The Challenges With Asking For More

Sometimes we ask to be challenged with new challenges but we haven’t fully delivered on the previous challenges we were given to handle.  And – why is it that we like to ask for more to do but we haven’t checked to see if we can take more on?  I believe it’s that we get impatient with ourselves, with others, with life, with work, with our trajectory – we just want to hurry up and get there.  Is it because some of us are natural overachievers?  Slow down. Take a deep breath and take stock of where you are and what you’ve accomplished or have yet to finish.  Think about the things you’ve learned, what you would do differently, and what you would do in the same way.  Reflecting on what worked and what didn’t work for you is a good exercise to do before we ask to do more.  As human beings we can only take on so much without sacrificing something else.  What are the things you can or are willing to sacrifice?  Have you thought about what the consequences might be?  You don’t have to dwell on it forever but spending a little time to think carefully about what you have accomplished (or not) and what you are asking to do more of – avoids overload, unnecessary stress, and failure.  


The Art of Delegating

Sometimes it’s hard to let go, especially of something you’ve been doing for a long time, something you are proud of, or something that has helped define you as a leader.  But the time comes when it’s necessary to let go, to delegate, and turn the baton over so that you can move on to greater things.

Knowing when to do this and who to choose to take over for you is very important.  There are a few things to consider:

  1. The individual you turn this over to should be ready, willing, and able to take over for you.  This doesn’t always mean it’s the individual with the title – it could be someone with administrative skills, someone that you believe has potential, has demonstrated skills in the past, and has been asking for more responsibilities.  Sometimes we choose who to delegate to because they are ‘next’ on the list or have more seniority.  Don’t be afraid to look for someone that is not on the ‘usual’ list of suspects.  This may mean that you have to manage the message with those that will perceive that they have been overlooked.  Seeking advice from other leaders on your team can help you sidestep any issues this may cause.
  2. Be explicit in your expectations for deliverables and be willing to hold the individual accountable.  Let them know how you like to communicate, how often you expect updates, and that you are there to help them if they need it.  
  3. Once you turn over the responsibility, you must meet with the individual regularly to monitor their progress, help them manage any issues that have come up, and ensure they have the resources they need to get the job done.  Don’t hover or micromanage.  Acknowledge that the individual will have a different style than you or may have a different skill set.  As long as the job gets done and the individual delivers – it’s all good.
  4. Be prompt in giving feedback.  Don’t wait until it’s too late or time has gone by. And if the person is not delivering, don’t be afraid to take it back and assign it to someone else.  

In sum, successful leaders don’t do it alone.  Success is a team sport.  Learning the art and science of delegation early can help free you (and your team) do more great things.  Don’t fall into the trap of thinking that you are expected to do it all or that delegating is not what good leaders do.  In fact, delegating is part of a leader’s core competencies.  The art of delegating is a critical part of coaching, mentoring, and developing new leaders including your successor.

For You

Today you found out you were laid off from work.  Beyond the shock, you felt dejected and angry.  Angry that they chose you, angry that you hadn’t left on your terms, and shocked that after all those years of service – you were the one they picked.   Your upbringing has made you want predictability, dislike taking risks, and like the routine this job gave you.  When the confusion of what happened clears your head, think about the following:  Yes, you were the one they chose.  But what if by choosing you they did for you what you couldn’t do for yourself?  Give you the freedom to do something completely different in life, reinvent yourself, re-ignite and chase old dreams.  What if by choosing you they liberated you from the fear that holds you back from taking risks, embracing uncertainty and new routines in life?  There should be no question in your mind that you will succeed at whatever you put your mind to.

You are an intelligent, passionate, loving, caring, compassionate human being with all the attributes that define success.  You have the IT factor, the right stuff.  The stuff that separates smart people from highly successful people.  So, go for it.  Take the time to explore what else, what if.  You will be tempted to jump right back in, to go back to the routine of what you know.  If you do, do so only after you have tested new waters, the uncharted ones, the ones you’ve dreamed about.  Don’t live to regret the things you didn’t dare to do.  Life is full of ups and downs, the mundane and the extraordinary.  Be grateful for it all.  Because even in the lows of life, there are precious lessons we are left with.  Someday you will look back at today as a defining moment.  The day you faced your greatest fear and you learned that happiness isn’t defined by how much money you make. It’s defined by how you chose to live your life.   Whatever you do – choose wisely.

