How Not to Settle for the Way it’s Always Been Done

Dr Rachel Morris: Have you ever pointed out things which could be done better only to be called a troublemaker? Or can you see loads of things in your day to day work which need to change, but trying to do so seems like more hassle than it’s worth? Perhaps you’re in a holding pattern, waiting until this person retires, or that person leaves so that you can eventually start to make things better at work.

This week, Dr Abdullah Albeyatti joins me on the podcast to talk about how to make changes for the better to your work, your career and your life. Why settling for what is uncomfortable but familiar could be slowly ruining your life. He’s done a huge variety of things in his career and says that you don’t need any particular skills, or to wait until the time is perfect to try to make things better. Just need to take a risk. We talked about the dangers of settling for the way things have always been done. Holding out and hoping for a change in an organization which deep down we know will never change, and how our mindsets around failure can hold us back from living our best lives.

Join us if you want to find out how status identity and fear can stop us from making the changes we know we need to make. How to know which battles to pick? For example, how do you know if it’s worth staying and trying to make changes where you are, or if you just need to walk away? Join us if you want to find out the sorts of risks that you can take in your work in your career, which will help you work happier and healthier.

Just to let you know about a free download that’s available for you this week in the show notes. In this episode, we talk about the importance of creating a successful life, not just a successful career. One way to do this is to work out what a successful working week looks like for you. In order to do this, we’ve created a downloadable tool called the THRIVE week planner. This will help you plan out what an amazing working week would look like and then work out what changes you need to make. Click on the link in the show notes to download your free copy of our THRIVE week planner toolkit.

Welcome to You Are Not A Frog, the podcast for doctors and other busy professionals who want to beat burnout and work happier. I’m Dr Rachel Morris. I’m a GP, now working as a coach, speaker, and specialist in teaching resilience. Even before the coronavirus crisis, we were facing unprecedented levels of burnout. We have been described as frogs in a pan of slowly boiling water. We hardly noticed the extra-long days becoming the norm and have got used to feeling stressed and exhausted.

Let’s face it, frogs generally only have two options: stay in the pan and be boiled alive or jump out of the pan and leave. But you are not a frog. And that’s where this podcast comes in. It is possible to craft your working life so that you can thrive even in difficult circumstances. And if you’re happier at work, you will simply do a better job. In this podcast, I’ll be inviting you inside the minds of friends, colleagues, and experts—all who have an interesting take on this. So that together, we can take back control and love what we do again.

For those of you listening to the podcast who need to get some continuous professional development hours under your belts—did you know that we create a CPD form for every episode, so that you can use it for your documentation and in your appraisal? Now, if you’re a doctor and you’re a fan of inspiring CPT, and you’re sick of wasting a lot of time you don’t have on boring and irrelevant stuff—then, why not check out our Permission to Thrive membership?

A joint venture between me and Caroline Walker, who’s The Joyful Doctor. Every month, we’re going to be releasing a webinar fully focused on helping you thrive in work and in life. Every webinar is accompanied by an optional workbook with a reflective activity so that you can take control of your work and your life. You can increase your wellbeing, and you can design a life that you’re going to love. You’ve got to get those hours, so why not make your CPD count to CPD that’s good for you. So, check out the link to find out more.

Welcome to another episode of You Are Not A Frog, and I’m delighted to have with me today, Dr Abdullah Albeyatti. Now, Abdullah is a GP from Leeds. He is the chair of the local RCGP Yorkshire Faculty, and he also runs two med-tech companies, a medical chain and my clinic. How on earth do you fit that all in that? I think it’s the first question everyone’s gonna want to ask you, as well as being a GP.

Dr Abdullah Albeyatti: I think I’m very, very fortunate. I say to a lot of people I don’t have the obstacles most other people have. I’ve got good health, I’ve got a very supportive wife, I don’t have any children. I have both my parents supporting me, both her parents supporting me. I’ve never had any trauma physically or mentally. I think I’ve been very blessed and lucky. It’s probably harder for me to fail than succeed, to be honest with you.

Rachel: That’s a nice mindset to have—it’s harder to fail than succeed. I think if lots of people had that attitude probably—or that mindset, then actually they would, they would try more things. I sort of wanted to chat to you on the podcast about that, I guess a lot of the mindset that you’ve had with stuff because you’ve achieved an incredible amount against some quite difficult odds. Against I guess working in a system that likes doing things the way they’ve always been done. Doesn’t like changing the status quo. Even if it does, like innovation, it’s actually quite hard. I guess it’s hard in any system to get any innovation and new stuff in.

