Becoming who you are. (Career Rx).

It's difficult to predict success based only on educational background and career experience, important as they are. More is needed. And one of the aspects that needs to be evaluated is the degree of self-actualization. Self-actualized individuals have worked out their personal issues well enough that their personal life no longer has to intrude into their professional lives and actions. In a word, they are free people. In career terms, self-actualized people are "company people," but not "yes-people." They are executives who have freed themselves to be able to internalize the growth, development, and strategic planning of their organization--because they are able to rise above personal considerations, to shed emotionalism, and see more clearly. Some methods you can use to figure out where you stack up are: Conduct a self-evaluation; identify role models; do what is called "a 360 evaluation."

Key Concepts: Self-Actualization/Becoming More Effective/Becoming Who You Are

"What are you looking for?" is the question I am most often asked by physician executives. What they mean, of course, is, What are your clients looking for? What are the characteristics that will set me apart and make me best qualified for the most interesting, challenging jobs? Do I have 'the right stuff'?"

Obviously, educational background and career experience are important. Clearly, an individual's ability to communicate well at various levels Is a critical skill. But it's difficult to predict success based only on these elements, important as they are. More is needed. And one of the aspects that I now evaluate is the degree of self-actualization. Other terms for this are maturity or seasoning, and it is exemplified by a kind of sturdiness that is proof against unexpected occurrences. Physician executives who compile an effective, objective record of accomplishment will demonstrate this best. (While success in one place will not guarantee success elsewhere, it is still often the best indicator of future achievement.)

You remember Maslow's hierarchy from Psychology 101? At the bottom is oxygen and at the top, self-actualization. (In terms of Maslow, average practicing physicians today seem to feel they're at the oxygen level, gasping for air.) In my professional opinion, physician executives' attainment of self-actualization Is related to ability to achieve. I have come to see self-actualization as a significant indicator that signals potential for success. Those who have achieved it are more likely to consistently succeed than those who haven't.

Losing baggage, gaining insight

The best brief definition I can give is this: Self-actualized individuals have worked out their personal issues well enough that their personal life no longer has to intrude into their professional lives and actions. In a word, they are free people. Self-actualized people are "company people," but not "yes-people." They are executives who have freed themselves to be able to internalize the growth, development, and strategic planning of their organization--because they are able to rise above personal considerations, to shed emotionalism, and see more clearly.

For physicians, this usually requires letting go of baggage, the emotional response that is often the first reaction when working outside their experience. When physicians act medically, they are scientists who use cool reasoning to logically consider the facts and only the facts. But it's no accident that physicians are considered excellent prospects for financial planners or speculators with blue-sky investment proposals--physicians may respond with emotion when asked to consider matters beyond their depth. However, it is imperative for physician executives who move into the business realm to leave this emotionalism behind.

Two levels

There's been little good news for most physicians in this country for a long time. If you listen to any group of physicians talk, you'll hear anger and resentment on a grand scale, mixed with despair and regret. This is an industry undergoing considerable change, and physicians feel that the majority has been "taken away." Physician executives who seek to lead within this negative environment have to work not to get swept up by the emotionalism of it and be rendered ineffective.

For better or for worse, physician executives are tasked with working closely with many who feel disenfranchised. So, even when a physician executive is self-actualized, there are still turbulent scenarios in every direction. And this makes the calm and steadiness of self-actualized leaders even more meaningful. What are some methods you can use to figure out where you stack up? Here are a few to try:

* Conduct a self-evaluation to determine where emotional responses have gotten in the way in your professional life. Be honest and look for insights within yourself.

* Identify as role models physician executives who have shown the sort of maturity and strength you want, and then try to connect with them. Ask advice from those who have succeeded.

* Do what is called "a 360 evaluation," a kind of feedback routinely sought by executives In many industries. Ask everyone around you--your superiors, your reports, and your peers--to evaluate your effectiveness. Listen to what they have to say.

* Depending on your evaluation results, consider getting professional help. A career consultant or other objective source can suggest new strategies.

Get ready for your BFO 

Here's an example of a self-actualized physician executive, someone I know and admire. He says: "I was a practicing OB/GYN taking a leading role in the development of a system-sponsored physician network. To put it mildly, I got sucked in to the negative dynamics that always attend any discussions in depth where physicians are concerned. It was making me ineffective until--one day, for no particular reason that I can identify--I realized that all of this contention had nothing to do with me, personally. It was all about the issues and not at all about me. With that insight, I began to take steps back from the fray, listening and offering ideas and working with people, but all from a different, saner perspective. It was a revelation and a relief to get out of the emotional abyss."

That physician executive had what I call a BFO (Blinding Flash of the Obvious) that changed his life. He then chose to leave active practice and become a full-time executive, and he has had considerable success as the driving force behind that system-based network.

I should note that the self-actualization insight rarely happens so suddenly. In most instances, development occurs gradually, over time. You are not changing who you are, but becoming who you can be.

So, what's the payoff?

In the realest sense, self-actualized people are more effective people. They are better able to deal with the hardest issues. They are persistent and fearless in seeking truth. They are able to confront the most difficult questions and deal fairly with them. These are some of the strengths I see in self-actualized people:

* Security in both competencies and in limitations. The smartest people are the ones who know what they don't know.

* Professionalism that lets training and skills shine forth.

* Respect for others that carries through.

* Strength to face the tough issues without ducking.

* Steadiness and firmness of resolve.

* Persistence in the face of adversity.

* Personal and professional serenity.

Your own BFO is waiting for you. and whether it happens all in a moment or slowly over time, it's essential for your growth as a person and as a professional. In these tumultuous times, you can be a source of support for many others who need your calm and courage.

Mary Frances Lyons, MD, is a Senior Consultant with Witt/Kieffer, Ford, Hadelman & Lloyd in St. Louis. She can be reached at 8000 Maryland Avenue, Suite 1080, St. Louis, Missouri, 63105 or by calling 314/862-1370. Please fax career development questions that you would like addressed in this column to Dr. Lyons at 314/727-5662.