Welcome to the Clinician Researcher podcast.
I'm your host, Toyosi Onwuemene,
and it is a pleasure to be speaking with you today.
Thank you so much for tuning in.
Today, I am talking about when going above and beyond
may not be the right thing to do.
And it's an interesting, interesting episode.
I'd love to hear your thoughts at the end of it.
But before I get started, I just want to let you know
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Okay, so going above and beyond
is our thing as physicians, right?
We just go the extra mile,
and it's part of our training.
This is not even just so much like,
oh, we're born this way.
It's that we've been practicing this for so long.
It is the way we think.
It's the way we do things.
So when you were an undergrad
and really trying to get into med school,
you were kind of the overachiever
doing all the extra stuff, the shadowing,
the doing the extracurricular so that you could write,
hey, look at all the stuff I did.
Let me get into the pre-med program, right?
So you did that.
And then you got into med school,
and you were the person who studied and studied and studied
and took tests and aced the tests.
Some of us didn't, some of us didn't.
But you did all that, and then you became a resident.
Oh my gosh, like how hard you worked.
You even took overnight call.
Then you became a fellow, and wow, you went the extra mile.
You're staying up late.
It's our tendency to go above and beyond.
While we become faculty members,
going above and beyond is not always beneficial.
It's not.
I would say going above and beyond is important,
and please do that as much as you can.
But if you try to go above and beyond in everything,
wow, it's kind of hard.
It's challenging.
No wonder you're burned out.
No wonder you feel like you wanna quit.
The question is, what are the things you need
to actually go above and beyond in,
and what are the things you need to do with minimal effort?
And it's challenging to know how to do that, right?
It's challenging to know how to do that.
But in fact, one of the things that I,
a story I wanna share is just, you know,
I just actually, I'm recording this
after a coaching session, and one of the clients,
one of our clients talked about how, you know,
she's on this project.
It's a collaborative project, and she seems to be
the one who's driving everything.
And she was like, well, you know,
all the rest of the collaborators are attendings,
and I'm the only person who's a resident,
and I really feel like, you know,
I feel guilty when I don't have extra results,
when things haven't moved forward
like they're supposed to.
And it turns out that she had a requirement
for a project that she's completed.
She's actually completed the project,
but now she's going above and beyond.
She's like, I'm done, but I wanna help
to see this thing succeed.
And it turns out it's a QI project,
and there's a lab director who's part of this QI project,
but she's on the project only to the extent
to which it fulfilled a requirement for her.
But so now she's on the project
because she wants to get a good letter from the person
who's gonna be a program director next year.
And so when we really broke it down,
it turns out that she was really trying
to make this person happy because she was hoping
that if she continued working hard,
then this person would like her more.
But it wasn't actually to her benefit
that she continued to make these kinds of investments
because you know what, she had actually finished
the project, she had finished her responsibility
on the project, and now her continued working
on the project was actually affecting other things
that she was supposed to be doing.
And so I tell her story just to share
that this is a common challenge for us.
We're going above and beyond in so many things,
and in reality, not all things are prioritized equally,
not all things are equally important.
So how do we separate going above and beyond
in the right things versus going above and beyond
in things that actually may not make sense?
So I wanna talk to you about questions to ask yourself.
Okay, questions to ask yourself.
So if you find yourself doing more than anyone else
in any collaboration, I want you to ask yourself why.
If you are the one who's doing all the work,
and this is not an unusual scenario,
found myself in this situation,
and I'm guessing that you have too,
but if you find yourself as the one
who's doing all the work,
and it feels like you're pulling more weight
than everybody else, pause, stop.
Say, hmm, how come this is the case?
And it's really important for you to pause and ask
because it helps you figure out how to move forward next.
Now you're pulling all this weight,
but the work is not moving forward
because the work really is work for five people.
And if the five people are not carrying their weight,
wow, you're gonna be carrying a lot of weight,
but you're also not gonna be making much progress.
And so the opportunity to stop and ask why it seems
as if you're the only one doing all the work is important
because it helps you decide how best to move forward.
Okay, so that brings me now to number two.
You wanna review for yourself
what are your obligations on this project.
Okay, let's say you're the leader of the project,
you're the PI on this project,
and you know what, it's really important to you.
And if you don't do the work, the work doesn't move forward
and you're like, well, I'm gonna carry it all myself.
You should ask yourself
are the other people needed on the project?
Hopefully they're needed
because you actually need them to do the work.
