This past year has been very eye-opening, to say the least. Some aspects of learning were more expected, especially with my structured courses. In my courses, I’ve been able to explore a new aspect of health delivery focused on innovation through behavioral economics. Historically, as a provider, I always thought that providing the right answer is the key to healthcare. Making the correct diagnosis, selecting the proper diagnostics, and correctly interpreting the results would lead to the most efficient delivery of healthcare. My coursework revealed that people are not rational – that having the right answer is often just a small part of the bigger picture. That without influence and accounting for external forces, patients with even the “right” clinical solution may not do the “right” thing. Yes, they should lose weight, but the gym is too far, and they are too tired after working two jobs. Yes, eating healthier is the right thing, but they drive home past six fast-food restaurants, and it’s so much easier to pick up dinner. Yes, they need to take their medications, but they keep forgetting because they’ve kept the medicines in the desk drawer, and they don’t look there to take it before bed.

Additionally, exposure to behavioral economics then drove me to want to explore patients’ beliefs and behaviors. Specifically, how do we meet them at their “spot” as opposed to having them meet healthcare where we think they should meet – ultimately, are we helping them if our presumed interventions have no impact? This line of thinking then leads to additional coursework on design thinking – something I’m currently exploring. Together, behavioral economics and design thinking have opened my eyes to how knowing the right answer contributes a mere slice of how to really influence our communities to get healthier and stay healthy.

However, this is not the most eye-opening aspect of my fellowship.

The most unexpected and eye-opening aspect of my fellowship has been my personal leadership journey. Coaching was something that was required for this fellowship. Initially, I wasn’t exactly sure how to effectively start this part of my fellowship. True, I understood the importance of coaching in the abstract sense – they were to serve as a guide throughout my fellowship. However, my coach’s impact has been much more than that. Through our initial assessments, he was able to quickly pick up on some traits of my leadership that I was completely unaware of. Through this, I was able to review past complicated interactions as both a leader and as a follower. In doing so, it became more transparent the rationale behind my responses and, more importantly, how I could have done better. My meetings with my coach were also an unexpected sounding board as I made some changes to my roles and responsibilities at my health system. His understanding of the healthcare world gave new insights into the behaviors of those around me and also gave me a better understanding of their drivers. Understanding why they made the decisions they made helped me better respond constructively without assigning positive or negative intent.

Additionally, as my health system as transitioned (mergers, growth), he has been able to guide me in my movement within the organization and the politics that exists in all organizations. I’ve never been good at the politics of things, hoping that good intentions will get me where I needed to go. Although I still believe in this, my exposure to the politics at work has opened my eyes to an aspect of interpersonal relationship I’ve come to appreciate. Lastly, my interactions with my coach have revealed my vulnerabilities. Over the last several months, my coach has asked if he can do in-depth phone interviews of those around me (my peers, my leaders, my reports) in a 360 fashion. In reviewing those selected by me to be interviewed, he revealed my biases in my selection of individuals. He’s currently in the process of interviews, and I am excited to hear back as to how I can continue to improve.

Finally, one last surprise has been how resistant I’ve been to self-care. Looking back over my months of journaling, I see a constant message of needing/wanting to focus on self-care. However, being true to self, I have not put in much of the work here. I’ve not explored new avenues of self-care. Or when I’ve started the path (such as meditation), I’ve not kept up and have let that pass. This reflection at my half-way mark of my fellowship is a much-needed reminder of this area. I will (again) start working on/sticking with my journey on self-care the next 12 months.

Overall, these past 12 months have been filled with the expected and the unexpected. It is clear to me that the unexpected has brought me more growth, which I will continue to pursue. I cannot be more thankful to be on this journey and excitedly look forward to the next 12 months!