Caught up in the hectic daily activities of clinical practice and administration, health care practitioners can easily lose sight of long-term goals … easily forget what they set out to accomplish for themselves and for their loved ones. Yet proven strategies exist to help busy professionals achieve happy, healthy, productive, and well-balanced lives. To help you regain some perspective, an expert in life planning and personal productivity presents the following tips.
"To be what we are, and to become what we are capable of becoming, is the only end of life," wrote Robert Louis Stevenson in Familiar Studies of Men and Books1. Simple as that goal may sound, most people get so caught up in the day-to-day activities of living that they never come even close to realizing their full potential or their lifelong dreams.
Physician assistants and nurse practitioners, like other health care providers, are particularly vulnerable to this "activities-of-daily-living" trap. Starting with The Oath of Hippocrates ("With purity and holiness I will pass my life and practice my Art.... Into whatever houses I enter, I will go into them for the benefit of the sick....") and ending with the rigors of daily practice, health care demands personalities willing to place the needs of others ahead of self. Does this leave the practitioner with no time to pursue personal goals and dreams? Sometimes. But there are ways to assure personal growth and fulfillment, which ultimately improve a provider's ability to care for others.
GOAL PLANNING: WHY BOTHER?
Goal planning challenges the individual to give life a preplanned direction by employing specific exercises and strategies. Through goal planning, a person can take the shapeless life "direction" that most professionals have fermenting in the back of their minds - that fatalistic voice that says "work hard, do your best, and let whatever happens happen" - and learn to control many of the key events that ultimately give form to a person's life.
The first step in goal planning is to ascertain the control you do have over your life. Try this exercise: First, on a clean sheet of paper, list the past five years vertically along the left side (1994,1993,1992,1991, and 1990). Next to each year, list the most important event that occurred in your life during that year. Now examine that list and estimate the percentage of control or influence that you had over those events.
After using this exercise with numerous groups, I've observed that most people exert a significant influence over at least 80% of the most notable developments in their lives. Too few, however, take the time to reflect on their influence, allowing themselves to drift into believing that external forces really chart the course. Seeing how much control you personally exert over your life helps you to realize that you really are in charge, and that you can chart a course to success.
How does someone actually plan for success in advance, rather than letting things happen and hoping for the best? Skeptics still balk; even though, in retrospect, they acknowledge some influence over events, they do not concede an ability to plan these events in advance. To some degree, their argument is true: Goal setting is not a crystal ball, nor does it carry with it any guarantees. But goal setting definitely improves your odds for a successful outcome.
Many companies use "Management By Objectives" (MBOs) to motivate their work staff to higher levels of achievement. This is a simple method of translating an organization's business objectives down to each individual's specific contribution. For instance, if the goal for your entire office is to see 500 patients each week, your individual objective might be to see 125 of those patients personally.
In one review of studies on MBOs2, 66 out of 68 studied (97%) attributed positive results to their use. In fact, in 28 studies using objective measurements, productivity was shown to increase by 44%. The studies also showed that when commitment on the part of the management is high, results are even better. When goals are personal and individual, rather than corporate or vague, they are more readily adopted.
TARGETING YOUR GOALS
To get the most out of each aspect of your life, start by creating a life plan from which to set specific goals. This way you'll know where you want to end up. Setting goals "programs" our minds: The goals we set direct our mental focus. Subconsciously, the mind works continuously to satisfy the expressed need.
Notice that, here again, I said "life plan," not "career plan." Goal setting has application far beyond one's career. In fact, those people who set only business-related goals decrease their odds of having a well-balanced, happy life: Those who direct their subconscious to solve only business problems risk creating lives that focus on careers and neglect all other areas.
MEASURE YOUR LIFEBALANCE
Use The Wheel of Life to measure your overall degree of life satisfaction and to identify areas that might benefit from goal-setting. On a scale of 1 to 10 (where 1 is low and 10 is high), ask yourself how satisfied you are with your: financial situation and career; social and cultural situations; spirituality and ethics; family and home; mental and educational levels; and physical well-being and health. Consider your answers carefully, taking into account the following issues:
Financial and Career
Do you enjoy your work? Do you feel you are making a contribution to society? Are you living up to your potential? Have you achieved a satisfactory standard of living? Have you planned for your children's education? What about your own retirement?
Social and Cultural
Does your circle of friends enrich your life and contribute to your sense of fulfillment and well-being? Is there at least one other person with whom you can discuss important life experiences? Do you have interests outside of your career and family (e.g., sports, theater, outdoor events)?
Spiritual and Ethical
Have you ever articulated specific personal values to yourself? Are you living up to those personal values? Is religion important to you? If so, are you happy with the way you are practicing your religion? If not, have you reconciled your relationship with a higher power or with the universe in general?
Family and Home
Have you realized your dream in terms of your home and family relationships? Be sure to use your own personal standards rather than society's standards.
Mental and Educational
Did you accomplish the educational goals you set for yourself following high-school graduation? Are you still growing and learning? Do you invest in your continuing education on a regular basis?
