Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
to build their own research program, whether or not they have a mentor.
As clinicians, we spend a decade or more as trainees learning to take care of patients.
When we finally start our careers, we want to build research programs, but then we find
that our years of clinical training did not adequately prepare us to lead our research
program.
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
However, clinicians hold the keys to the greatest research breakthroughs.
For this reason, the Clinician Researcher podcast exists to give academic clinicians
the tools to build their own research program, whether or not they have a mentor.
Now introducing your host, Toyosi Onwuemene.
Welcome to the Clinician Researcher podcast.
I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you
today.
I am talking today about focus.
Thank you for listening to the five keys that are important for your success in 2024 and
clearly beyond 2024, depending on when you're listening to this.
I have been talking about different keys for success, including taking control of your
thoughts, taking control of your decisions, and also taking control of your actions.
Today, I'm speaking specifically about focus, and I want to just celebrate clinicians everywhere
because the fact that you're a clinician is a sign that you know how to focus.
If you've come through medical school and residency and even fellowship, you know how
to focus or you're able to get resources to help you focus, so you're able to do that.
But one thing that's interesting for me when I became a new faculty member and I made the
transition from being a fellow to being a faculty, one of the challenges I had was,
well, what do I focus on?
Because as a fellow, as a resident, I had many things to do, but the goals are pretty
clear.
These are the metrics of success for the program, and I accomplish all these competencies, I'm
done.
I graduate, I get the certificate.
But then as a faculty member, it becomes a lot more challenging because, yeah, there
are all these criteria for promotion and tenure, but what am I supposed to be doing in my day
to day?
The clinic feels overwhelming.
Our responsibilities are so many, and they overflow.
How can I focus on my research?
How can I do that?
How can I move forward the things I want to move forward and also be a great doctor and
also be a great educator and administer the things that I've been called to be an administrator
over?
So there are a lot of things pulling us in different directions, pulling our attention
in different directions, and the challenge we experience, and I think is a growing problem
for us, especially in this age of technology, is that our attention is pulled in so many
directions.
Our attention is a commodity that people are buying and selling, and if we are to take
control of our experience, especially as we lead research programs, we really do need
to take control of our attention.
We need to focus on what is important.
There are so many trivial things, there are so many things to do, but how do we focus
on what's important?
And that's what I'm going to be talking about today.
Okay, so I'm sharing with you five things to consider as you expand your focus so that
or intensify, I should say, your focus as you lead your research program.
So the very, very first thing is to focus on what matters.
Focus on what matters.
Now, the challenge of focusing on what matters is that sometimes it feels like everything
matters, especially when people are yelling about it or they're calling you so many times
or they keep paging you over and over again.
The challenge is to focus on what matters, but how do you determine what matters?
Because it feels like everything matters.
So I'm going to pause and say that everything does not matter.
At least everything does not matter equally, and there are some things that matter more
than others.
There are some things that matter more than others.
For example, when I was a faculty member about a year or two into my faculty career, I came
home one day and my husband had just brought the children home.
And my daughter initially had been talking and all of a sudden she went silent and she
was just staring blankly.
And then she started to have a grand mal seizure and she proceeded to become unresponsive.
I had just come home from clinic that day.
It was a long day and I had a lot of notes to do.
And I will tell you that we rushed like crazy.
We didn't even wait for the ambulance.
We were in the car, drove to the hospital because I knew exactly how fast and we drove
fast.
And we spent time in the ICU.
We spent time in the hospital and we went home.
And not at one point during that did I turn around and say, oh, wait a minute, I've got
notes to complete.
Oh, wait a minute.
What were the results of those labs?
Because in that moment she was the one who mattered most.
My family, being there for my family and being able to move forward in spite of the crisis
was important.
Just so you know, she's fine.
But it was an important reminder to me in that moment of what mattered.
I couldn't even think about my clinic for three, four days until when she was home and
doing so much better.
So we focused on what matters.
Now that being said, is family all that matters?
No.
We're clearly in academia.
We're clearly in clinical research.
We're clearly researchers for a reason.
We are going to continue to move work forward even though we're people who have families
and we love and care for our families.
