The Undiscovered Country

image from Dall-E via Bing Chat. “2 physicians with a hilarious and terrifying mentor experience.”

This is an interview between Dr. David Bar-Shain, originator of the PACmentor program. The PAC is the Physician/provider Advisory Council comprised of physicians who attend the Epic User Group, and Dr. Bar-Shain is a senior informaticist at MetroHealth in Cleveland, Ohio. I took the transcript of our 30-minute conversation and broke it down into 2-minute reads.

• I. Find a mentor. Mentor’s job. Confidence. Curiosity. 1-pager. Stories.
• II. Book club. Being Boring. War Stories.
• III. Is Mentorship = Therapy? The Psycho 80.
• IV. Meetings. Coaching. Peer Mentors. Networking. Blind-spots. Listening.
• V. Lateral thinking. More Book Club. Persistence of Memory. Stumbles.
• VI. Failure Resume. CT ruined healthcare. Mentor a mentor? Downstream.

Ready? Here’s part 6 of 6. If you have time to listen, the full 30-minute audio interview is here. Here’s the audio-only interview (33 minutes).

Failure Resume

Mentor a Mentor

Rowing Downstream

END OF CONVERSATION. 

image from Dall-E via Bing Chat. “2 physicians with a hilarious and terrifying mentor experience.”

This is an interview between Dr. David Bar-Shain, originator of the PACmentor program. The PAC is the Physician/provider Advisory Council comprised of physicians who attend the Epic User Group, and Dr. Bar-Shain is a senior informaticist at MetroHealth in Cleveland, Ohio. I took the transcript of our 30-minute conversation and broke it down into 2-minute reads.

• I. Find a mentor. Mentor’s job. Confidence. Curiosity. 1-pager. Stories.
• II. Book club. Being Boring. War Stories.
• III. Is Mentorship = Therapy? The Psycho 80.
• IV. Meetings. Coaching. Peer Mentors. Networking. Blind-spots. Listening.
• V. Lateral thinking. More Book Club. Persistence of Memory. Stumbles.
• VI. Failure Resume. CT ruined healthcare. Mentor a mentor? Downstream.

Ready? Here’s part 5 of 6. If you have time to listen, the full 30-minute audio interview is here. Here’s the audio-only interview (33 minutes).

Mentorship and lateral thinking

CT: To the point about reading books, I love the idea of lateral thinking. Sometimes the head-on approach doesn’t work and sometimes by reading a book it gives you an idea. My Informatics group has a little book club.

Book club and the persistence of memory

CT: I no longer attend on the inpatient service but since my days two decades past when I was in the inpatient service at the end of the rotation it used to be a month-long rotation, you take the interns and residents out to dinner, and the other thing I used to do is buy them a book, like Atul Gawande’s Complications. Such a book will prompt a higher-level thinking about healthcare in this country and where are we going.

It’s surprising how powerful that tiny gift is. It’s a $14 book. I met someone 20 years later who said, “You gave me a book years ago, and I never forgot that you did that,” and that’s a $14 purchase.

Book club example: Switch

CT: I have a team of 20 informaticists. Buying all of them a book costs me something on the order of $400, but I find it to be tremendously valuable to have a recurring book club where we’re talking about things like Switch. The book Switch, the Heath Brothers wrote this, and it’s about the rider, the elephant, and the path.

And if you haven’t heard about this, for example, we think that we are the rider. We’re the intellectual person who controls the animal and we think to ourselves, I took the left path because I reasoned about it and I read the differences, the p -values in favor of the left path. I took the left path.

But so often, it’s the elephant that decides. The elephant feels something, doesn’t like this, doesn’t like this, and makes a snap judgment. And unfortunately, what happens is the rider then justifies it by thinking, “Oh, I took the left path because this is why.”

But the elephant was the one who made that decision. It was a gut feel decision. And that goes along with, the system one, system two, thinking. System one is a snap-judgment system. System two is careful reasoning that system takes a lot of glucose energy, it takes a lot of brain power to do. Often we are lazy and use system one to make the decision.

The book Switch is all about how you influence the feeling of the elephant. You influence it with story and not with data.

In informatics we’re data driven, very much using our System two thinking. Well we’re very proud that we are data driven, these are OUR analytics! And yet one person tells a story in the other direction, and, sorry, the elephant has already made a decision.