But if they're not, then maybe make it a solo project.
Don't make it a collaborative project.
But if it's a collaborative project
and it needs to be collaborative,
then you do need the engagement of the collaborators.
And so they all need to buy in
or the work doesn't move forward.
And if the collaborators say, well, we don't wanna buy in,
it's important information,
it's information that allows you to say,
well, how do I wanna move forward?
Do I wanna continue to work with collaborators
who are actually not pulling any weight?
Or do I want a new project, find new collaborators?
And sometimes it actually is harder to continue,
you're like, ah, I've already invested a lot,
I'm just gonna keep going.
It is hard to continue to drag people
who don't wanna do the work, very, very hard.
And in fact, sometimes they will derail you
from the finish line.
You have to decide, is it important enough
to continue to drag these people along
or do I cut my costs, cut my losses and move forward?
So here is an opportunity for you to stop
and assess what are my obligations here?
Especially if you're not even the lead on the project,
maybe you're not in the PI,
but somehow you're working harder
than everybody else on the project.
Ask yourself, what are the things I'm required to do?
You wanna understand your obligation to the project.
What did I commit to doing from the beginning?
I may be the one carrying everything now,
but what was my commitment from the beginning
and what was the commitment of the others
in the collaboration?
And that's important so you recognize
how far have you gone beyond what you promised to go
and who else is responsible, co-responsible with you
for moving the project forward, okay?
The next thing I want you to do
is to now list all your other priorities
because sometimes these kinds of projects
can feel overwhelming.
And there's a sense that, wait a minute,
what else should I be working on?
What else should I be doing, right?
So what you wanna do is you wanna list your priorities
and you wanna ask, well, what else am I supposed to be doing?
What are the other things I'm supposed to be doing?
So in this particular case of the coaching client
that I'm talking about,
she actually had a major exam coming up
and that was a priority.
And what's interesting is while she was really focused
on putting all the energy in this project
that she was carrying further than the people
she was working with,
she actually didn't have time to study for the exam.
And here's the thing, if she didn't pass the exam,
the people on the project would not be happy, right?
These are her attendings.
So if you are so busy doing a project
that you weren't even supposed to really be doing
and then you didn't study for the work
that you were supposed to be doing,
people are not gonna be happy with you.
And so it was an important strategy
for her to go through and list,
well, what are the other things I really need to be focused on
and where does this particular project rank
relative to the other work that I'm doing, right?
And when she put them all in rank order,
what she found out was that, wait a minute,
this is like at the bottom.
I've completed my obligation.
Everything else I'm doing here
is still number 17 on my list,
maybe more like number eight,
but it's not at the top of the list.
And so all this extra work
where she was going above and beyond
was actually not serving her
because in going above and beyond on a low priority project,
she was not able to do even the bare minimum
on a high priority project.
So how important it is for you to actually be able
to prioritize the work that you're doing
so that you recognize where this particular project fits
and whether you should even be giving this project
the light of day.
So we went from talking about, well,
I wanna go above and beyond to, wait a minute,
should I even be doing any more work on this project?
And at the end of our coaching call,
she came to understand that actually she needed
to submit her quit notice.
She needed to say, hey guys,
it's been great working with you
and I'm moving on to the other things.
But she was only able to discover that that was needed
after she really took the time to prioritize
her list of activities
and put this particular project in context
of all the other things that she was doing.
Okay.
The next thing is to ask yourself, well,
how does this project overlap with benefits that help me?
And this is really important,
especially for us when we're early career
and we feel as if like we owe other people
and we need to do things that benefit them
even if it doesn't benefit us.
In life and in academia,
the best work you're gonna do benefits you
and it benefits others as well.
It's always a win-win that really moves you forward.
If you're in a situation where all the benefit,
all the investments coming from you,
but all the benefit goes to someone else,
it feels heavy, you're gonna resent the other people,
especially at the end of all the work
when they don't even recognize
how much of an investment you've made.
And so you owe it to yourself to start to ask the question,
what isn't it for me?
How can I make sure that at the end of this experience,
I actually get what I need?
And it's not a selfish question.
It allows you all to pull in the same direction.
Because here's the thing,
if you have no benefit, but all the investment,
you may not feel like really making an investment
because you don't perceive that you're getting much benefit.
And so ask yourself,
how can I overlap the benefit here with benefit for me?
I'm so glad that I'm doing this work
that allows this director of a certain lab program
to get a QI project done that helps the lab
then to meet its metrics or meet its requirements,
or at least allows them to test a particular new process.