But what we don't want to do is to neglect the things that matter for things that matter
less.
And so, yes, we want to make sure that we focus on nurturing our relationships so that
we can continue to enjoy the careers that we're building because no one ever said, hey,
I got all these awards and research and I'm so excited even though it cost me my family,
my relationship with my children, my relationship with my parents, my relationship with my spouse
or significant other.
No one ever celebrates all their accomplishments above their families.
And so that's one of the things that's important is to focus on what matters.
And how do you focus on what matters?
You make sure that you are healthy and well so that you can be there to nurture your relationships,
relationships take energy, relationships take time and investment.
And that is why it's important for us, especially because we're clinicians, to make sure that
we tame our clinical workload so that it gives us time and space to do all the other things
that we need to do, including taking care of our families, taking care of our health,
taking care of our mental and emotional well-being.
These are the things that matter.
Focus on what matters.
Define what that means.
Define the hierarchy because you're always juggling these things, but define the hierarchy.
What takes the highest priority?
So number one is focus on what matters.
Number two is focus on the most important asset that you have in your academic career.
Yes, you want to focus on the most important asset you have in your academic career and
that asset is you.
Yes, you are the asset.
You are not just an asset, you are the asset.
Without you, your career crumbles.
Without you, your life is ended.
Without you, nothing else matters.
And here's the thing, the institution will continue long after you're done at the institution
or maybe in this life.
You are the asset that you are building.
One of the important criteria as you're moving forward in building your research program
is to make sure you are building the asset.
Focus on building the asset that is you.
How do you build this asset?
Well, you build this asset by expanding like you're crazy.
You pour in information in there that enhances you.
You attend career development workshops.
You go to anything that enhances you.
You read, you study, you show up for programs, you join communities that enhance you.
You exercise, you eat well, you sleep well.
Wow, that sounds like a full-time job, doesn't it?
And it is.
The reason you need to focus on you as the, not a, but the, or not and, but the asset
is because when you appreciate, when you appreciate in value as an asset, everything around you
appreciates.
The work you do appreciates, your capital, your network, it appreciates.
Financially you appreciate.
Everything appreciates the moment you, the asset, appreciates.
And so what you don't want to do is sacrifice the asset on account of anything else.
I think there's an analogy in Stephen Covey's book, The Seven Habits of Highly Successful
People about having the goose that produces the golden egg.
And actually he alludes to the story about the goose that lays the golden eggs, you know?
And if you remember the story, the farmer had a goose that laid golden eggs and they
would have to wait because the goose only laid one egg a day.
And finally they came up with this brilliant idea.
What if we kill the goose, take all the eggs out of the goose and we can have all the gold
at once?
And so they killed the producer of the gold and they were left with no gold.
You are the producer of gold in your research program.
It's you.
You make everything happen.
And therefore you want to focus on maximizing the value of the greatest asset you have in
your career and in your life.
Focus on the most important asset and that is you.
All right.
Number three is to focus on the vital few.
And we talked about this in I think the decision making episode where we talked about the fact
that wow, there are many, many, many, many, many, many, many, many, many, many, many, many,
many things you could do, but not all of them are important.
And in fact, most of them do not move you forward.
And so the principle of the vital few, I got really from actually a couple of books.
So essentialism by George McKeon and also the Pareto principle.
And actually that's kind of highlighted in the 80-20 rule by Richard Koch.
I think that's his name and I'll confirm it in the show notes.
But yes, there are very few things that move the needle in your life.
You may not know what they are until you do the analysis, until you study and then you
figure out, oh, wait a minute.
Oh, you look at the data and you're like, what?
Last year I spent a lot of time on four research projects, but only this one research project
yielded two manuscripts, three abstract presentations, and an opportunity to go and talk.
And all your projects yield big returns.
And you're like, well, I got to keep working on them equally.
No, you do not.
The one that gives you the biggest bang for your buck, that is what we're talking about
as the vital few.
And so you want to focus on the things that move you forward.
And if you're a clinician transitioning to build a research program, one of the things
that's most important is really growing your ability to write, to present, and to really
declare your work to funders, to people who will read your work, to the lay public, to
your scientific community.
