Category Archives: Figure Stuff Out

The best question you can ask your doctor sending you off for a bunch of tests – blood test, biopsy, x-ray – is this: how will it change what you do next?

In my work as a resident in radiology, one of the most important teaching focuses is Recommendation.  Although not commonly placed in a diagnostic report, the element of advising your referring doctor is implicit in your Impression of the radiologic examination.  It took a while for me to recognize what it means to fully embrace the role of a consulting physician:  Your colleagues are in doubt about their next step, and your job is to help them decide.

This has two implications:

(1) If the doctor ordering the test is 100% sure about what their next step, then your test is extraneous and therefore should be cancelled.

(2) If your test will not help the ordering doctor move closer to that next step at all, then your test is unhelpful and therefore should be cancelled.

In life, many of us have been “stuck” before too.  We have overarching, bird’s eye view of what we want to accomplish.  We know that these goals are divided into smaller goals, and smaller goals, and yet smaller goals.  But we are “stuck” because there is nothing that connect us from where we are to where we want to be.

As a radiologist, if you can help a doctor find the right next step, then you’ve done your job very well.

As a friend, if you can help someone make that connection between where she stands and where she wants to be, help someone make that single next step, however small, you will have been a great friend.

It begins with a single step.

Humans are lazy.  We don’t like to think hard.  Proven. In this smart guy’s book.

But sometimes people take brilliant decision science theories too far.

It’s true that very few decisions in this world can be made as black-and-white, but most of us find making a decision using black-and-white terms much easier than by “weighing all the pros and cons.”  This phenomenon is well studied and is called heuristics or attribute substitution – we make decisions by replacing a hard question with an easier one (subconsciously).

Case in point:  Continue reading →

“What’s your take?” is a question people sometimes ask when they want your opinions on a subject at hand.  Sometimes it also mean they are actually asking whether you agree with them.  If you were to agree, you get the opportunity to paraphrase their opinions.  If you were to disagree, the phrasing is such that you aren’t forced to start the response “No” as would be necessary with the question “do you agree?” (or risk not actually answering the simple yes-or-no question).

It’s an opportunity to create an engaging discussion without confrontation, a question worth pondering over for a few seconds before answering.

Throughout management training I was taught “More isn’t better; better is better.”

But there’s a problem with being better. To be better means to be compared against something.  Sometimes it’s competition against another person – do better than that rival.  Sometimes it’s competition against the self – do better than what you did yesterday.  Sometimes it’s competition against an ideal – as in “you can do better.” Being better implies optimizing on something, that somewhere above where we stand exists a higher level of achievement.  To be better means to take what we  already do and improve it based on the evaluatives of an existing rubric.

The problem with “better,” then, is that it only works when your customers – and here “customers” takes on a wide meaning: patients, buyers, parents, whatever – uses the same rubric that you do.

Being better is also very hard to do – to find the “Best” out of N choices, a computer makes N-1 comparisons, each comparison based on a rubric of many parameters. Humans take shortcuts by substituting this algorithm with a heuristic – a much easier question.  Most of the time, “who’s the best doctor/plumber/dogsitter” gets subconsciously substituted with “who comes up in your head first when I mention doctor/plumber/dogsitter?”

In other words, our customers very frequently end up thinking very differently about “better,”  and being better isn’t always better.

We end up with ourvery own type of better – how we uniquely contribute to the team, the organization, the customer.  How we communicate these qualities shapes how we differ from their choices. Different is how people remember us, walking away from that first meeting.  Different is what stops us from becoming a substitutable commodity.  Different is better than better.

We all know getting started is tough; that’s not news.  Writing the introduction of your paper, the first day on a new job, starting a company, all tough tasks.  Taking the first step requires a certain amount of know-how.

Taking the second step, though, is an entirely different matter.  It requires trusting that the first step you took was in the right direction, and that you are ready to commit and take things further.  With the first step, you are just experimenting.

The second step requires courage. It is what transforms a footprint into a path.

You leave the world with the relationships you’ve formed over the course of your time.  This is why people like having a drink with friends, watching movie with someone, or eat lunch with an associate, even though the acts of drinking, watching, and dining do not technically require an accomplice.

This is also why vowing to spend the rest of our lives together makes us so happy.