We have the elephant and the rider, and then there’s the path. And the elephant’s going to take off down the easiest path, and therefore, can you shape the path, at least, for the elephant. One of the stories that comes out of the book, that I love, is about people who own car washes. Car washes often have a loyalty card.

Nine punches, and the 10th car wash is free. You’ll get a 10 % uptake for people who will use your loyalty card.

BUT if you create a 12-punch card, and the 12th one’s free, but when you hand out the card, you punch the first two right away, people think: “I’ve already got two Free Punches on the punch card, I am already ahead! I should do the third one” and then you get a 30 % increased uptake. Holy smokes, shaping the path makes this unconscious bias. Look at the progress I’ve already made!

How can we use that in informatics? Can I make a checklist where the people can automatically check number one and number two, and then I’m already on my way, I better do number three. These are the types of things we read about and think, how does that apply to the work that we’re trying to do? Because I can make a checklist just like the next guy, but who’s ever done a checklist where the first two are easy to check off, did we design it that way? Engineering the environment.

 Mentee stumbles

CT: It’s not your job to make sure your mentee never stumbles.

This is like child rearing. Beware of the idea that we’re gonna mow the grass and make sure there are no pebbles, so our children won’t ever stumble. It’s not your job to do that with your mentee either.

It’s their job to grow and you point them in a direction, but you let them make their own mistakes and it’s not your job to call up and make sure everything is okay.

DB: I’ve often analogized that to “You’re the coach not the player” a coach doesn’t go on the field and play.  On the ultimate play of the game, they coach from the sideline and send their best player out with hints about how to perform.

CT: Yes, you get them to grow their skills and point them in a direction and encourage them, give them some confidence, but you’re not there playing the game.

DB: And then if they stumble or if they fail, then they have an item for their CV of failures, right?

 CONTINUED NEXT WEEK

image from Dall-E via Bing Chat. “2 physicians with a hilarious and terrifying mentor experience.”

This is an interview between Dr. David Bar-Shain, originator of the PACmentor program. The PAC is the Physician/provider Advisory Council comprised of physicians who attend the Epic User Group, and Dr. Bar-Shain is a senior informaticist at MetroHealth in Cleveland, Ohio. I took the transcript of our 30-minute conversation and broke it down into 2-minute reads.

• I. Find a mentor. Mentor’s job. Confidence. Curiosity. 1-pager. Stories.
• II. Book club. Being Boring. War Stories.
• III. Is Mentorship = Therapy? The Psycho 80.
• IV. Meetings. Coaching. Peer Mentors. Networking. Blind-spots. Listening.
• V. Lateral thinking. More Book Club. Persistence of Memory. Stumbles.
• VI. Failure Resume. CT ruined healthcare. Mentor a mentor? Downstream.

Ready? Here’s part 4 of 6. If you have time to listen, the full 30-minute audio interview is here. Here’s the audio-only interview (33 minutes).

Take-aways from meetings

CT: I have to be careful not to tell too many war stories, but I rarely end up with a big workload. It’s usually, here’s some ideas, let’s see how those work out. I can’t wait to hear how you did with that next time.

One of the things that is important to keep in mind is that mentor-mentee meetings should not be in themselves heavy lifts. I shouldn’t be assigning 17 hours of work to you. I should be talking about, “Hey, read this book if you’re interested and I hope I got you excited about it. Hey, if you’re excited about writing one pager, let’s have you try that out and let’s talk about it next time.”

Both of us should be coming and saying, “I can’t wait to talk about X, Y, Z, but I shouldn’t be dreading it. Ugh. Oh, this deadline is huge. I’m supposed to write this 17-page thing for this person.” No, it shouldn’t be that.

It should be a meeting of the minds, a sparking of ideas, and excitement coming out of it. I can’t wait for the next time.

DB: It really sounds like people get that out of their meetings with you.

Coaching vs Mentorship vs Peer Mentorship

CT: Another idea is that you’re an advocate. The terms can be confusing. Is it coaching? Is it mentorship? I guess there are different definitions.

I meet with lots of folks in my organization. Some are leaders in clinical areas, but don’t report to me. In some cases, we find our conversations mutually helpful. For whatever reason, we’ve agreed, let’s meet again. This was useful to both of us. And it’s not always a power dynamic of I’m mentoring you. Sometimes it’s peer mentorship. “Hey, I can help you with some things. You can help me with some things. Let’s reflect on the common struggles we have.” Sometimes that can be incredibly powerful.