Physical and Health
How satisfied are you with your current level of physical health? Are you living up to your own standards in terms of diet and exercise? Are you fit enough to do the things you want to do?
Having quantified your responses on a numerical scale, next record your answers by putting a mark on each spoke under the respective categories. Assign the innermost notch on the wheel a value of 1, and the outer ring a value of 10. After you have marked all of the spokes, connect your marks, creating your own "wheel." Congratulations to those whose wheel is round and hugs the outer edge of the figure. Chances are that you are reasonably happy and are living a fairly balanced life. However, any other shaped/configured wheel suggests room for growth.
For example, if your circle is lopsided, the low score(s) identify the area(s) in which you need to focus your goal-setting efforts. If your wheel is round but small, you need to set goals in all areas of your life in order to expand your wheel and to achieve greater general satisfaction.
S.M.A.R.T. GOALS
Whether personal or for business, the most effective goals are designed to be S.M.A.R.T.:
Specific
Measurable
Attainable
Realistic
Tangible with a target date
Consider the difference between these two goals: 1) Reduce your unnecessary expenses at home; or 2) Reduce personal monthly long distance telephone costs to $45 by July 1,1995. The second goal sets a specific target for personal phone use. Subconsciously, your mind can now monitor the length of time you spend on long-distance calls.
Using your wheel of life, set a series of goals and then rank them according to their priority. Remember, you should be specific so that you program your subconscious to target the areas of your life that you have identified as needing improvement.
THEN WRITE IT DOWN
In the same way that entering a note in a patient's chart reinforces the importance of a particular observation, written goals tend to carry more mental weight than goals we set only in our minds. By taking the time to think a life plan through and organize it in writing, we program our subconscious mind to give the written plan a priority.
Goal-setting and achievement are lifelong processes; make a concerted effort to enjoy each milestone as you travel the road to success.
So, select a few areas from your life wheel that you consider opportunities for growth and write them on a piece of paper. Keep in mind that this exercise is meant to help you; written goals simply reinforce a message to your subconscious. Should you change your mind, you can add new goals, or modify your old goals. All you need to do is rewrite your list.
Why emphasize the need to write life goals? Several important reasons come to mind. First and foremost, human beings tend to forget things. And while it is fine consciously to decide to change a goal, it is quite another matter to lose a goal in the craziness of a busy, challenging year.
The discipline of writing forces us to think through a goal more thoroughly; consequently, we subconsciously assign great importance to that goal, and tend to feel more committed to its achievement. By providing ourselves with a written deadline, we must take personal responsibility for any success or failure. Adding a time frame to the goal forces a plan of action if the goal is to be reached.
For an example, let's return to the patient-chart analogy. An entry that reads "Ordered culture and sensitivity on Monday, 5 PM. Started antibiotic A, 1 g b.i.d.; will check results in 48 hours and continue antibiotic pending appropriate sensitivity and patient response," reflects a much better treatment plan than one simply saying "Monday: began patient on antibiotic A." Goal setting really is far more effective when specific steps are integrated with written time frames and dates to document our thinking. And as anyone who sees more than one patient per day knows, most people's minds won't hold onto extensive, detailed plans without such documentation.
HOW TO BEGIN
Take some time right now to write out one goal you have for the future. Once you have written it down, go back and make sure that it's S.M.A.R.T.
After that, develop a specific action plan, with target dates, for achieving your goal. An action plan simply lists the steps you need to take to get from where you are now to the end point of your goal. No action step is too small to list. The objective here is to break down the task into manageable pieces.
Finally, schedule those actions into your daily appointment calendar. That way, you won't forget about them, and you can't employ the "I lost the piece of paper" excuse.
You should repeat this process every month with a new goal, periodically checking your progress with The Wheel of Life until you can honestly report that your wheel meets your own standards of success. And don't stop then - life is always changing...moving on; new goals are always needed. Ritualize this process: Make it a habit.
USING A COACH
Just as patients turn to you when their health falters and their home remedies do not work, you can turn to a professional coach should your wheel of life become critically misshaped. Don't be afraid to ask for assistance. Whether you need help with financial planning, family counseling, spiritual growth, career guidance, time management, or any of the other facets of a successful life plan, your life is too valuable to leave to chance. Once you've identified a serious problem, the first step of your action plan may simply be to seek expert advice.
AND FINALLY, ENJOY THE PROCESS
Goal-setting and achievement are lifelong processes. Don't fall into the trap of perpetually waiting until your next accomplishment before you celebrate. Make a concerted effort to enjoy each milestone as you travel the road to success; don't waste time worrying about goals you haven't yet reached. Keep your expectations realistic: No one reaches all of his or her goals. Remember that progress is always ongoing. Relax, and enjoy the process.
REFERENCES
1. Stevenson RL: Familiar Studies of Men and Books. New York City, C. Scribner's and Sons, 1902.
2. Locke EA, Latham GP: A Theory of Goal Setting and Task Performance. Englewood Cliffs, NJ, Prentice Hall, 1990.
Published in the 1995 issue of Clinicians Reference Guide. Reprinted with permission.
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