An informatics scenario challenge: Rock vs Hard Place

Generative AI response to
“a physician informaticist caught between a rock and a hard place”

The scenario:

YOU are a physician informaticist. You are board certified in informatics, you are an effective physician builder, and enjoy an excellent relationship with your department chair and clinical colleagues. You have protected time to this work. You have excellent IT analyst colleagues who will collaborate and help get your projects over the finish line so that they’ll be used. You have built scoring tools, you have built smartforms to better capture clinical findings, you have built analytics reports that clearly demonstrate that you have improved the care of the patients in your clinics.

AND YET. Your organization is part of a large health system with byzantine socio-political dynamics. You have multiple bosses, and each boss has very different ideas on what you should and should not work on, and they don’t like each other. Projects that you initiate and introduce to your leaders disappear from view, only to resurface later as some one else’s idea.

A project that you were not initially involved with is now YOUR problem. Some project team built a Best Practice Alert that interrupts all the doctors, and no one is happy: it doesn’t have the right information to help with decision-making, the doctors are bypassing it, the intervention is not working, but HEY. YOU’RE the expert on workflow, so can you help us? Tonight? We need to fix this tonight.

Disrespect. Misunderstanding.

Why don’t they keep you involved on projects you initiated? Why don’t they involve you earlier on projects where you have expertise? Despite your best efforts to describe your dilemma, it seems your bosses don’t really get you and aren’t listening.

And, you have made accommodations for quite a while. Maybe it’s okay, maybe it will be better next time. Maybe you’ll finally get be publicly recognized. Oh, not this year? Okay, maybe next year.

A rant from a colleague

What if you heard this from a colleague? What would you do?
Multiple choice:

• Say “Goodbye!” Run for the hills and don’t talk to your colleague any more
• Say “Time to LEAVE, my friend. Freshen up your CV and get on the road.”
• Say “I’m sorry to hear this. That must be difficult.”
• Nod your head sagely and stay silent, and hope they feel the empathy waves coming off you and start brainstorming their own solution
• Jump right in a do the male/female Mars/Venus conflict thing and try to SOLVE THEIR PROBLEM without being asked to. (Have you seen the youtube video “It’s not about the nail?” Hilarious. And, I see myself. If you HAVE NOT seen it, go there, and then come right back)

Reader, I have used all of these responses in my long and confusing career. What a disappointment I have been to my mentees and colleagues.

The parallel universe

This time, though, in a recent conversation, I went a different way. This is something I vaguely learned during a leadership exercise, I’m not sure to whom to attribute this.

Given the scenario above, I said instead: Here is a task for next time we chat.

Take a time machine 2 years into the future. You have made some choices, advanced your career, and now you can’t WAIT to talk about the amazing things you’re working on.

How did you get here?

This task will take 2 hours.

Set aside some time. Get a bunch of blank pieces of paper, some color pens, sticky notes, scissors, glue, whatever you have to be creative. TURN OFF your laptop, phone, notifications. No interruptions. No electronics. No one around to judge you.

Your mindset: Blue sky thinking. Post-cards from your future. Turn off your editor brain that says “You can’t do that.” Everything is possible.

Be outrageous. Make a mess. This is your time.

Task 1: Quantity not quality. Fill an entire page with ideas of what you might be doing in 2 years. If you fill it, keep going.
* One column of ideas are “Redesigning my current role”.
* One column is “Stay in my current field but make a big leap”.
* One column says “NO limits. BUT, I cannot stay in my current field”
Fill the page. Most of the ideas will be terrible. Keep going. Dedicate at least 30 minutes to this. Your brain is not permitted to edit or cross out.

Task 2: Highlight the ideas that appeal to you in all 3 columns. Pick a few from each column and write a few sentences filling out the idea, just enough to develop some feelings around it. Does it excite you? Surprise you?  Disgust you? Bore you? Scribble some notes. Spend at least 30 minutes on this.

Task 3: Get up. Go outside for a walk. Think purposefully about NOTHING. You have just prompted your brain to jump out of its rut and be open to completely new directions. Don’t listen to music or an audio-book or podcast. Be silent with your thoughts. Let your mind wander. At least 30 minutes. Some would even argue that you should sleep on it and conduct task 4 tomorrow. This is to allow system 2, your subconscious and non-directed brain to explore.

Task 4: Were there more ideas to scribble down? Pick your favorite idea from columns 1, 2 and 3 and write a page about each one. Scenarios you see yourself in. Things you are working on in each parallel universe. Projects you’ve accomplished. The joys of that work. Draw a picture. Use scissors and glue to build an artifact. Envision yourself in that role. Feel it. Close your eyes and look around in that world. Spend at least 30 minutes.

As you conclude your time, look at your 3 papers. One of them speaks more to you than the others. In one of them your inner child rejoices. In one of them, your energetic younger self cannot wait to get going. What is it?

Your handwriting sucks

At the least, it can be fun to see: a) how badly your handwriting has degenerated as we handwrite less, and express more thoughts by typing or speech-to-text, b) what it feels like to be in kindergarten again, scribbling, coloring, drawing, c) see how your right-brain creativity can take some time to come out of hiding.

Who knows? There might be something really useful or interesting there. Is it time to act? If not right now, should we remind ourselves to do this exercise again in a year?

This is an exercise in lateral thinking. This is a way of jumping your brain out of the usual well-worn cobblestone paths with deeply-grooved ruts from horse and oxen-drawn carts rumbling along them for millenia. Sometimes going “off-road” can spark an insight.

CMIO’s take? What did you come up with? Are there fragments of these dreams that you can put into action now? Where did this journey take you? Take a picture, send it to me! Let me see!