Passing the Baton

Sometimes it’s hard to let go, to know when you are no longer being effective or being heard.  Oftentimes, there’s someone else quite capable of taking the baton and succeeding at whatever it is you are trying to do.   Whether you are trying to convince a child to eat their vegetables, or convince a donor to give money, negotiate a deal, or settle a dispute – we miss the cues.  When a person better equipped to do whatever it is you are trying to do raises their hand and asks for the baton – we resist passing it.  We would rather sacrifice success than to do it.  Is it pride, is it our competitiveness to win, is it the way we are wired to think about our abilities?

 Sometimes, we overestimate ourselves and what we can do.  If we only take a step back to reconsider the circumstances, we may find that we could use the help of someone else.  Asking someone else to step in and take over shouldn’t be seen as a set-back or a personal failure, but rather a strength.  The ability to do that may be the missing ingredient to getting it done, to solving the problem, and to ultimately succeeding in life.  Success is rarely a one person sport.

March On

This month the world’s women organized and marched for women’s rights – for the right to be treated equal to men.  All over the world the masses gathered and came together for justice.  My family marched in New York.  My daughters said, ‘for the first time in a long time it feels good to be part of something bigger than ourselves.’  Their generation had inherited the unfair ‘me’ label.  People held signs of all shapes and sizes and sayings.  One 90-year old woman’s sign read – ‘I can’t believe I still have to march for this.’  How true.  How is it that in 2017 women still have to advocate for equality, for choice, for their ‘inalienable rights’?

Marching felt good.  They marched for women but they also march for all those that still feel oppressed, discriminated against, and unfairly treated.  My two daughters have taken this on as their purpose.  They have a movement they want to join, a legacy they want to leave for their own children.   I smiled.  Finally – something people can unite around, something my daughters will look back on and say – I was there.

The Mind-Reading Trap

Sometimes we expect people to do things that we haven’t clearly articulated they should be doing. We think they should be able to read our minds. Why do we find it so difficult to spell things out to people? Do we want to avoid confrontation, are we uncomfortable with telling others what to do, or do we think they are more capable than they really are?

In our angst to get things done, we may be under the misguided impression that the individual has what it takes to get the job done. Even more frightening is that we may not have empowered them with clear lines of authority for what we expect them to be able to do. If people have clarity on what you expect from them – perhaps they will rise to the occasion OR not. In either case, it is tough to judge someone on something that they don’t know they have to do or they feel empowered to do. And lest we forget, any job requires basic individual competencies but the real success comes from having the right TEAM that have complementary skills to help that individual get things done. The individual you have tasked for the job may not have the all the right skills AND/OR have the right team in place to succeed.

So what to do? Communicate. Set the right expectations. Check in regularly. Provide the resources and guidance needed. AND hold the individual accountable. In the end, they may not be able to do the job but at least you will have given them a fighting chance.

Before You Walk Away

I’m not sure how many of us pursue the things we care deeply about as part of how we make a living. Or how many of us wake up every day with gratitude that we have a job we love. I believe that this is the secret to life happiness.

If you have the privilege to have this kind of job today, you must carefully consider all new job opportunities that come your way with this value as your compass. Sometimes job opportunities will fall in your lap that seemingly look terrific today. But when you look at them with your long-term lens you may realize that you have short-changed yourself for the future. Will you be doing something you love or just getting more money or a big title? You may not have a choice but to take a job for more money. But when you are doing well and don’t have dire financial circumstances, you must think carefully about all new job offers. Where does the new position take you, will it move your career forward in the future, will you wake up every day excited to go to work?