A peer mentor can hold you accountable to move forward in your career. For example: “Why haven’t you revised your CV?” “Oh, yes I did promise to do that with you.”

 Networking and mentorship

CT: A mentor is an advocate. Sometimes you say, “Let me introduce you to this other person, because I think he/she could help you achieve what you’re trying to do.” Or, someone else I know in the organization is trying to do something similar and maybe if you team up, you will be more successful. I’m always thinking in the back of my head, “who else in my network can be helpful to you that maybe you haven’t met yet?”

Iit’s always surprising. In fact, what happened among my separate mentees, was one person was complaining about pediatric vaccines and another one had just talked about pediatric vaccines at XGM and I’ll say, “You guys should talk to each other.” And I love to take credit for the two of them talking to each other, coming up with great ideas and say, “You are such a great mentor, because we solved this thing.” And I say, “You’re welcome and all I did was introduce the two of you.”

Mentor’s job: Blind spotting

CT: The other thing I think about is sometimes you can see blind spots.

If you’re only in your own head and struggling to make progress in informatics, sometimes you keep bashing against the same thing and you don’t see it. But just being a person in the room listening, you can sometimes say, “Well, have you ever thought about putting on the other person’s hat and how do you come across to them?” And they say, “Oh, yeah, I must be a big pain in their butt.”

Listening more than talking

And you say, “How would you think about approaching that?” The mentee then says, “I could probably be nicer or I could probably look for something in common.” Then I could say, “These are great ideas.” I love just asking questions and most folks have great ideas that they’re just afraid to voice. And I love just having them talk until they say, well, that’s a great plan. I say, “I’m glad I helped you by asking questions because you already had a great plan. I just needed to give you some space to talk about it and assemble something useful.”

DB: That’s a great idea. The patient often knows their own diagnosis.

CT: Exactly. If they can just express it to you. It’s surprising how often this works with patients. “Tell me more about that. Tell me what ideas you have. Really? That sounds really fascinating. Have you ever tried that? You’ve never tried that? Well, how about between now and next time you try that?” Patients love it and, they think you helped them, but they came up with the idea. I’m just validating.

Listening is so powerful. One of my colleagues used to say. “The more I listen, the more my patients learn.” I suggest the same for mentors.

 CONTINUED NEXT WEEK

image from Dall-E via Bing Chat. “2 physicians with a hilarious and terrifying mentor experience.”

This is an interview between Dr. David Bar-Shain, originator of the PACmentor program. The PAC is the Physician/provider Advisory Council comprised of physicians who attend the Epic User Group, and Dr. Bar-Shain is a senior informaticist at MetroHealth in Cleveland, Ohio. I took the transcript of our 30-minute conversation and broke it down into 2-minute reads.

• I. Find a mentor. Mentor’s job. Confidence. Curiosity. 1-pager. Stories.
• II. Book club. Being Boring. War Stories.
• III. Is Mentorship = Therapy? The Psycho 80.
• IV. Meetings. Coaching. Peer Mentors. Networking. Blind-spots. Listening.
• V. Lateral thinking. More Book Club. Persistence of Memory. Stumbles.
• VI. Failure Resume. CT ruined healthcare. Mentor a mentor? Downstream.

Ready? Here’s part 3 of 6. If you have time to listen, the full 30-minute audio interview is here. Here’s the audio-only interview (33 minutes).

Is a mentor a therapist?

CT: Sometimes being an internist ends up being a therapist. I had a student who was shadowing me who then went back to their program director and said “I’d like to be reassigned. Most of Dr. Lin’s practice is psychiatry and I’d like an internal medicine experience please.” I thought to myself: “Well in about 20 years come back and tell me what you think about internal medicine then.”

But I really enjoy hearing and letting people vent. And sometimes they talk enough that they solve their own problem. And boy, what a jujitsu move that is, to just be quiet and say “Huh, and what do you think about that?” or “How did you approach that?” or “What are you thinking about it now? And what ideas do you have now?” And eventually they get to a solution for themselves. Then they say: “Oh, thanks for this great advice.” And all I did was ask questions.

