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
