The Physician Philosopher Podcast

TPP #2: Start Before You Are Ready

Why do you stay in a job that you hate? Is there something else you think about doing, but you just can’t come up with the courage to make the change? What’s holding you back from taking that leap of faith?

Larry Keller

Today’s Thought: Start Now 

Today’s thought is this; if we wait until we’re ready, we will never take the next step. You must start before you’re ready, you must start now.

A lot of people that I know get stuck in inaction. They will send me emails, they will correspond with me, and basically mention how they don’t like a portion of their life. It might be their marriage. Or maybe their job. It is oftentimes they’re burnt out, or feeling overwhelmed or stressed.

They have an idea of what’s wrong. They have an idea of what they would like to be doing differently, and they just don’t make any changes.

So why does that happen? Why do we get stuck in inaction, why can’t we just get the gears turning to move us in the direction that we want?

Doctors Hate to Fail 

The biggest reason we don’t take action is that doctors hate failure. We hate it. Right? We’ve gotten to where we are by being highly successful people. And so the idea that we could fail at something is one of the greatest fears in our lives. Now this is true for lots of different areas in our life, right?

We hate the idea of failing our friends and family, right? The idea of failing your spouse, or failing your children, or failing your coworkers, or your boss, or chair. You have certain expectations that have been placed upon you. You have certain expectations that you hold to yourself. And the idea of failing those expectations is sometimes paralyzing.

In the book Daring Greatly by Brenee Brown, she really dives into why we hate failure so much. For my male listeners, the biggest reason is that we feel shame. She says that we feel shame when we feel, or think that we feel, or have the potential to look weak. We will do just about anything that we can to avoid looking weak.

So what does that look like in life?

Well, if you’re a doctor, it looks like not asking for help. It looks like trying to do everything on your own, trying to be a hero, being everything to everyone all the time. And that will result in terrible outcomes, right?

Why Do We Hate To Ask For Help?

We know that there’s a suicide epidemic among physicians. A doctor a day kills themselves, dies by suicide.

How does a strong, intelligent, resourceful, human being end up deciding to end their life?

Well, that’s obviously a complicated topic. But one of the big reasons is that we are taught, over and over and over again, that asking for help is shameful. And this is such a silly idea, right? We know that’s not true. Because when we see other people reach out and ask us for help, we don’t look at them and say, “Wow, you’re such a weak person.” Right?

You actually look at that person and say, wow, that takes a lot of strength to ask for help. Yet when it comes to us, we don’t do that.

We’re so afraid of asking for help, we’re so afraid of the shame that might come from something not being successful, that we will often prefer inaction to starting something new.

How Your Thoughts About Failure Create Inaction

Let’s say you’re in an employed position and your employer, or your boss, your chair, whoever, has asked you to see twice as many patients in the same amount of time. They’re not going to pay you anymore. They’re not going to provide any scribes or any additional help. They are just asking you to do twice the amount of work with the same exact resources that you currently have. That’s the circumstance.

Those are the facts, verifiable. Email was sent. Documented. So this produces a thought, right?

The thought, that you want to open up your own clinic. Or maybe you want to start a side-hustle, but you don’t really know where to start. So your thought is, I want to do those things. I want to make a change, but I don’t know where to start.

And when you think about that idea, “I don’t know where to start”… The feeling that produces is that you feel overwhelmed, and you feel frustrated and potentially stressed out by the fact that you don’t know where to start. You are in this situation you feel trapped in, and now you feel overwhelmed because you want to make a change, but you don’t know how to do it.

And the action that ultimately produces is inaction. You don’t do anything. So then you are now stuck in the job that you hate. You don’t like that they’re making you do twice as much work without paying you, or providing any additional resources.

And so it’s this cyclical Thought Model where you don’t like something, you realize you need to make a change, but then you have a thought that you don’t know how.

This is a really deadly model. And it’s one that we get stuck in all the time.

Learning to Fail Forward

So one way that I like to think about this, that I’ve been taught, is to fail forward. In other words, to accept failure as a part of life, any time that you are trying something new, anytime that you are looking to make a change, anytime that you are being a human being, right?

When you start looking at failure in a positive light you can fail towards your goals. And you’re not going to look at that as the ultimate thing to stay away from. It’s all about shifting that mindset, that thought. And when we can fail forward, then we’re not so scared of starting.

Failure is part of life. It’s something that we need to experience. And actually, it’s good for you. If you’re not failing, I would argue that you are not pushing yourself hard enough. You’re not trying enough new things. You are not looking to be a better parent, physician, partner, whatever your role is in your life.

The big picture is that you’re never going to be ready enough. And you’ve taught this to yourself so many times in your life. At least I have.

I wasn’t ready to have kids. Were you ready to get married? I wasn’t ready enough to go to medical school, or start residency, or become an attending physician. I’m really well-trained, I’ve worked really hard to get to where I am. But man, like this just feels really daunting.

When you get forced into that hot box, or you get forced into the line of fire, all of a sudden you find out you are ready. All you had to do was get that first foot forward, start by starting. And then you found out, wow, I’m actually not a terrible doctor. I’m actually pretty well trained. And I can help people.

What Happens When You Start Before You’re Ready

You find out that you are ready, and you start by starting. You put that first foot forward, and then the second one comes along with you. And then all of a sudden, five years later, you’ve been an attending physician for five years.

It’s the same thing in any other area of your life. You have to trust yourself. Know who you are, what you’re about. You also have to know yourself enough to know that you probably needed a little bit of pressure, right?

Set the date, set the deadline, set a time by which you are going to make this decision. You’re going to make this change. Make a decision to make a purchase that may be not be refundable. Get a career coach.

Make a decision to start the side-hustle, buy the website, buy the LLC for your state. Get your employer identification number, EIN.

If you start by starting, you’re going to find that you are ready, and that you are resourceful, and that you will figure out how to do things. As you fail forward, as you take that leap of faith, you’re going to find that ideal life that you’ve been wanting.

It’s all about changing that thought. If we wait until we are ready, we’ll never take the next step. So you must start before you’re ready, you must start now.



  1. PrudentPlasticSurgeon

    Great post!

    I believe it’s ok to hate failure, that allows us to learn from our failures. But we cannot fear failure. It’s then that we don’t even try.

    I fully believe in the power of mindset and it’s ability to change our reality.

    The Prudent Plastic Surgeon

  2. Capital Curmudgeon

    Hi, I think this post contains a lot of truth. I find that failure is typically not an all or nothing bet, and frequently failure to does not pose a risk that would completely wipe our your savings or create a serious risk of physical injury.

    Even failures can bring some moderate success if you can learn a new skill along the way. I find Scott Adams’ thoughts on systems v. goals to be helpful as well: https://www.scottadamssays.com/2013/11/18/goals-vs-systems/. If you fail in the right direction, you can still make progress.

    I have also found Tim Ferriss’ fearsetting exercise to be really useful. See: https://tim.blog/2017/05/15/fear-setting/. It forces you to explicitly identify the risks and benefits you face. Usually, the risk is not as high in reality as it is in your imagination.

    Capital Curmudgeon


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