Sometimes when you add it all up – it doesn’t add up. Take it all in, subtract out the differences in location, costs of living, and other incidentals – you may find that it’s a step back, not forward. Patience is at a premium but remains one of the most important things we should strive for in life. It will be tested, especially at times when you are vulnerable, when you think you need a change. Slow thinking is needed. Don’t rush life changing decisions. Be deliberate, thoughtful, and seek out advice from trusted individuals. In the end – follow your instincts, always keep the long view in mind, and ask yourself – will you love what you do?

How are you perceived?

Sometimes not everything (or everyone) is what it seems. Sometimes we think we know what people really think of us, how we come across, and what they might say when we aren’t there. Some of us don’t care, some of us do. And then some of us partially care and therefore want to know. Whatever category we fall into, most human beings want to be liked, respected, or both. We generally know who doesn’t like us and who does. The hard part is finding out that those that we think like us, really don’t – they just act like they do. This can be a hard blow when you are young, but when we are older, we pride ourselves in not letting this get to us. The truth is that it still hurts even though we are grown. So here are 3 tips on how to cope with this or be prepared for it:

1) develop trust and relationships with a few good people. You don’t need 500 friends, you just need a handful that will be there when you need them.

2) let time and circumstances be the judge of who is a long-standing supporter and a friend and who isn’t. There are some that are ‘situational’ friends and allies. When the circumstances change, they do too.

3) never let anything or anyone surprise you. While we want to believe the best about others sometimes, they don’t have the best of intentions for us. They just look out for themselves and will turn on you in a nanosecond. Don’t sweat it or let it surprise you. Just move on.

My Convocation Speech For The Graduating Class of Rutgers NJ Medical School

On Monday, May 16th, I was honored to be the Convocation Speaker for Rutgers New Jersey Medical School graduating class of 2016. Many of you have asked for a copy of my speech, so I wanted to share it with all of you. It was truly an amazing experience that I will never forget. I’d like to thank Rutgers New Jersey Medical School Dean Bob Johnson for inviting me. It was a very special day.

“It is a real privilege to share this day with each of you – Dean Johnson,  Members of Rutgers University and Board of Trustees, Fellow Honorees, Esteemed Faculty, Proud Parents, Families, Loved Ones, but especially, the 2016 graduating class of Rutgers–New Jersey Medical School.

And now to the Graduates:  You made it.  You did it.  You stuck with it, you persevered. Today is a day you will never forget.  You have earned the right to be here! Congrats!

The first thing I would like to say is thank you.  This is an extraordinary honor.  Delivering a convocation address is a great responsibility – I have lost a lot of sleep over standing here today.  What should I say, what if I say something wrong?

Then I thought about my own convocation.  Unfortunately, I couldn’t remember who he was and very little about what he said.   Suddenly, I felt really liberated for today and will proceed without any fear.  But if you remember anything about this speech – just remember that I said that too graduated from this great medical school.
I will be brief today as I have total respect for brevity and getting to the point. Plus, I know how anxious all of you must be to get your diplomas and get to that party.

When preparing my remarks for today, I asked some of my student mentees – ‘what would you want a speaker to tell you at convocation.’  Here’s what they said – ‘tell them a little about your own journey and then give them some tips for the next few years of training and beyond– so that they know that in the end – it’s all going to be okay.
So what happens after you graduate medical school and when you are finally start your training?  What tips do I have for success?  To give you my thoughts on that – I must first give you context for where my own journey has taken me.

I graduated this medical school at the age of 39.  When I received my degree, I walked up to the stage with my 10 year-old daughter, Kristina to get it.  After all, she had sat in many classes with me when I didn’t have a sitter.
While it’s been 20 years since I was on this stage – I will never forget the lessons I learned here.  And will always be grateful for the opportunity this medical school gave me.

You see this medical school has had a wonderful history since 1954 – a track record for attracting and recruiting non-traditional students.   I was as non-traditional as they come.