I thought it’d be really good for listeners to talk to you because whilst most of us are not doing stuff on the scale that you’re doing in terms of running these massive businesses with million-pound investments, and all those sorts of things, we are trying to make things better, where we work—for our patients, for ourselves, for our colleagues. I think you’re probably better place than those people say.

Actually, how do you overcome stuff even when there’s obstacles in the way? How do you make changes, and have you always been someone that has tried to make things better ever since you were a little boy?

Abdullah: Yes, I think so. I mean, it depends which way you look at it. From my perspective, I’m always trying to right the wrongs or tried to seek justice, if you will. But I think if you talk to other people have met me, they’ll just call me a troublemaker because I will always find the things which trigger me and just think like, “That’s not right! Why are we not doing something about that?” I think that’s what attracted me to medicine is, “Oh, I can fix lots of things here and get involved. There’s lots of good I can do.” Then obviously, as you say, even within our industry, you come across so many barriers and challenges.

We pay a lot of lip service, I think. I think medical students or young doctors listening to this will know when we talk about audits or quality improvement projects. You get so excited. You put 3–4 months into it presented to the department, you’re like, ‘Yes, I’m going to make a real difference here.’ ‘That’s fine. Just file that away, and we’ll sign you off.’ That for me was so disappointing during my early years in medicines like, ‘But we can make a difference. Why are we not making a difference? What’s the problem?’ Obviously, you know that there’s so bogged down with everything else that it’s hard for them to have that view to see what opportunities are available to them to make things better for themselves—let alone for their patients.

Rachel: What do you think of the biggest barriers. You said actually they’re so bogged down with a day job. Is that the only barrier? Are there other things get in the way?

Abdullah: I think the barriers are multiple, unfortunately. I think we get into this position where we think digging in is better than challenging, and sticking the course is better than reflecting on, ‘Maybe we’ve not gone in the right direction, and we should review and reflect on what decision we’ve made.’ Some I see a lot in day to day GP. I’m still clinically active, and I’m also part of the LMC here in Leeds.

We just had a meeting last week where we’re seeing 25%-30% more patients face-to-face. We even did during non-COVID times. I returned to my colleagues and I just had a look, ‘Where is the line in the sand? Is it when it’s 35%? 40%? Is it until someone has a mental breakdown? Is it until one of our colleagues takes their lives?’ Like why do we have to get all the way to the end, all the way up to crisis, push the panic alarm and sound the sirens? Why don’t we just draw the line in the sand from now and say, ‘This is it. This is the most we can do, and we need to look at how we can do things differently.’

I think that’s the biggest challenge we have is that trying to galvanise people and tell them, ‘It’s okay to say enough is enough. It’s okay to say I’m not happy with how things are we need to do things differently because I can’t cope in this system.’ I think a lot of GPs, unfortunately, they try being the hero of their story or the hero of their community. I don’t know how they do it. I really don’t know how they do because, for me, I can see the burnout. I can see that only bad times for their own personal lives. If not for them, then the loved ones that have to live with them at home is down the road.

Rachel: That’s such an interesting point that you’re making that you’ve seen people stay this comfortably in familiarity, and more comfortable to stay in something that’s really rubbish. Then, they are actually making a change and going through that discomfort of making a change.

I’m wondering if it’s for the reason that you pointed out right at the beginning, is that often you’re labelled a troublemaker rather than a change maker—is a troublemaker? Why else are we more content to stay how we are and slowly burn out in the process, and actually make that change? Is it all to do with what other people think of us?

Abdullah: No, I think it’s less to do, to be honest, with what people think of. I think of doctors in general, or what we think of our colleagues, I think it’s more to do with the standards we set ourselves because we’re under this false impression that everybody else is coping okay. Everybody else is doing fine. So, why am I going to now show my vulnerabilities and show that I’ve reached my point of attrition where I can’t take any more? I think that’s a really dangerous position to be in. It helps to have this kind of open forums or podcasts such as yours, that people are open and transparent about, ‘Look, I am struggling here.’

