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  • Dr. Lalit Chawla

E#18: When You are Asked for Advice on Tough Decisions- Turn the Table


In this episode I talk about how to help people who are stuck. The solutions is surprisingly simple but not always used and it lies with one sentence.

The Best Advice is No Advice

(This is the core of the transcript from the podcast. The Intro has been removed and some areas improved for reading ease.)


Helping people decide is what this week's podcast is about- advice, how to give it, when to ask for it and much more.

I first want to share with you a story of a surgeon colleague didn't know what to do. She, like most surgeons, works over 80 hrs a week and loves what she does. She is phenomenal. She has a great bedside manner, she's superb technically, and committed to her family. Her relationship with her supportive husband is wonderful, and she connects with her children consistently well. She's not a Type A person, she a Type AAA person with so much energy that it can make high achievers feel inadequate. She loves teaching younger surgeons but had to put that on hold to help with newly needed administrative duties and leadership roles in the hospital. She was enjoying the contributions she was making at the executive level that improved the hospital's efficiencies and just absolutely loved it.

The hospital administrators were now asking if she would consider taking on additional leadership and administrative duties which came with attractive financial incentives. The challenge she now was facing was that she didn't want to increase her hours at work, but would need to either give up teaching the young and upcoming surgeons if she was to still maintain some quality time with her family. Essentially, she was given a promotion to change the hospital's efficiencies, something she always wanted to do, but now was faced with a dilemma between her career aspirations vs. spending time with her family or giving up teaching.

She had spent much time contemplating various solutions but still hadn't come up with a final resolution. She was smart enough and understood she needed to keep a balance in her life but knew that there are limited hours in the day. After she told me her situation, she asked me, "So Lalit, what do you think I should do?"

"So Lalit, what do you think I should do?"

My reply was, "gosh" and then paused for a bit "I don't really know. What would you advise me if I came to you with that scenario?" She paused with a somewhat confused look and said she wasn't sure what I was getting at. So I repeated back to her as if I had her problem, almost word for word, and then asked her, "So what do you think I should do?" I turned the situation around; in other words, role reversal, I turned the table from becoming the adviser to becoming the advisee.

Her reply, as best as I can recall, was the following:

"Well, I guess I'd tell you to make a list of the pros and cons on a piece of paper so you can visually see the options written in front of you. You'll have better clarity as to what's important. I know teaching medical learners excites you. You enjoy the enthusiastic learners, and you love helping them have a great experience so they don't have some of the same experiences you had when you were training. But you know you can't do both jobs right without adding more time to your work schedule? That's going to affect your home life. Perhaps you could scale back the number of medical learners you have in the year, so you don't have to give up teaching altogether. You could ask the administration if you could possibly share the role with another physician? Have best of both worlds.

You could ask Greg, in Internal Medicine, to see if he would collaborate and spilt that role with you. That would have some benefits because and you and he are like-minded and you could bounce ideas off each other. Yeah, basically you could create a third option. I think that might work because this type of work also aligns with what interests Greg has as well. This way, you can still maintain your hand in developing better policies in the hospital and still teach. Perhaps that's what I'd tell you Lalit".

I paused, shook my head approvingly and waited. She smiled and got the message and then said, "thank you for the advice" as she marched on at a 100 miles an hour.

"I don't really know. What would you advise me if I came to you with that scenario?"

Making decisions that matter can be hard because of varied emotions, many priorities and all sorts of moving elements that can confuse the person who is trying to make the decision. We, the individual, can't see the big picture because we are in that picture. We need to step out of it so that we can see all the relevant elements. We need to remove the blind spots and create other options that may not be obvious to us. And that's why we need to bounce ideas off one another.

Making decisions that matter can be hard because of varied emotions, many priorities and all sorts of moving elements that can confuse the person who is trying to make the decision.

Do you ever notice that sometimes a third person will suggest something to you and you are surprised that you didn't see that solution on your own? That's something that happens to all of us at some point in our lives. That's why removing your problem from yourself and putting it elsewhere allows it to be more objective. Much like when we put/write the issue down on paper. Similarly, when we let someone else speak that problem or challenge, changes the context of the way you see it. When you, the person with the challenge, pretends that you are advising another person as if it's not your problem, solutions and priorities reveal themselves. You take your emotions out of it, and you learn what truly matters to you. You become the advisor and not the advisee. You turn the table. As Dan and Chip Heath say in their book, "Decisive-How to Make Better Choices in Life and Work”, ask the "The best friend question”; essentially what advice would you give to your best friend?"

Giving advice isn't always easy and sometimes the best advice is no advice.

When you turn the table, you physically remove yourself from the situation, and things become clearer. Think about how easy it is to give advice? It's naturally easier because you are more objective. That's what great counselor's and coaches do. They know how to reflect back to the person about what's important. That's why the hardest thing for clinicians, friends and other well intended people do is to simply keep their mouth shut. Speech is silver, silence is gold. And when people come to their own conclusion, they have a greater likelihood of adopting that change because it comes from their own level of awareness of what they feel is best for them. People will always value a solution if it is something that they have created.

Turning the table also abolishes illogical think such as "all or none" thinking and allows for people to come up with creative options.

We "turn the table" intuitively when we "bounce" ideas off our friends, colleagues, spouse etc. This technique helps when people are choosing if a person should ask someone out for a date, choosing a new career, making a major financial purchase, trying to navigate a relationship, resolving some emotional trauma or any activity a person is fearful or apprehensive about. The "turn the table" question is simple, straightforward, and the person begins to find their own solutions that matters to them. People support their own plan. When you remove your own personal emotion out of it you say things like: "go ask her/him out, so what if they say only live once." or "do you really need a new car or are you just buying it because you want to? Or "if you stay in that job, you'll grow increasingly some online training and it will open doors for you...this is the time for you to do it!"

Now regarding the situation with my surgeon friend, I didn't know all the details and options that were available to her. I also didn't know what was truly important in her current life stage and goals.

Foot note: People in medicine, and other occupations such as teachers, entrepreneurs, have to be conscious of the time and energy they give. It's difficult to say no at times to more work, requests, and things that will help make systems and processes better. It takes a skillful mindset to resist temptation and peer pressure to do more work or do things against the standard work culture. People in the helping professions mostly overextend themselves in terms of their time commitment because they haven't learned how to say no and not feel guilty about it.

So back to my surgeon colleague, when she asked me that question, I didn't know to what degree she loved teaching. I didn't know, could she spend more time at work? Were her husband and children more involved in their own activities that they didn't need to see her as much? So by me asking her the question "what would recommend that I do" changed the way she saw her situation.

So remember ask the person who is struggling with the decision,"how would you advise your colleague, spouse, friend, or child, in a similar situation and summarizing the information/situation for reasons of clarity thus allowing the person to put a new face to their problems. Turning the table around will enable them to create options and outcomes that works for them and that they most likely will succeed as it adds internal ownership. In simple terms, this whole process it's also called role playing and role reversal.

Consider this question when someone is looking to you for advice. This is a question that helps them set their own life map with their own rest stops and supports along the way.

Giving advice isn't always easy and sometimes the best advice is no advice.


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