That's one of the most important things you do.
You're a writer, a scientific communicator.
And so that is one of the things that gives you big bangs for your buck.
You become a great science communicator.
You become a good writer.
You're able to communicate with funding agencies, and they will give you money so that your
program continues to run.
You're able to communicate with the lay public.
And you might find some philanthropic donations to move your program forward.
You're able to communicate well with the science community, with the scientific community,
and you get invited to give talks.
And you are able to present your work at meetings.
And so being a science communicator, focusing on communicating your science regularly and
intentionally is one of the highest yield things that you do as a clinician scientist,
as a clinician researcher.
And so you never want your ability to grow and thrive as a science communicator to suffer
at the hands of things that other people could do for you or at the hands of things that
you could be replaced in doing.
I know ELOG patients.
We love to take care of patients.
And many of the patient care things we provide can be provided by people who have not been
at school for as long as we have, or who have not done that kind of training for as long
as we've done training.
And so it's important to make sure that while we continue to move our clinical programs
forward, we don't let our research, our scholarly communication suffer at the hands of something
in which ultimately we could be expendable in.
When you think about it as a clinician researcher, you're moving forward a program of study.
Remember, I said you are the asset.
If you don't do this program of study, somebody else might not do it.
I mean, if you say work in diabetes, there will always be a researcher working in diabetes,
but the specific angle that you bring to diabetes research is not something that anybody else
can easily reproduce, especially if it's your baby, the thing you're most excited about.
Therefore, there are very few things that move you forward in the direction of being
the expert in this specific space, and that's what you want to focus on.
And there will be many opportunities.
People will come, they'll say, oh my goodness, come be part of this and come do that.
There'll be so, so, so, so, so, so many, but not all of them will move you forward in the
way that is meaningful to you.
You want to focus on the things that move you forward.
Okay, that was number three, focusing on the vital view.
All right.
The next thing you want to do is to focus on eliminating things that derail you.
Energy wasters, time drainers, all the things that just make you, okay, it's energy, energy
drainers, and time wasters.
Yes.
You want to get rid of all that.
And what do I mean?
Sometimes your colleagues that write you emails, I make you so mad.
Oh my goodness.
I read one of those yesterday.
And the challenge with these things is that they take up so much time and energy because
you're so mad.
You want to compose the perfect email just to show them that you know, and you take a
lot of time to do that.
What you're not doing is doing your writing.
And when you finally satisfy yourself, that you have sent the perfect comeback, you can't
even stop thinking about how it's landing and whether it's doing the right amount of
damage that you hoped.
And then at the end of the day, you're kind of drained.
You have no energy to move your work forward.
Wow.
And was it worth the hours that you spent trying to school that person and you didn't
get to move forward?
And so if you're going to succeed in your research programs, you're going to succeed
in moving forward, one of the things you will do is to not let things bother you.
You're going to ask yourself, is this absolutely critical to my forward motion?
And if the answer is no, you move forward.
The reason this is important is because there will always be challenges in academia.
Wow, the system is slow as molasses.
There are always challenges.
There are always people complaining.
There's always a problem to be solved.
And one of the things you don't do is to set yourself to try to move a pillar that keeps
a building standing.
Academic medicine is the way it is because it works for academic medicine.
It doesn't work for many individual faculty, but it works for systems.
It works for institutions.
If it didn't, those systems would not exist.
And so sometimes we push ourselves against things that we think we can change.
And what we're not recognizing is that they're pillars.
And while we're pushing these big pillars that are actually immovable, what we're not
doing is moving forward our scholarship that actually can make transformation possible
in a way that can be subversive.
And so there are different ways to transform the system.
And I'm not asking you not to transform the system.
What I'm saying is that you've got to recognize your role.
What is your role?
What is the thing that you can do?
And only you can do it.
And I want to argue that if you're a clinician moving forward a research program, trying
to make big waves and moving about from person of influence to person of influence to try
to push change is maybe not the first path that you tread before you've really fully
established yourself as a scholar.
Because the way academic institutions are established, scholarship is really, really
honored.
And many times people who don't have as much scholarship can still contribute significantly
and scholarship continues to be honored.