We all struggle for different reasons. I think the important thing to recognise is that when we are doing all kinds of careers, you’re going to do this for the next 30-40 years. If somebody has just graduated, you need to plan for the next 30-40 years. I think that’s probably a lot of what inspired me to move out of a traditional medical career because originally, I was training to be a surgical trainee and EMT trainee in London. Then, I locumed as an accident emergency registrar. I realised, while I was looking at my colleagues, this is not the life that I want. I’m seeing them going home stressed, tired, breakdowns in relationships. I just thought, ‘I can’t embark on this journey as well.’

I think we’re too smart, too hard-working. We’re too well organized to fail because we’re not going to make the maybe momentarily difficult decisions but in the long run, will really pay off. Thankfully, by looking further afield, I think there’s so many opportunities with a fantastic degree that we all have. We just need to see what is that further afield thing we can do.

Rachel: I’d like to talk about that, what’s that further afield thing in a second. Just wants to come back to this changing what you’re doing. I was talking to a trainee the other day that has completed her training in her bills. She was ready, lined up for a surgical job, and she decided that she wasn’t enjoying it. She’s changing to a completely different field. Still in medicine, changing to do different training. Even though she knows that she has passed her training with flying colours, and she’s been accepted on some other training scheme, and it’s a positive decision for herself and her life and her enjoyment of work. There’s this niggly thing back of her head that, ‘I’ve failed because I can’t hack it.’ Do you think that’s what lots of doctors think?

Abdullah: I had that. I had that. When I left surgical training, which was the most I think the smartest thing I’ve ever done in my life is leaving surgical training. It was the wisest decision and the most focused decision I think I’ve ever taken. But the fallouts on a personal level was I can’t believe I’ve succumbed to being a GP. This is what we spoke about in medical school. We said failed doctors become GPs. Even my father would say to me, some Iraqi descended Middle Eastern background, my dad said, ‘But you’re a surgeon! What are you doing?’ There was a lot of swallowing pride, if I’m being honest with you.

Obviously, I absolutely love being a GP, being involved in RCGP and LMC. But I would be untruthful or be dishonest if I pretended that there was a version of me 10 years ago that would look down on GPs, or take those referrals from GPs in the NT, and then turn to my colleagues and say, ‘Look at these jokers. They can’t get any diagnosis. They don’t know what they’re doing.’ There is definitely this inherent tribalism within medicine as well where you want to feel like well, ‘I’m coping, and other people should cope the way that I am.’ The truth is sometimes you need to just recognise that this is not the right path. There’s not the right way to do things, and I’m really grateful I recognise that early on rather than I’ve gone even more committed into that surgical specialty, even paid for even more exams and more courses, and found the other way out.

I congratulate people that change their careers, whether they change it at consultant level or before. You definitely did the right thing because you shouldn’t be questioning, ‘Should I change my career?’ I think that question pops into your head once. You owe it to yourself to try. Look maybe it doesn’t work out for you. Maybe it’s not all that’s cracked up to be. That’s fine. At least you won’t have that haunting idea in the background of, ‘You know what, I’m still not happy and I’m really disappointed I didn’t try.’ I think you’d be more disappointed not trying than disappointed for trying and failing.

Rachel: Totally. I remember when I did my career change. Had exactly that thing, ‘Oh, I just couldn’t cope with the job.’ Actually, it took me quite a while, and quite a lot of unpicking and coaching, and start to realise, ‘It wasn’t I couldn’t cope the job. I could cope very well with the job.’ It was the fact that I wasn’t using any of my strengths in the particular role I was doing. I wasn’t doing what I enjoyed in the particular role I was doing. As a result of that, I wasn’t enjoying the job and I was feeling really disillusioned.

You can be stressed and burnt out because you’re not enjoying yourself and you’re not using your strengths just as much as the fact that you’re overwhelmed by too much work. If we get this mindset of actually, ‘I am choosing to do this particular thing because this suits me, it’s using my strengths, not because the really resilient people can hack it in this job, and they can’t hack it in that.’ It’s such a dangerous, dangerous mindset to be in.

Abdullah: I think we are so blessed with the degree that we’ve come out with. When people say, ‘I don’t like doing on calls.’ ‘We’ll do a job that doesn’t have on calls.’ ‘I don’t want to see patients.’ ‘Okay, we can do that instead—microbiology or something?’ ‘Yeah, but I find that boring.’ ‘Okay, then you can go do GP’ ‘But I think that’s stressful.’ ‘Okay, then go work for the MDU or the GMC.’ ‘But I don’t like that stuff.’ Again, there’s legal work. You can be a health advisor to all these tech companies that are popping up every second. There’s so much variety that you can do. Worst-case scenario, I believe medicine—everybody respects a medical degree. I think it’s his lack of valuing yourself of valuing how much you’re actually worth to society let alone within the medical profession. I think people need to be happy in themselves.

