The Physician Philosopher Podcast

TPP #68: What Pizza Can Teach Physicians About Priorities

Editor’s Note: You may not be surprised to hear that I am speaking at the upcoming Physician Freedom Summit on March 4th-5th. I wanted to invite you and let you know that you get FREE access to watch my interview as well as the other 15+ speakers. You can check it out here.

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There are moments in life where we are forced to get really clear on what matters most to us.  For me, this happened recently with Kristen getting diagnosed with COVID.  All of a sudden, that clarity I am constantly looking for in terms of what is most important. What I should currently focusing my energy and focus on to create purpose in my life…. Came very quickly into view.

I had one job.  Taking care of my family. That was it.  Where I’d normally spend time thinking about my next podcast episode idea, writing for my book, or creating content for upcoming talks… that all went to the way side.  My only job was to make sure that my kids made it to their activities, food was on the table, kids were bathed, and hair was braided so that I wouldn’t have to feed the “Tangle Monster” (what we call the brush we use to get tangles out of Anna Ruth’s hair).  

Going through this experience where we have an all-of-a-sudden clarity made me think about priorities in life.  That’s exactly what happened to me this week as I could really only have one priority. Everything else took a back seat.

Gaining Clarity

Now, you have to understand something about my family’s dynamic.  My wife, Kristen, is our rock.  She is what makes EVERYTHING work.  I am a big-picture, abstract problem-solving visionary.  I make complicated things simple, create frameworks to explain problems other people have a hard time understanding, and have been the person that people come to for advice my entire life.

This might all sound great, but it comes with some obvious failings, too.  I am TERRIBLE with details.  If you want me to help you figure out what you should do with your next steps in your career or life, I can do that better than most.  However, if you want to know what I did last Saturday.  Or you need help creating a detail oriented process.  I am not your guy.  

I am also unbelievably forgetful.  This is why my nickname at work is Dory – as in the forgetful fish from Finding Nemo.  

The point is that Kristen is the one that organizes all of the details, makes sure that the i’s are dotted and the t’s are crossed.  She knows all of our schedules inside and out, and makes sure we all get to where we need to be and when.  She plans out our weeks, because she is the detail-oriented person who has this super-human ability to juggle all of these balls in the air.  

So, when she went into quarantine with COVID I was the one responsible for all of the details.  And since this is not my natural strength, it required 100% of my focus.  Naturally, I was concerned that this would be a problem.

The Great Thing About Clarity

However, it wasn’t a problem.  It ended up being a huge opportunity for growth with my family.  When moments like this in life happen they crystallize our clarity immediately.  Having this one very big responsibility meant I could not focus on anything else.  So, that’s what I did.

In other words, it whipped the slate clean and forced me to get really clear about what mattered most.  I learned to use my problem solving skill set to delegate to my kids to do tasks they would not normally be responsible for on a typical day.  

Our family grew closer together because of the adversity. That’s what these moments often do.  They provide perspective and clarity.  

Other things that would normally happen simply got deleted.  I didn’t have the ability to do them while I was taking care of everything else.  And this clean slate is what I want to discuss in this post.  

Urgent versus Important Tasks

I spend a lot of time coaching clients on priorities.  They are often trying to figure out exactly what they want to do be doing with their career.  They are usually loaded up with leadership positions, various tasks at their job, and the additional clinical responsibilities they have as a physician in medicine.

The natural process that most people go through when trying to gain clarity on the various things they are involved in is to start trying to subtract things from all of their current priorities to try and get down to what they really want.  Unfortunately, this often complicates things.  

Deleting is infinitely harder than starting with carte blanche and adding what matters most.  My situation this week is a great example of that.  With Kristen being sick, I didn’t have a choice.  The slate was wiped clean.  Starting from there it was very obvious I could only do three things.  Take care of my family, go to work for my clinical shifts, and prepare for the three talks I had on my schedule.  Everything else was not getting done.