And so it's important to recognize what is my role?
What is my skill?
What are the things I bring that nobody else can bring and focus on expanding those things?
Because nobody can take those away from you.
Positions come and go, especially depending on the political climate.
And so while you continue to do administrative roles, you want to make sure you have a body
of scholarship that will go with you wherever you are.
And so you want to focus on eliminating things that waste your time so that you can enhance
the things that matter.
The fifth thing is to focus like someone who is incapable of doing anything else.
Yep.
Now you choose your area of focus and you want to just be, what's the word there is
a term for where you feign ineptitude to some extent.
It's like, oh, we need somebody who can help us move the table.
Oh, you can move the table.
I see your arms are very strong.
That's not why you're here.
And so you're like, oh, I would love to help you move the table.
I'm not very good at those things.
I mean, I'm not asking you to lie, I'm just saying that that's not what you're supposed
to focus on.
And I know I'm using an example of moving the table, but maybe I use another example
of planning the holiday party.
I mean, it's so awesome that there's a holiday party and it's so awesome that you're so good
at organizing that someone feels like you're the one to do the holiday party organizing.
But the time that you're spending during the holiday party organizing is time that you're
not spending moving your own program of study forward.
And the truth is, if for whatever reason you kind of drop dead out of exhaustion and you're
carried emergently away to the hospital, somehow the holiday program still gets done.
But what doesn't get done, what doesn't get done is your research because you're the champion
of your research program.
So if you are going to succeed in moving forward to your program of scholarship, you're going
to feign ineptitude and things that are not your primary concern.
If you look around and there are four or five, six other people who can do exactly what's
being requested, don't volunteer.
Wait, wait and see who else volunteers.
Don't be the first to jump in to do the thing that other people can do for you.
I have to tell you that one of the inefficiencies of academic medical centers is that many times
physicians are asked to do things that are really clerical because people are trying
to save time and money.
But the reality is that as clinicians, you bring high value in your scholarship to academic
institutions.
Your scholarship helps make the academic institution academic.
And so don't accept a situation where someone says, well, I just want to save money by asking
you, a highly valued clinician who can generate revenue as a clinician and a highly valued
creator of scholarship to come do something clerical that I could pay somebody minimum
wage to accomplish.
And so this is the challenge of academic medical centers.
They continue to do that.
And by they, I'm not talking a specific person.
It's just the way the system works.
And what you're going to do because you recognize the value of your program of scholarship is
to not allow those things to cloud your experience, is to not allow those things to prevent you
from moving forward.
What that means is you're going to guard your program of scholarship jealously against these
things that encroach and that don't have to encroach.
And here's the thing, the moment they can't find you because you are so focused and you're
feigning ineptitude about all these clerical things that you really shouldn't be doing.
Wow, all of a sudden funding arises to be able to fund a clerical position to do that
work.
But the fact that you keep volunteering keeps them from finding anybody.
How convenient.
I don't mean to sound cynical, but I do want to share is if you will not move your program
of study forward, nobody will do it for you.
But people will come every day to pull you from your program of study, not because they're
trying to derail you, but just because people are people.
And we're just wanting to look for someone who can help us.
We're not really asking, is this the highest qualified person for this role?
Is this the person who actually should be doing this?
Is there somebody else who should be doing it?
We don't ask those questions because it's more convenient, it's easiest to ask that
nice doctor who always says yes.
So you're going to focus on the things that you are supposed to be doing, feign ineptitude,
about everything else.
Okay.
Those are the five points I'm giving you for your focus this year.
One is to focus on what matters.
Number two is to focus on the most important asset, that's you.
Number three is to focus on the vital few.
Number four is to focus on eliminating time wasters and energy drainers.
Number five is to focus like someone who doesn't know how to do anything else, feigning ineptitude.
All right.
That's it for today.
You know somebody who wants to coach with me, maybe you, maybe somebody else, please
send me a DM or sign up for a coaching consult call and the link will be provided in the
show notes.
It's been a pleasure talking with you today.
Thank you for listening.
I look forward to talking with you again the next time.
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic
clinicians learn the skills to build their own research program, whether or not they
have a mentor.
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