Values - what's really important to you?

Whenever the subject of values comes up, I become a bit uneasy. Partly because I am always initially confused about the definition and partly because I sense danger about telling anyone what my real values are.

Almost everyone who talks or writes about values has a different list of words. The following list was taken from The Shifting Sources of Power and Influence by Charles E. Dwyer[1]: power, security, respect, esteem, status, acceptance, approval, gratitude, appreciation, recognition, success, achievement, autonomy, security, fun, transcendence.

If people ask you if you value these things, you may respond, "Yes, oh yes, of course, I do," but if they ask you if you spend time, money, and energy on them, you may have a different answer. If they ask, "Do you value the security and acceptance of family?" you probably would respond, "Absolutely." But if they pushed you further and asked, "When was the last time you were home when your children got up in the morning or before they went to bed at night? you might squirm as you answered. Other uncomfortable questions would be: "How often do you communicate with your child?" "How often do you spend 15-30 minutes with him or her where you mostly listen and don't pass judgment and don't quickly tell him or her how to fix a problem?" To have a good relationship with a child, you need to spend that kind of time at least a couple of times a week, and ideally every day.

If you want your spouse to feel valued, you need to spend 15-30 minutes every day talking and listening to each other and one date a week, perhaps over dinner, where you look at each other face to face, listen and talk. Going to a movie doesn't count. That's observation, not interaction.

Covey says that he begins each day with his "values firmly in mind. Then as the vicissitudes, as the challenges come, I can make my decisions based on those values. I can act with integrity. I don't have to react to the emotion, the circumstance, I can be truly proactive, value driven, because my values are clear."[2]

Once you are clear about what you value, it is easier to decide what you want to do based on those values. Here are some examples of a personal mission statement that focuses on what one person wants to be and do based on his values:

* Succeed at home first.

* Seek and merit divine help.

* Develop one new proficiency a year.

* Maintain a positive attitude.

* Keep a sense of humor.

* Do not fear mistakes--fear only the absence of creative, constructive, and corrective responses to those mistakes.

* Listen twice as much as you speak.

* Concentrate all abilities and efforts on the task at hand, not worrying about the next job or promotion

The following list of 12 questions[3] will help you dig deep into your mind and heart to come up with what you have valued in the past and what you want to value in the future. I have written some made up answers to help you begin the thinking process. If you take the time to write out your own answers to these questions, you can pick the words from a list of values that you not only say are important to you but that you can demonstrate you truly do value by the way you spend your time, money, and energy.

Looking at the Past

* What are some of the major events that stand out in your mind? Moved to Roanoke. Went to University of Virginia for college. Duke for medical school. Mass General for internship and residency. Brother died. Married. Birth of children.

* What general direction did you have? Always moving toward being an internist.

* Where and with whom have you spent your time? Hospital during training. With wife. With patients. Some with children. With tennis partners. Running.

* What has taken your energy? Seeing patients. Filling out forms for government and insurance companies. Worrying about malpractice. Being chairman of the department.

* How have you used your money? House and all associated maintenance. Country club. Church. Children. Clothes for me and family. Travel.

Looking at the Present

* What do you want to accomplish? Help with the massive changes in health care. Influence larger number of people than just one-on-one patient contact. Be a part of decision making as health care makes drastic changes.

* What do you want to create during your life? Healthy successful children. A retreat center for exhausted, discouraged physicians. Retirement nest egg that will allow me to keep the same life-style during those years.

* What are you struggling with? How to make mortgage payment and other payments when income is going down. How to decide what things to cut back and determine who will make the cutback decisions

* Who are some people you admire? Great athletes. George Sheehan. Lee Kaiser. Stephen Covey.

* Who are the people that matter to you? Wife. Children. Parents. Friends. Patients.

* If you were at the end of your life and looked back on this period, what would stand out as important? Helping launch children into adult lives. Helping physicians accept the inevitable changes that have been and are still occurring in health care. Supporting wife in her emerging career. Helping mother adjust to being a widow.

* What do you do to take care of yourself? Play tennis. Run. Eat better than I used to. Spend time with friends. Spend some time alone.

"If you know what your values are --

If you know what your standards are --

If you know what is important to you --

If you have a point of view --

Then you have a sense of direction.

Then you know where you are going."[6]

Levinson says knowing what you value can sustain you through times of momentous change: "...there are some things that don't change: our basic values. They are like psychological glue, holding us together through changes in roles, directions, and identifications. The better adjusted survivors of prisoner-of-war camps and similar terrible experiences were those who had a set of values, usually religious. Our values give us a way of feeling good about ourselves. In times of change it can be very difficult to know what is right and what is wrong. This is particularly true when you have identified with an established set of organizational values and a given way of doing things, and then they change. Under such circumstances it's necessary to think through what is important to you, what you believe. These things are often deceptively simple--a belief in being just or in doing your best no matter what, or in the intrinsic worth of every person, or in learning, for example. When the organization's values change, your own values become the core around which to refocus your efforts and make sense of the change. Then you can find a way to continue to live according to your values.[4] Because there are such tumultuous changes occurring in health care, taking the time to assess your own values can help you to the other side of chaos.

Also, it is necessary to be aware of your own values before you can begin to recognize what other people value. According to Dwyer, in order to influence you, I must "put a perception in your head that if you engage in certain behavior, your values will be served best." When you are adept at assessing your own values, you are more observant about others' values and you can listen intently to discover what they think is important. At that point, you can more easily influence them.

Filley claims that "you and I persist in giving people rewards that are things we like instead of finding out what they like .... To give people rewards that we value often results in no motivation on their part and perhaps a feeling on our part that the receivers are ungrateful .... People who are concerned with survival and safety may not value recognition and achievement and other higher needs until those for survival and safety are met."[5]

If you get your own values in mind, you become more aware of how others might answer the above questions. One physician might have delivering high-quality health care as a most important value. Another might value most making money. You can appeal to the first one by pointing out how a change will be better for the patient. For the second one, you can demonstrate that a certain change will result in losing less income than expected.

When you are trying to influence others, it is helpful to resist passing judgment on their values. The physician who values money may have noble reasons--he or she may give much of it away, or perhaps grew up poor enough to worry about where the next meal would come from, or may be financially supporting parents or siblings. The point is to try to appeal to the others' values and then persuade them that what you want them to do will serve their values.

After you have written answers to the above 12 questions, keep them where you can look at them once a month. Check to see if you are spending some time on what you really value or if you have gotten lost in the details of everyday life.

References

[1.] Dwyer, C. The Shifting Sources of Power and Influence. Tampa, Fla.: American College of Physician Executives, 1991. [2.] Covey, S. The 7 Habits of Highly Effective People. New York, N.Y.: Simon and Schuster, 1989. [3.] Fritz, R. Creating. New York, N.Y.: Fawcett Columbine, 1991. [4.] Levinson, H. Career Mastery. San Francisco, Calif: Berrett-Koehler Publishers, 1992. [5.] Filley, A. The Compleat Manager. Middleton, Wis.: Green Briar Press, 1978. [6.] Newman, M. How to Take Charge of Your Life. New York, N.Y.: Harcourt, Brace, Jovanovich, 1977.

Barbara J. Linney, MA, is Director of Career Development for the American College of Physician Executives, Tampa, Fla.