DB: Well, but how do you avoid becoming the person’s psychiatrist? Because sometimes mentees come with a tremendous need. They may have experienced trauma, or they may be experiencing trauma now that they might reveal to you. How do you put the brakes on that kind of content for the mentee -mentor relationship so that you can be professional and not be their psychiatrist?

CT: I don’t have any. any hard and fast rules. I mean, we can always say, I’m sorry to hear that. Let’s move this back to informatics and how does that apply to what you’re doing now?

80 / 20 rule, or the Psycho 80

CT: I always come back to the 80 /20 rule. Some people believe, as I did in my early career, that Informatics is about IT design and where you put the button and what kind of analytics and did you get the P-value up to a certain level?

However, 80 % of successful informatics is the socio-political skill of the folks doing the work. One might call it the Psycho 80. The 80% of the work that is NOT technical, it is instead psycho-social skill.

And even if you have the predictive model exactly where you’d like it, did you talk to the right leader about it? Did you tell the right story? Did you convince the right clinician to convince their colleagues that they should be looking at the score? How do you do that on an interpersonal level?

To some degree it is psychotherapy, it is confidence boosting, it is interpersonal relationships and then bringing that back to what you’re trying to accomplish. I’ll also say that one of the books, I don’t know where this came from, probably from my daughter who wants to go into psychology, a book called The Gift of Therapy where a psychologist reflects on 30 years of their practice and boils their 50 chapters of lessons down to three things.

Therapist skills for mentorship

CT: And I find that really applies to mentorship. And the three things are accurate empathy. I love that. Accurate. I’ve heard of empathy, I’ve heard of accuracy, but never the two words together. Accurate empathy is understanding correctly what the person is telling you. Accurate empathy.

And the second one is unconditional positive regard. Huh, I think, unconditional positive regard. I happen to do that. It’s not my intention to do that. But whenever a mentee approaches me, I always think, well, you’re doing great work. How can I help you? I never say: “I’m not sure that thing is a good idea.”

In fact, one of my colleagues who I’m trying to coach into being a mentor says, “why is it that after two or three meetings, they never want to meet with me again?” And I ask him, “What do you talk about?” And he says, “Well, they bring me projects and I tell them that the reasons it’s not going to work.” And I say, “Ah, maybe the first thing you ought to say is, good job for coming up with that idea, that I can see where you’re trying to go with it. Tell me more about that.” And then that way you can problem solve together rather than, “All right, here’s the five reasons that your approach is wrong.”

No one wants to come and just be battered over the head with why their pet project is never going to work.

And unconditional positive regard is one of those things I hold unconsciously as you’re coming to me. The point is, how can we make it go, whatever you’re trying to do? How can we make it go? And sometimes you have to pivot and sometimes you have to drop it because it’ll never work, but I’m not the one to do that. I’m the one to say “What you’re trying to do: And why is it we get getting stuck here?” And let’s ask about that. Let’s be curious.

DB: And what’s the third thing?

CT: And the third one is genuineness. Because if you’re doing accurate empathy, but in the back of your head, you’re thinking, “This is idiotic, why am I here?” The nonverbals leak across. So, I always come with curiosity.

Also, I’ve been lucky. Thank you for always sending me fantastic mentees. I think that’s part of my success is that the people I mentor with are hardworking, they’re enthusiastic, and they always have great ideas. And it’s easy to come to the meeting and say, “I’m really curious. What’s happening? What are you working on?” And, “What have you been successful at?” It’s easy to do that. And if you come with that attitude, it’s always a pleasure.

When I look on my calendar and see mentorship meetings, I think, “This is going to be a great day” because unlike other informatics meetings, where CT is assigned 17 tasks, and I’m gonna have to work all night on this project, in contrast, mentorship meetings are light workloads for me and so enjoyable.

 CONTINUED NEXT WEEK

image from Dall-E via Bing Chat. “2 physicians with a hilarious and terrifying mentor experience.”

This is an interview between Dr. David Bar-Shain, originator of the PACmentor program. The PAC is the Physician/provider Advisory Council comprised of physicians who attend the Epic User Group, and Dr. Bar-Shain is a senior informaticist at MetroHealth in Cleveland, Ohio. I took the transcript of our 30-minute conversation and broke it down into 2-minute reads.