How did I decide?  By focusing on only one of the four quadrants of time management. I looked at all my tasks as either urgent or non-urgent.  And then separated them into important and non-important. Then, out of self-preservation, I only did the things that were urgent AND important.  And that led me to family, three talks, and my two clinical shifts.

The Pizza Topping Study

This may sound like a singular experience that I had… but it isn’t unique to me. This is actually how we are wired.  In a 2002 study, researchers from the University of Iowa looked into a question about how people purchase pizzas.  They wanted to know what would happen if people started with a blank slate and ordered their desired pizza versus starting with pizzas that already contained toppings and having to take toppings off they didn’t want.  

Essentially, they wanted to know if consumers built their pizza up from nothing would this look different than when they scaled down from a fully loaded pizza.  The background here is something called the Endowment effect where people value what they have more than the exact same thing if it is not theirs.  For example, if you own a home, you think it is worth more than you would if you did not own it.  

So, they took 115 students to find out.  Half of them were placed into the build up group and given a regular cheese pizza for $5 with an option to add 12 different ingredients at 50 cents per ingredient.  In the scale down group they were given a fully-loaded pizza with all 12 ingredients at a price of $11 (the same price if the other group added all the ingredients) and were told the price would be reduced by 50 cents for each ingredient removed.  

What did they find?  Well, in the build up group, the average pizza ended up having 2.71 ingredients while in the scale down group the number of ingredients was closer to 6. In other words, when trying to delete things that were already included in the pizza, it led to keeping twice as many ingredients on the pizza.  Similar findings were found when performed in a variation of this study in Italian consumers.  

Pizza and Priorities

What can we learn from this pizza study?  It is called the Status Quo bias.  This is what happens when people prefer for things to stay the same way instead of doing the hard work to figure out what they actually want.  

When we start from an already fully loaded schedule, it is much harder to eliminate current responsibilities and tasks than it would be if you started from a clean slate and decided to sign up for what you actually wanted to do.

This means that we have to fight against the status quo if we are looking to gain clarity about what matters most to us in life and what direction we want to go with our careers in medicine, our family life, and the other various asks we have on our time.  

In other words, let’s say that you are currently the medical director of your group, hold three leadership positions on various committees at your hospital, practice clinically, have a physician side gig doing real estate, and you are also married with kids… and you feel completely overwhelmed.

How do you go about figuring out which task to drop?  If you start from the Status Quo, or you current situation, you will end up keeping more responsibilities than you really want.  This is what happens to most of us.  

Wiping the Slate Clean

There are some lessons to be learned from this study and recognizing that we are all wired to keep more than we would voluntarily add.  

First, we should be quick to say no, and slow to say yes… once things are added it is harder to get rid of them.  This is why creating a Hell Yes Policy is so important. Once you have a ton of clarity on what matters most to you, it becomes much easier to say no to anything that doesn’t make you say Hell Yes.

Otherwise, you’ll end up saying yes to many things and saying no to what matters most – like your family and friends.

Second, if you are trying to gain clarity on the direction of your career, how to stop feeling overwhelmed, or to make a tough decision about your next step… it is better to start from a clean slate than it is to try and subtract things that you are already doing.  The Status Quo bias is strong.  

What would you do if you started with a clean slate? Carte Blanche?  That’s the more important question to answer.

The third thing we must ask ourselves is why do we have to wait for an impossible situation to provide this clarity?  Why do we have to wait until our spouse is sick and quarantined with COVID for this clarity?  Or when we become disabled or lose our job?  

The truth is we don’t have to wait.  You can gain that clarity right now, which is exactly what my coach helps me do each week, and what we help clients do when we coach them.  

Regardless of how you decide to gain that clarity, I encourage you to start with a clean slate and “build up” to your ideal situation as opposed to trying to “scale down” from your current Status Quo.  Otherwise, you’ll end up keeping a lot of things that don’t bring you passion or purpose in your life.  And when you lose your way, just remember pizza, priorities, and the Status Quo Bias.

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