reflecting on change


In the past we have spoken quite a bit about reflecting in order to get to know oneself better, and in order to find better ways to deal with issues and concerns. We have spoken about how we are using reflective writing in the resdiency program to help identify how well the Pediatric residents are internalizing lessons on professionalism. This post represents a reflection on how well or poorly I am dealing with the unexpected changes to this blog.

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I am giving myself a C+, which is by far the lowest grade I have ever gotten on any project or item I have worked on.


Because, although I consider myself a change agent, and tell people how well I "embrace" change, I find that I did not handle the sudden, unexpected but necessary changes that happened recently. In fact, I was on the verge of letting something as simple as needing to learn to use a new system, and working with the web design experts to create an enhanced interface for my readers, distract me from continuing to write and stimulate thoughts and responses. I felt it was "too much."  In short, I was "whining." One of my very good friends pointed that out to me, and I am grateful for that help.

As with every roadblock or detour, I believe it is important to learn as much as possible so that I can try to be certain that "the next time" something unexpected or not part of my plan happens, I am not derailed from my overall goal. Here is what I have learned about myself:

  1. I don't like change as much as I thought I did
  2. I don't like change when I am not in control of it
  3. I am not as adventurous as I would like others to think I am
  4. I occasionally demonstrate lapses in professional behavior
  5. I may take it out on others when I am frustrated with my own powerlessness

So now what? Now that I know these things about myself how will I use this knowledge to become a better person? That's the really hard part of reflecting. Making a change in how one views the world and how to respond to it in the future.

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We need to look back to look forward.

So, hopefully, the next time I am confronted with a new, unique, uncomfortable situation I will respond more positively. I will hope that I embrace the change I see and make something positive out of what could affect me in a negative way.

What do you think?

How do you respond to unanticipated changes in your life? For those of you in health care, can you see parallels to how we respond when our patients "dont read the book?" What about when treatment fails, or the patient does not have the disease we thought we were diagnosing?

Leave a comment below and let's have a discussion.




Recent Comments

Dr. Alice. the change comes when we really aren't in control. The reflection lets us know that, yes! we have been in the changing rooms again. Been reflecting more myself. I see that what I need to be, is more important than what I want to be. But, we all know that right?

Thanks Billy. Truth is hard. Truth is liberating. Truth is all there is, in the end. I appreciate you stopping by, and greatly appreciate your comment. 

This was an incredibly important reminder to get back into the habit of doing something we were trained to do in Business School -- and do it on a regular basis. Even though I didn't realize it until I read this blogpost, I've been thinking a lot in the past few about the importance of reflecting -- professionally and personally -- as means of looking at problematic matters at home (for instance living with a teenager who is getting less than stellar grades simply because he won't turn in his daily homework -- had I "checked it" more regularly, might he have better habits or academic discipline?) or something at work that troubles me to the point of boiling over (stewing is a waste of time, Scott -- think of what you could have gotten done if you'd just accepted the reality of the situation instead of trying to rationalize what is "wrong" about it).

By incorporating reflection into my routine, I come to recognize that I have control of much more than I realize. And that realization has happened twice in the past four days. Very timely article for me, Dr. Ackerman. Thank you!

Scott, this series of posts on reflecting has been part of my explanation of how I am working with my residents on learning and internalizing professionalism. It is the way that I am trying to grapple with the need to demonstrate to the pediatric Residency Review Committee that we can measure not only outward professional behavior but also how much they have internalized the precepts of professionalism. It is helping me at least as much as it is helping them. You are right; we need to continue to do this our whole lives.

For doctors, for most of mankind, we are taught that we should embrace life-long learning. Yet for that learning to be most useful it should be based on reflection, and we should change because of what we have learned. 

I am so glad that you stopped by, Scott. Thanks for contributing such an insightful comment.

Change = more work

You're a busy gal, so it's not surprising that you wouldn't love change when you're busy. I still think you're great and appreciate the introspection.

Keep at it. The new blog format looks great.


Oh Aaron, look who's telling me I am busy. The 8PM Warrior himself! Thanks for stopping by, and thanks for your words of encouragement. I have not been very prolific recently, but hoping to change that. Time to stop using the "I am too busy" excuse, right? It helps so much to know folks are reading and taking the time to comment. Thanks again.

Oh and congrats on the new addition!!

love the new look/format! although the change may have felt like a chore at the time, the end result was so worth it & certainly a labor of love.... Looking foward to the next one DD

Donna, I am so glad that you like it! Next one coming soon. I do aim for weekly, I would love to post daily but lucky if I get them in monthly. Getting comments and knowing someone is reading, and maybe even waiting for another post, helps to encourage me to be more productive.

Thanks for the comment.

I'm curious what you do when (not if!) you detach from the BUSY/ever changing! fray periodically? What helps you return to center?

Sally, right now I return to center when (not if) I go to Boston to connect with my grandchildren. They keep me centered. If not, I fall over when they jump on me! Actually, I am headed there tomorrow (Saturday) for the weekend. Taking photos is the other way I unwind. Taking photos of the grandkids and turning them into photo books is my favorite hobby.

Thanks for stopping by and for leaving a comment.

Your one statement, "I don't like change unless I am in charge of it" realy hit home. It is sooo true. Gives me more perspective on the projects I am doing to bring about change. Thanks.

I guess that is true for many of us. This change is growing on me, especially since so many seem to like the look and feel of the blog now. 

Thanks for your comment

Dr. Ackerman, thanks for preserving with the blog. I am a self reported change lover, but your post did cause me to futher reflect that it's control and coming up with new ideas that I love. I agree with you; I don't really care for change I'm not in charge of.

Thanks, Emily. I think most of us "change agents" love change BECAUSE we CAN control it. Better to embrace it than have it take you by surprise. I am happy if my posts can help others learn something about themselves. They certainly help me learn something about myself.

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About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

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