At the time that I came to medical school, I was selling real estate.  It was then that I met someone that asked me a question that would ultimately change my life.  She asked me, ‘is this what you wanted to be when you were growing up?’  ‘Not exactly.  ‘I always wanted to be a doctor,’ I said half-laughingly.  ‘Why didn’t you?, she asked.  ‘Because I didn’t have the money and I didn’t know how,’ I responded.

You see, I’m one of 5 children, born and raised in the Bronx to Puerto Rican parents who struggled to get by.  At the time that I was growing up only 60% of kids graduated high school.  I not only graduated high school but I attended a community college where I could study and work and help support my family.

When I graduated that community college, I went to work as a lab technician in a local hospital and because they reimbursed for tuition AND I loved science – I went back to night school.  It took me 8 years of night school to get my bachelor’s degree in biology.

So you see your question is a good one.  What I always dreamed of becoming didn’t seem possible for me so I just stopped dreaming.   And then she said something that would change my life.  She said, ‘if you dream that you can, then you will.  You just have to believe it.’  AND that was the statement that began a journey that brings me here today.

I took the Medical School entrance exam only once.  I applied to one medical school – this one.  2 months later, I received a phone call from Dean George Heinrich that I had been accepted to this medical school by early decision with a four year scholarship.  Who knew, that I had the potential, and who knew that with the right support – I would succeed.  This medical school did with programs like the Hispanic Center of Excellence that have existed since 1991 to mentor under-represented individuals like me.

Since its inception, this medical school has provided care to the poor and vulnerable. It has taught tolerance, diversity, and the belief that all human beings are created equal.  This education serves us all well at a time in our country when we will increasingly provide care for a diverse and global community.

I graduated at the top of my class, I’ve had the privilege of becoming the Chair of Medicine – the only Puerto Rican woman, Chair of Medicine in the continental US and most recently an Associate Chief Medical Officer – the position I hold today at Lehigh Valley Health Network.  None of that would have been possible without this medical school and my wonderful teachers – many of whom are still here.

So what tips do I have for success for the short and long-term.   Believe or not, time will go by fast.  You will look back like I’m doing today and say – where’ did the time go, how did I do that?

There are 3 things I believe will be really important for the next few years:
First, treat every person, every patient, and yourselves with dignity, respect, and kindness.  In a few months you will be licensed to practice medicine.  You will be licensed to care for someone’s life.  What you will be licensed to do is a privilege, a calling, not a job.  You will be faced with questions or problems you won’t know the answer to.  Admit what you don’t know and work hard to find the answers.  Patients won’t care about how much you know, but they’ll always remember how much you cared. Maya Angelou once said – people won’t remember what you said, but they’ll remember how you made them feel.    This will mean that you have to hone the art of listening to your patients without technology or a device in your hands – they will tell you what’s wrong with them and they’ll appreciate that you were present for them.

Secondly, you will undoubtedly make mistakes, admit them, and own them.  Saying I’m sorry is sometimes the best medicine.  During my first year after graduating residency, I began taking care of patients at a local health center on Broad Street in Newark.  After a long day of seeing patients, I walked into my last patient’s room – a patient with diabetes and foot neuropathy – and I immediately chastised her for wearing shoes that were obviously too tight and uncomfortable for her feet.

I proceeded to extoll the virtues of comfort and fit and began admonishing her about the adverse effects of diabetic neuropathy.  And then in a very low voice she said to me – Doc – I just bought these shoes.  They’re new.  You always take my shoes off and I wanted you to see something nice for a change.  I’ll never forget the moment when my doctoring got in the way of my empathy.

Learn from your mistakes and then move forward.  You will face adversity, that’s okay. From it, you will develop resiliency and become a better doctor for it.   And you will learn the value of humility.

Lastly, don’t forget to take care of yourselves and your family and friends. Remember to fill your cup so that you can fill the cup of others.  Do things that bring you joy, make you laugh, and help you recalibrate from the pressure of your profession.
This is one of the hardest things you will need to do but a very important one. Self-care is critical to wellness and happiness. Allow your families, friends, and loved ones to help you balance your lives and work. Ask them to call you out when you aren’t doing a good job at it. I work on this every day. My family will invariably tell me – Mom, stop checking emails. Be grateful for their support and when you are with them – Be present.