• I. Find a mentor. Mentor’s job. Confidence. Curiosity. 1-pager. Stories.
• II. Book club. Being Boring. War Stories.
• III. Is Mentorship = Therapy? The Psycho 80.
• IV. Meetings. Coaching. Peer Mentors. Networking. Blind-spots. Listening.
• V. Lateral thinking. More Book Club. Persistence of Memory. Stumbles.
• VI. Failure Resume. CT ruined healthcare. Mentor a mentor? Downstream.

Ready? Here’s part 2 of 6. If you have time to listen, the full 30-minute audio interview is here. Here’s the audio-only interview (33 minutes).

Book club

DB: And they’ve also told me that you’ve assigned books to them.

CT: I enjoy reading and frankly, I’ll say my guilty pleasure is audiobooks because there’s no time It’s a long work day and then exhausted in the evening.

DB: And so what hours are there to sit down and read or playing the ukulele or maybe that’s work hours.

CT: I’m on my bike riding and sometimes I’ll listen to an audiobook while I’m out on the trail.

DB: With one earbud in.

CT: With a one -earbud in, yes? Right, exactly. And I can consume books like Switch or the Righteous Mind or Thinking Fast and Slow and realizing there’s things outside of healthcare that explain how our brains work and how do I apply that to our design and informatics. There are many great ideas outside of healthcare. In addition to improving your design of your Epic EHR, yes, but also there are many tremendous ideas outside of healthcare.

We used Net Promoter Score as a physician satisfaction tool that in 2011-2012 weren’t being used in healthcare. We began using this as a satisfaction score. We heard from others: “Where did you get that?” It’s an industry standard outside of healthcare. Why are we not using these tools?

I like reading outside of my industry. That’s a very small lateral move to bring that into health care and use it here. I enjoy talking about books and new ideas.

DB: If you give somebody an assignment and ask them to read the book, how long do you give them to consume the book?

CT: Oh, it’s nothing that formal. I will usually say, well, from this book, I have this idea, And it’s not an assignment. It’s if you choose to read it, this is where I got this idea. I’d talk about it with some excitement, apparently according to my mentees. “You said that so interestingly that I had to go read the book.” “Fine, let’s talk about it next time.” You should you choose to.  It’s not an assignment.

A boring mentor? Do’s and Don’ts

DB: Tell us more about your techniques.

CT: Well, I had one of my mentees say “Gee, the last person I had as a mentor spoke for nearly an hour about what they thought I should learn about leadership to the point where I ended up doing Epic in-basket work while they were talking because it was just not applicable to me.”

And I am surprised by that because I believe that during a mentor-mentee meeting, the mentor should be listening more than half the time. In a patient interview, if the doctor is talking more than half the time, you’re not really getting it. Part of it is just being all ears and trying to withhold advice until the mentee’s done talking, explaining what position they’re in and what advice they’re looking for.

I find that to be tremendously rewarding because hearing the story of where they’re coming from is very gratifying for me to connect with another person on a human level.

Mentor war stories

And I’ll end up telling you a story personally as well. “Oh, oh, yeah, I did that 10 years ago. I stepped in exactly the same thing and here’s what happened.” And they’re respond: “Oh, I’m not the only one.” I think those war stories can really help somebody in that regard.

“Oh? you did that too?” “Yes, I did.” I Sometimes I feel like being a mentor is in some ways being a therapist. I apply this to being in patient care as well.

 CONTINUED NEXT WEEK

image from Dall-E via Bing Chat. “2 physicians with a hilarious and terrifying mentor experience.”

This is an interview between Dr. David Bar-Shain, originator of the PACmentor program. The PAC is the Physician/provider Advisory Council comprised of physicians who attend the Epic User Group, and Dr. Bar-Shain is a senior informaticist at MetroHealth in Cleveland, Ohio. I took the transcript of our 30-minute conversation and broke it down into about 2-minute reads.

• I. Find a mentor. Mentor’s job. Confidence. Curiosity. 1-pager. Stories.
• II. Book club. Being Boring. War Stories.
• III. Is Mentorship = Therapy? The Psycho 80.
• IV. Meetings. Coaching. Peer Mentors. Networking. Blind-spots. Listening.
• V. Lateral thinking. More Book Club. Persistence of Memory. Stumbles.
• VI. Failure Resume. CT ruined healthcare. Mentor a mentor? Downstream.

