection comes, which stings, by the way, even if you knew it was a high

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tier journal that was out of reach for you, it stings.

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And instead of like wallowing in the sorrow, you're like, well, there we have a plan.

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Let's go on to plan B. And so that's what I'm talking about, automating some decisions

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that if you don't automate them when you're strong and happy and healthy, when you're

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tired, weak and discouraged, they become even harder decisions to make.

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So think about the decisions in your life that you're making consistently that you know

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you're going to have to make.

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For example, what grants are you going to write this year?

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Just make those decisions now.

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There may be opportunities that arise, but most of the time the opportunities that you're

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going to go for are already known.

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So you want to make that decision.

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How many grants are you submitting this year?

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What are the manuscripts that are in your pipeline?

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Don't like every Monday sit down and say, what manuscript am I going to write this week?

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Have a plan for your writing.

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So those are the decisions that you automate so that you can free yourself up for the big

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decisions.

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Okay.

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So now let's talk about the big decisions.

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You want to optimize for major decisions.

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You really want to optimize for major decisions.

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And by that, I mean, you know, you know, by the end of the day, you're tired.

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You know that the end of the day is not the best time to make decisions.

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You don't want to leave major decisions until the end of the day.

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Or if the decision comes down to the end of the day, you want to defer the decision making

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until you are your most optimal, until you are at your, at your best.

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So if I'm a morning person and I am, and I know that I make the best decisions in the

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morning, then any major decisions, no matter how angry I am about them, if I'm being rational,

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if I'm being lucid, I will defer them till the morning.

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Now there are some of those emails, some of those things that come up that make you so

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mad that you're like, I must respond now.

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I must tell you exactly how I feel.

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And wow, what a great temptation to avoid making the decision in that moment to send

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the email or not to send the email.

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And what works for me, what helps me, what I'm going to do.

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For me, what helps me is to defer the decision because I'm tired and I'm cranky, but in

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the morning my head is clear and I know exactly what to say.

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So you want to optimize decision making for your, your best time.

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And if you're an afternoon person and in the morning you can't think straight, don't open

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your email in the morning and start looking through when you're not ready to respond to

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those emails that you know are coming optimized for your decision making.

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Another way, and this is something that I do, is that I, I told you earlier, I have

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a people pleasing tendency.

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I want people to be happy with me.

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And so I need space from every decision to be able to sort out how much of this is what

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I want to do versus making you happy.

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And so the more distance I have between the request and the decision, the better it is

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for me.

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Now, life doesn't always give you those long opportunities, but even a couple of seconds

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or a couple of minutes of stepping away and taking time to think about it is helpful to

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me.

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For that reason, if I'm going to optimize decision making, I defer the response to the

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request from the request.

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I separate them by as much as I can.

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So let's say something's like, well, I need this answer urgently.

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I'm like, can you give me 10 minutes to think about it?

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Or if I can wait till the next day, I'll say, I will get back to you by tomorrow.

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I need to sleep on it.

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And so that's what I've been learning and practicing.

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Because to be honest, this doesn't come easily.

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But that optimizes my decision making because then I'm not making decisions when I'm tired.

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I'm not making decisions when I'm not at my best.

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And that allows me to make decisions that are really high quality.

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Okay.

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So those are the five things that I shared with you today.

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And the first one is to analyze your decisional framework by going back to the decisions you've

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made and seeing what were the sources of those decisions.

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Number two, visit the root of your decisional biases.

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That's make sure that you understand where you're coming from, why you think the way

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you think, why you make the decisions the way you make your decisions.

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And then upgrade your information sources.

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You make certain decisions because you think a certain way, because you have certain information

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about maybe certain groups of people or certain types of things.

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Like for example, you know, grant writing is hard.

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Okay.

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And it's a skill that you can grow.

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And so you need to upgrade your decisional information sources, right, by going and figuring

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out from the people who have, you know, have grown into grant writing, not that it becomes

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less hard, but that they have a skill that they've gotten good at, right, and you can

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too, if you, you know, put in the reps and put in the work and get the feedback that

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you need.

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So getting the information that allows you to recognize that it's a learned skill and

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you can learn it too is helpful.

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So upgrade your information sources.

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Automate trivial decisions and they don't necessarily have to be trivial.

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Decisions that you're needing to make over and over and over again, automate those decisions.

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And then number five is optimize for your decision making, especially your major decisions.

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You want to make sure you get enough rest.

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You want to make sure that you are in the right place.

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You know, the things that you need to do, you have space time away from that decision

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to be able to make the right decision.

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Okay.

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So those are the five things I want to talk to you about in the importance of your decision

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making and the things that you should think about as you're moving into the year.

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And this is pertinent to every area of your life and certainly as you're thinking about

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what manuscripts am I going to, you know, publish this year?

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What are some of the grants that I'm going to put forward?

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What are some of the conferences I want to go to?

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Just, you want to make sure that you have a framework for moving forward in making good

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quality decisions.

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All right.

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It's been a pleasure talking with you today.

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Please, please, please share this with somebody else.

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00:25:41,760 --> 00:25:43,280
You know, leave us a review.

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00:25:43,280 --> 00:25:46,800
If you've been listening for a while and you feel like, oh, this podcast is really, really

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00:25:46,800 --> 00:25:48,400
helpful to me.

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00:25:48,400 --> 00:25:52,520
And you think, huh, this is a five star worthy podcast.

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00:25:52,520 --> 00:25:53,960
Leave us a five star review.

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00:25:53,960 --> 00:25:55,760
We would appreciate it.

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00:25:55,760 --> 00:25:58,120
And other people would appreciate being able to find us too.

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All right.

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It's been a pleasure talking with you today.

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Thank you so much for listening.

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I look forward to talking with you again the next time.

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00:26:11,480 --> 00:26:16,840
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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00:26:16,840 --> 00:26:22,280
clinicians learn the skills to build their own research program, whether or not they

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00:26:22,280 --> 00:26:23,640
have a mentor.

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00:26:23,640 --> 00:26:29,760
If you found the information in this episode to be helpful, don't keep it all to yourself.

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00:26:29,760 --> 00:26:31,480
Someone else needs to hear it.

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00:26:31,480 --> 00:26:35,540
So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.