It's great that that work is able to do that,
but does it help you advance?
Does it help you write another publication?
Does it help you gain visibility?
If at the end of the day,
the only benefit is that somebody else is pleased,
it's time to reconsider the project.
I'm gonna say that again.
If at the end of working on this project,
the only benefit is that somebody else is pleased with you,
then it is not worth even working on a project
and definitely not worth going above and beyond.
Now, here's the thing that came up in this conversation.
It was like, yeah, but this person's gonna write me
a letter of recommendation.
It's like, well, who else can write you
a letter of recommendation?
Is this the only person
who can write that letter of recommendation?
And well, how does this project,
continue to work on this project
beyond what you've done so far?
How does it get you more
of what she would already maybe write for you right now?
And the more she had time to think about it,
she recognized that, wait a minute,
I've done a good amount of this project.
I'm at the point where I've done a lot of great things.
I don't actually need to do any more.
And that's important
because trying to make other people happy
is actually a losing battle.
We're not very good at making other people happy.
So it's kind of, it's a project you should just drop.
Like if you're doing anything in life
to make anybody else happy,
you should start to really seriously think about
whether it's even working.
It's like you're putting all this energy
and you're not even getting the outcome that you want
because you can't choose for other people.
You cannot guarantee that they're gonna like you.
All you can guarantee is that you do the work
you're supposed to do.
In this situation, my client had actually done so much more
than she really needed to do.
She'd gone above and beyond already
and going more above and beyond was really not necessary.
Okay.
The last thing I wanna ask you to do
is to call out people pleasing.
And I will tell you that there is no shame of judgment
in being a people pleaser
because in reality it's part of our training in medicine.
You know, we struggled hard to impress people enough
to get into medical school.
And we were just begging to get in.
We're like, I don't care where you take me.
I just wanna get in.
And then we get to residency
and we have all these subjective evaluations.
And it's like, hey, sometimes I feel like
I'm just here to make you happy.
And that's what we're training to do.
And then we get to our fellowships and we're like, hey,
I just want the attending to be happy.
And so we practice a lot of people pleasing
and it doesn't necessarily serve our careers.
And maybe it works for us up until a certain point
but the moment we become faculty,
it becomes less and less effective.
And so what I wanna invite you to do
is to see the areas that you are going above and beyond
just as a people pleasing strategy and call it out.
Say, hmm, I'm just doing this to make someone happy.
And that's important.
So you recognize where you really should focus your energies
and you don't invest more than is necessary
because people are pleasing.
It just doesn't get you very far.
I mean, it may get you far with this person
but what really ultimately happens
is that the person you're pleasing
doesn't even know how much you're putting into it.
They don't really appreciate the work you're doing.
And sometimes they turn around and they're like,
yeah, your work sucks.
And then it really hurts.
Maybe you haven't experienced that, but I have.
And it just, then you stop and you're like,
why am I even bothering?
And it's a great question.
Why are you bothering?
Why is that your goal?
And how does that serve humanity
in the way you wanna serve humanity
in your role as a clinician researcher?
All right, so those are the five things
I want you to think about when going above and beyond
is feeling especially icky.
And you're like, I'm not sure I really wanna be doing this
or it's feeling like a drag, it's feeling heavy.
Ask yourself these questions.
So the first question is why?
Why am I doing the most work in this collaboration?
The second thing is, well, what obligations
do I have in this project?
What do I absolutely need to do?
And what are the things other people should be doing?
Number three, list all your other priorities
and rank this project relative to those other priorities.
Number four, ask how much of this work
actually overlaps with benefits for me
as well as benefits for other people.
And number five, call out people pleasing.
If you recognize it, definitely call it out.
So this week, I wanna invite you to think about a project
that you may feel like it's dragging on you.
Like, oh, every time you think about the project,
you get bad feelings inside,
you get an ugly knots in your stomach.
Think about that project.
And I want you to evaluate the investment
relative to the benefit.
And I wanna invite you to think about
what could your experience be
if you invested your energy in moving work forward
instead of trying to make people happy?
What could the outcome be?
I'm excited about you putting energy into work
that actually really advances your career.
And so I hope that you'll rethink going above and beyond
in every aspect of your life and be strategic
about where you go above and beyond.
All right, it's been an absolute pleasure
talking with you today.
Thank you so much for listening.
I look forward to talking with you again
on the next episode of the Clinician Researcher podcast.