“If you want things to be different, perhaps the answer is to become different yourself.”
— Norman Vincent Peale

Transitions in life are never easy. Sometimes they are thrust on us—a layoff or a divorce or a sick child. They may be presented as opportunities, such as a promotion or new job, or they may be hard choices that we must make about our careers or future lives.

In any case, as I said, transitions are not easy, because they require us to grow, and in some cases, let go of what we once were in favor of something different and, we hope, better.

Getting From the Wrong Place to the Right Place

In the course of your career, have you ever found yourself in a position that was just a bad fit for you? In these situations you might be faced with a hard fact—you’re eventually going to be fired if you don’t move on.

This doesn’t mean that you’re a failure; it’s just not where you need to be. The success of your transition in these cases often depends on at what point you finally take charge of the situation. And sooner is always better than later.

I remember one leadership position I held that was a bad fit for me. I knew I wasn’t happy, I knew I wasn’t performing up to the level that I was capable of, and I knew I was in trouble. I quickly began to realize that as long as I stayed in that mindset, I would continue to perform poorly, and that I would have to move on if I were to excel again at what I do.

The German writer and philosopher Johann Wolfgang von Goethe once wrote, “Everybody wants to be somebody; nobody wants to grow.” Transitions are all about growing, and sometimes growing means that you have to let go. I made the decision that instead of eventually facing being let go by that company, I had to let myself go, and I moved on. It was a good career decision for me, and it helped me to grow.

Letting go is a scary situation for many people, because with it comes not only losing part of your identity, but the fear of making mistakes once you move on. Goethe also addressed this aspect of growth when he wrote, “Men err as long as they strive.”

Goethe was absolutely correct. One of the best ways that you can tell that you’re in the wrong place for you is that you don’t feel compelled to reach for higher levels of achievement and performance. You need to be in a place where you do feel that calling and where you feel comfortable knowing that you will (and can) make a few mistakes along the way. Also, when you continually get feedback that your performance or your behavior is not what is expected and you feel that every day is a struggle, it’s time to consider that this may no longer be the right fit for you. Organizations change. Expectations shift. Life is too short to be miserable in a job where you spend 50 to 75 percent of your time.

In many cases, it’s actually the organization that is a bad fit for the individual, and not the other way around. I know one physician leader who was struggling in his job because of his boss, a micromanager, insisting on being continually kept in the loop on every minor detail of operations in this physician’s department. It was a burden of reporting and constant communication that the physician felt was keeping him from being effective at his job. He was drowning in it, and he was underachieving because of it. The problem in his situation was that he was not going to change the boss, and the boss wasn’t going anywhere. As Norman Vincent Peale once said, “If you want things to be different, perhaps the answer is to become different yourself.” In this case, the physician’s best answer was to move on.

From Physician to Leader

One of the most important transitions for a physician is from clinical service to clinical or executive leadership. This is a transition that is especially challenging for the driven, type-A, jump-in-and-fix-the-problem mentality of most physicians. Making this change successfully absolutely requires physicians to let go of many things that they were in the past.

One of the things that physicians need to let go of is the power of sole decision-making. I’m not saying don’t be decisive, because you must, but you also have to hand down that decision-making power to others and let them do their jobs, or you’re going to have a bunch of people deciding that it may be better for them to move on than to keep working for you.

A transition is a learning process, and often the learning doesn’t come easy. Transition-management pioneer William Bridges says that transition can be confusing and discouraging at times.

“It isn’t like other forms of learning, where you look for something and then find it,” Bridges says. “It is more like having the reality-rug pulled out from under you and falling flat—and then getting up and noticing that the world looks different.”

This is not the way physicians in a clinical setting operate, and they can’t afford to. You assess the patient, diagnose the patient and take the best possible course of action to fix the problem. Generally, you don’t ask for someone else’s opinion and you do the work yourself. You can’t do that as a leader, and sometimes you have to accept the fact that some decisions, and their outcomes, are good enough. Not perfect, just good enough.

Coaches can help during the transition period to leadership because they combine valuable feedback from others around you with a detached, neutral person’s point of view that can help you identify the strengths you need to hold onto, and the parts of your former identity that you need to let go.

Bridges says that to make successful transitions, giving up parts of you is key, and can be an excellent learning experience. “In letting go of the person you thought you were, you see that some of what you thought was essential to being ‘you’ really isn’t,” he says. “You discover you are still ‘you’ without those things, and that can be a big discovery.

From Here to Somewhere Else

One of the essential parts of a physician’s identity, besides being a doc, is the community they serve. Many doctors plant roots and they want to stay in a community, so they’re not as willing to try something different somewhere else, and this can create a lot of pressure for them. That pressure can cause them to pass up opportunities in other places or even avoid transitions that would mean going to another hospital or organization in the same area.

A physician might get a better offer in another hospital or healthcare organization, but he or she may be unwilling to move because of the time invested in the current job. It might be seen as a choice between a known evil or an unknown one. It also may be a huge opportunity that offers much more money or prestige, but the physician may choose not to take it because, as Goethe wrote, we may want to be somebody, but we may fear the “growing” part.

Don’t get me wrong—I’m not advocating jumping at every opportunity, or, for example, leaving an unfulfilling job when you have two years left before your health insurance will be paid in full for life. There are trade-offs. However, you have to decide whether concrete considerations, or fears of transition, are holding you back.

I concur with Bridges’ outlook on transitions, and in the following quote he explains why they can be especially tough for physicians, who are inherently driven to solve problems. “Instead of viewing them as calls to let go of our familiar approaches to life, we see such times as occasions when things have inexplicably gone to pieces,” he said. “We are likely to try to put things back the way they’re ‘supposed to be.’ Seeing them as problems to be solved, we miss the message they carry. The message: time to move on, time to die and be reborn, time for transition. Seeing them as problems to be solved, we miss the signal that a developmental opportunity is at hand.”

Transitions should be seen as opportunities to develop and grow, no matter how they come about. If you’re going to make a successful transition, you have to accept that you’re going to be vulnerable, and especially as a physician, you will have to resign yourself to the fact that you can’t always know what will happen as a result of your actions.

You have to learn to let go to make it work.