Ready? Here’s part 1 of 6. If you have time to listen, the full 30-minute audio interview is here. Here’s the audio-only interview (33 minutes).

PACmentor program

CT: Thanks, David, for inviting me to have this chat.

DB: The PAC Mentorship Program started four years ago, and we’ve had more than 170 people involved. CT has been an incredibly impactful and productive mentor, and so I thought we’d take a couple of minutes today to download the secret software. and figure out what does CT do that other people could learn from in their mentorship pairings and see if we can improve mentorship with an experienced mentor telling us his experiences.

How to find a mentor. Need more than one?

DB: Can you characterize your style or what you think about when you meet somebody? How would you suggest people go out and meet somebody?

CT: First of all, a disclaimer, I don’t claim to be an expert in this area. I enjoy it, and I’m sure I have blind spots on things that I don’t do well. One of the things I read about recently before I get into how we start is the idea that was earth shattering to me, that one of the jobs of a mentor is to ensure that your mentee has more than one mentor because in many cases one mentor won’t be able to serve all of the needs of a mentee.

If it’s financial budgeting for research project, I’m going to be terrible at that. And asking enough questions to understand: “You need to find someone else who could complement the skills that I can bring to the table.” That’s one tip.

DB: And are people able to go and find a mentor outside of the aegis of the program that they came to you in them?

CT: I think each mentee is different. Some have great agency and they say, “Oh, got it. Good idea.” And off they go. And others say, “How do I start with that?” And then you can help explore that.

DB: So what would you tell somebody who says, “Oh, I don’t really know. I got to you because I filled out an application and somebody said you’d be a good mentor for me, but I don’t really know how to find someone else. How would you suggest that I go and find somebody else?  How can I approach somebody to be my mentor?”

CT: It becomes a Q &A and an exploration. ‘Who do you know in your organization? Do you have any connections? What thoughts do you have?” And sometimes mentees will just be really tentative and say, “Well, I don’t know.” I have two or three ideas, but I think they’re stupid.” And I’d reply “Say more about that.”

A mentor’s job: confidence

CT: And sometimes a mentor’s job is to infuse a little bit of confidence. You might say: “That’s a great idea.” “Well, maybe I will reach out.” And sometimes just that, it can just be a nudge in the right direction.

DB: When you were younger, did you have experience with that where you were able to approach someone and ask them to mentor you?

CT: I was not great at advocating for myself as a mentee. In my organization, Informatics didn’t exist until 1997.

I was chief complainer. And I basically bootstrapped my way into a job by complaining enough that they said just put him on the committee because he’s just gonna cause problems otherwise. He’s this squeaky wheel. We will make him own the problem.

Being curious

CT: In terms of meeting a new mentee, I think about it like meeting a new patient. The primary idea is curiosity. I’m interested. This is a up-and-growing person who is eventually going to blossom in this field. And I see this as the way we grow our expertise and informatics nationwide, worldwide. And the more they can have a foothold, a step up, the easier it is for everybody, a rising tide. 

Who sets the agenda for a meeting?

DB: Do you find that mentees come to you with an agenda, or do they come to you with, “I’m not really sure what I’m supposed to get out of this relationship?”

CT: I’ve really enjoyed working with the mentees I have.  It’s the entire spectrum. Some sit down and say: What are we supposed to talk about? And you have to co-invent it. Hey, what’s your job like? Tell me what you’re struggling with. Maybe I ask: Tell me the things you’re proud of. And we take it from there. And sometimes it’s not at all what we expect the conversation to be

Other times people come with, “I have three questions. First, I’m going to allocate 20 minutes to this question, 20 minutes to the second question.” I reply: “This is great. You are super organized. Fantastic. Let’s just go with that.”

DB: And who takes the initiative to set up that first meeting and then the second and the third meeting?

CT: I rely on the mentee. When I connect with the mentee, the first thing I say is “You drive the boat. If I never hear from you, then it sounds like maybe you’re not interested. I would expect to meet with you, let’s say I on a monthly basis and then we could change it depending on whether this is useful to you. But I expect you to come with an agenda. What questions do you have? What do you want to talk about? And then we can explore it from there.” And that’s generally worked quite well.

Video or phone or in-person?

DB: Do you usually do FaceTime video or do you do phone calls?

