How To Quit
Quitting has a lousy reputation for physicians. It makes sense; we became physicians by just not quitting. We didn’t quit our educations after high school; we went on to college. And then from college to medical school, residency, and sometimes to fellowship. Sometimes we “not quit” our way into advanced degrees. When my training got difficult, I learned to give myself the “I can do anything for (insert hours to weeks to months)” pep talk. Practicing medicine requires a commitment to lifelong learning, so “not quitting” is woven into our profession. Maybe it’s not so much that we don’t quit; it’s just that we never finish.
On reflection, it turns out that I’ve quit many things. I ran a single marathon to raise money for charity and decidedly quit running any sort of long-distance immediately after. Training for the marathon left me with a shredded iliotibial band, and I couldn’t walk without a limp for a month. I quit watching movies with Tom Cruise in them after he said that Brooke Shields was an irresponsible mother because she used medication to treat her postpartum depression. When the pandemic gave me a full-time house spouse, I quit planning meals and grocery shopping; I’ve become that person who is visibly distressed because the soup isn’t in the same aisle it used to be at the grocery store. About a year into my first faculty position, I figured out how to quit coming to work at 4:00am to pre-round before my days on service. I’ve quit hospital committees that no longer align with my professional goals; it was a bit uncomfortable putting an end date for those committees on my CV, but it has not, to my initial shock, been a death knell for my career.
I recently learned about the Tom Hanks Rule. In an interview with Business Insider, he said:
“I realized...that I had to start saying a very, very difficult word to people, which was ‘no.’ I figured out that’s how you end up doing the favorable work you do... Saying yes, then you just work. But saying no means you made the choice of the type of story you wanted to tell and the type of character you want to play.” (https://www.businessinsider.com/tom-hanks-tribeca-film-festival-talk-2016-4)
When we view this rule a bit differently, it means that saying “yes” to something we do not really want to do means that we must implicitly say “no” to something that we may really want to do. Saying “yes” to things we do not really want to do (or continue saying “yes” to things that no longer serve us by just “not quitting” them) means we end up with calendars full of professional clutter that precludes us from trying things that we really want to do.
So how should we quit things? Suppose you’re coming up on a yearly evaluation with your division head. In that case, it’s a great time to sort this out because you’re likely already updating your CV and documenting your accomplishments for the past year. Even if you’re not at that time point, it can be as simple as going over your calendar and giving each thing one of four labels (Exercise is courtesy of Dr. Linda Street via her Simply Worth It podcast (https://www.simplystreetmd.com/blog/episode-119):
Something I am directly paid to do
Something I am indirectly paid to do
Something I am not paid to do but love
Something I am not paid to do and do not care for
Professional clutter is the thing with the label “not paid to do and do not care for.” These are the first things to quit. Pick your last day for each and put them on your calendar. Take a day to craft a transition plan if necessary, and don’t make it precious or complicated. When it comes to transition plans, they’re better to be done than perfect. Listen out for the little voice saying, “Well, that person won’t do it as well as I do.” Can that person initially do the task at least 70% as well as you can? I bet they can. And your allowing them to run the show means that they’ll grow themselves to manage the task maybe even better than you did.
Be careful about what gets the “indirectly paid to do” label. Academic medicine has a way of making everything something we’re indirectly paid to do. For example, I am a clinician educator, so 20% of my time should be spent teaching. I could give every single educational undertaking the “indirectly paid to do” label, but that category would get very bloated if I didn’t note that 20% of my time should only be eight hours per week (for a forty-hour work week). If you find yourself with a larger-than-reasonable “indirectly paid to do” column, spend a few months deciding which things you love and are not just hanging onto out of a feeling of obligation. Quitting things doesn’t have to be a one-and-done slash-and-burn event. Show yourself that quitting something small doesn’t make a professional ripple and gives your schedule some breathing room. Then quit something a bit bigger. Then work your way up to quitting the “big things.” Clinical psychologist Dr. Nicole LePera then has a graceful way of ensuring our calendars do not return to their previous state: when offered an opportunity that does not serve you, express appreciation, say “no,” and then wish the person making the offer well. I may have a neon post-it on my monitor: “Appreciation + the ‘no’ + well wishes.”
So go quit something. Get some breathing room on your schedule. Microsoft recently found workers spend two full days a week on email and in meetings, for crying out loud. (https://www.wsj.com/articles/workers-say-its-harder-to-get-things-done-now-heres-why-2a5f1389)