What about after your residency training is done?  What can I share with you that I believe will help you for the long run.  There are 3 things that I believe in.

First, be a lifelong learner.  I went back to school after I graduated my residency program to get a Master’s in Public Health and Health Policy and earlier this year I enrolled in some finance courses at Wharton.  I figured healthcare finance is a mess and I want to be part of the solution.  Don’t stop learning.  Be adaptable, Be flexible, and Be Curious.  You will have the privilege of practicing medicine at a time in healthcare where artificial intelligence may be your consulting partner, where robots may work alongside of you to provide better and safer care in hospitals, where we will remotely do surgical procedures and monitor any disease or condition from our patient’s homes or wherever they are, where we will be able to treat every patient with the precise medication that genetically targets their conditions, where we will cure cancer and other chronic illnesses that have plagued our society, and where what we can’t imagine as possible – will be possible.

Australian researchers have created a new BioPen, it’s a 3D printing device that allows surgeons to print human stem cells right into joints to create new cartilage, we are developing new materials including electronics that will go on or in the body to monitor health, and we are creating biomaterials that will replace human joints.  But that’s only the beginning:  Today, we are making carbon fiber composites to enable lighter-weight vehicles, we are creating solar panels capable of providing electricity to the entire world, and we are creating nanomaterials that will drive breakthroughs in energy storage and quantum computers.
So learn to love new ideas and experiments.  Value imagination.  J.K. Rowling once said, ‘imagination is the not only the unique human capacity to envision that which is not, and therefore the fountain of all invention and innovation, it is also the power that enables us to empathize with humans whose experience we have never shared.’ Everything was impossible until you did it.  Live in wonder.

Wonder why, and prize “Why not?” as your favorite question. Be insatiably curious, and question everything.  AND above all – whatever you do and whatever comes your way – practice the art of humanism for every person you touch.
Second, find a mentor.  Surround yourself with people who are smarter than you. Continually seek advice, be open to constructive criticism, and develop extreme self-awareness.   Seek to be continually inspired by something or someone.  If your work inspires you, you will never work a day in your life.

Lastly, pay it forward.  Be a mentor to someone else.  Take initiative, and volunteer.”  Honor service to others and share your life lessons – you never know whose heart you may touch.  Giving of your time is the most precious gift of all.  Doing something that is for someone else, for a greater good, that is selfless, and contributes to your community and our society is one of the secrets to life happiness.

You don’t have to travel the world or the nation to give back and give a hand to someone else who needs help.  You can give back wherever you are – you can give back right here at this medical school.
In closing, I hope that you will be guided by values that will shape the kind of human being your patients are hoping will provide their care.  You are a special class.  You have all the information that mankind has gathered in the palms of your hands – your phones.  Now use that information to make a better world than we have today.  I wish for you the courage to make the tough choices, the integrity to stand by them, and the grit and determination to face anything life throws your way.   Keep Dreaming.  Keep Believing.

Congratulations once again and enjoy the celebrations and good wishes you will receive as a graduate from the Rutgers–New Jersey Medical School.  You have earned these accolades and have a lot to be thankful for.  Best of Luck on your journeys.”


5 Things to Remember When You Think It’s Time to Leave your Job

1. Take the time to truly assess your job situation. Be certain that you are doing it for the right reasons. How you leave an organization is as important as when you entered it. Stay engaged until you’ve left.

2. Talk it over with someone you trust. Leaving a job is an important decision.

3. Once you’ve done the above, take the opportunity to do your homework. In the ideal world, find another job that gives you a promotion or a growth opportunity.

4. Consult your family and assess your personal situation. If you have to move, make sure they are comfortable with where you want to go. This is will affect them too.

5. If possible, use a professional or a head hunter to help vet opportunities. If you must contact others to help you, make sure they keep your decision confidential.