CT: I’ve really liked seeing the faces of the mentee. In recent years, most of my mentee meetings have been during the pandemic and I’ve gotten very good at Zoom. And having a face -to -face over Zoom, being able to see the nonverbals, the hesitancy, the confidence, that’s been really helpful. There are occasions when one of us is not near a computer and will substitute a phone call, but I strongly prefer a video

DB: And do you prefer an agenda ahead of time, or are you really OK in the second and the third meeting with just continuing the…? conversation?

CT: An agenda ahead of time is not really necessary. Frankly, I’m busy enough. And I imagine most mentors are busy enough that you’re not sitting down and studying the agenda ahead of time and saying, oh, I’m going to bring these ideas to the meeting. Having an agenda presented during the meeting, I think, is sufficient.

Assignments? The 1-pager

DB: One of the things your mentees have told me– I know all three of your current mentees and have talked to them about their experiences– I’m going to bring these ideas to the meeting. I’m going to bring these ideas to the meeting. of the things they’ve told me is that you give them assignments.  Can you talk a little bit about those assignments that you give them?

CT: I don’t know that I come with particular agendas. I find that in our conversations there will be recurring themes. One theme is, as an internist, I’m guilty of this as well, is overthinking a project or over-explaining a project.

Here’s where I’m going to launch into a war story that you’re gonna have to stop me.

But the danger of war stories from mentors is that sometimes it turns into a personal therapy session. And I was so frustrated, and let me tell you this 15-minute story. And I think we have to be very careful that any stories we tell need to be in the service of, whomever you’re speaking with. But one thing that I’ve done in my past was over-explain Open Notes. For example, we tried to, I tried to implement Open Notes in 2003.

And I wrote a 17-page white paper because, by gosh, I was going to anticipate and answer every possible challenging question that people could throw at me about Open Notes.

I wrote it and I distributed it. Who read it? Nobody. It was too long. It’s too much explanation, and it looks dense. And I’ve since learned that, write a one -pager. It is like a newspaper. If it doesn’t fit in your limited space, it doesn’t belong there, and if you can’t communicate it on one side of one piece of paper, you’re overthinking it.

One assignment I give to my mentees is, “Whatever project you’re working on, you have to explain it one side of one piece of paper.” “What do you mean? My explanation is seven pages.” “Well, you’re over explaining it. Can you get it down to one page?”

And, that one page needs to combine data for the left brain and story for the right brain, because no one’s mind is made up from reading data.

“Oh, the p value is 0.5? I had better change my behavior!” No, only a story has the change to change a mind. It’s someone who said, “when I did this, this happened to my patient. That’s why it’s better.” And I say, “Oh, that totally makes sense.”

I ask folks: “Why don’t you write an engaging document. One side of one piece of paper that gives story AND data?” And bring that to our next meeting.

DB: And have your mentees succeeded at writing those one-pagers?

CT: It’s been a lot of fun to see them evolve from, “Wow, that was six -point font, but you fit it all on there.” To “Let’s get rid of three -quarters of that text. Show me a picture, show me an image, tell me a story. There are no quotes on here. It’s all p -values.” “Oh, that’s right. I was supposed to include that.” And version 2, version 3, look, this is convincing. If I would see this in a board meeting, this could convince me that this project is worth it.

And they keep working at it and getting better.

DB: So you introduce the idea. They write it. They send it to you in an email.

CT: I’ve given some comments outside of a meeting. But most of the time, we look it over together at the next meeting. And I don’t edit it and say, “Here’s the finished sentence.” I say, “Here’s what I don’t get from your project. This is part is not well explained.” Or, “Yes, there’s a bunch of data, but where’s the story? How do you tell me the why?”

DB: And who reads those one-pagers? What do they do with them?

CT: Well, that’s the other problem, which is when I write one -pagers, I can critique myself and say, “Who am I writing this for? I’ve written it for myself. I pat myself on the back. Look how good I am.” And then I think: “who’s actually gonna read it?” Then I realize: “this is half for informaticists and half for frontline doctors. I need to rewrite this because I need to know who my audience is.”

And that’s what I get from my mentees, is I wrote this thing because I like it and then I realize, who’s this for? It is only for myself. At the same time I’m critiquing them, I’m critiquing myself.

 CONTINUED NEXT WEEK