Rachel: I do think diversifying it is one of the ways to survive at the moment because you use other bits of your brain that you don’t necessarily always use just doing the face-to-face stuff. I think your point about trying other stuff. I think a lot of people when they come to me for coaching, or they’re talking about career change, it’s like, ‘Well, what else would I do? There is nothing else.’ I definitely thought that, ‘What skills do I have? I don’t have any transferable skills? How am I going to know?’

I think the problem is a lot of stuff that’s out there just isn’t advertised. We think, ‘Well, what would I do?’ It just takes a bit of trying and failing—or not failing. It takes a bit of trying and realising, ‘Oh, that’s interesting. I’ve tried that.’ ‘I didn’t like that one either.’ ‘Brilliant, that is fantastic.’ What I’ve done is learn, ‘I didn’t like doing that.’

Abdullah: Even the word failing I think is not a negative thing. It’s such a different mindset between medics and non-medics. In the non-medical world, failing is celebrated. There is no shame or stigma attached to failing. I tried this business idea—it failed. I tried this other idea—it failed. I hired this guy, he was useless—it failed. Then, I finally have that combination of learning. Of course, you learn from your failures. I finally tried number 710—and that actually worked for me. Whereas in medicine, God forbid you fail an exam. God forbid you didn’t get that cannula in first time. God forbid, your suture came loose. There’s so much shame. There’s so much stigma associated with failure that we’re so scared to even try or leave that area because of the shame that comes with failing.

I think, for example, when I embarked on the things that I’ve done—huge capacity to fail and embarrass myself in front of my colleagues, and posting stuff online, and it could all fall apart, and you invite criticism, and you invite people saying, ‘Well, what’s he doing? What’s this nonsense? He’s not a proper doctor! What’s he talking about? I can’t relate to him.’ On the other side, ‘This is some kind of scam or sham!’ Or ‘Look, what he’s doing? He’s left the NHS!’ Look, don’t worry about other people’s opinions and whatnot, and don’t worry about failing. Just be true to yourself. Try, learn, and by all means, fail and fail fast so that you realise, ‘Actually, I thought I was going to enjoy that. I didn’t enjoy that as much as I did. But I did enjoy that element of it, and I’m going to stop digging and going more pursuing this area.’ Until you find your niche and what you actually enjoy. But I think it’s that shaming, that stigma that’s associated with failure that we need to get away from because non-medics, they fail all the time and they just get on with it.

Rachel: You go on to sort of business development courses and stuff like that, and the whole agile lean thing. It’s all about failing fast, isn’t it? There’s people that I’ve talked to. They have an idea for a product and they put it out there before it’s even been made so that they know if it’s gonna work or not. They say they can fail fast, and if you fail faster, the better your organisation, the better your product. You know how things aren’t going to work. I think as medics, we want to create this wonderful career. We’re trying to find exactly what we want to do to make things perfect. We develop it and then we do it. Then, we’re surprised when it doesn’t work, which I guess is what QI is trying to do, isn’t it? It’s finding the tiny little things and work our little things that you can change.

Coming back to when we want to make changes in practice because everyone’s burning out and we know we cannot cope and where’s your line in the sand? Is it 35? Is it 60? Is it 100 patients in the morning? When are you going to say ‘no’? The problem is I don’t know what else I would do to make this better. We tried something last year, and it didn’t work, and everyone got really hats off in the practice. Therefore, we’ve just gone back to the old ways, and we’re so worried about doing something different. How would you suggest that you bring some of that agile, lean mindsets into our work, into what we’re doing so that we can just try stuff and actually not be frightened of failing? Or actually, look for where the failure is so that we can learn?

Abdullah: I think, from the examples I’ve seen, so it’s in a few practices which tried to implement some technology, or some new way of interacting with their patients, or a new way of structuring their appointments. The reason it breaks down from what I’ve seen is that you didn’t get the whole team on board. You didn’t get everybody on the same page. It was some doctors in a corner making a decision that said, ‘This is the way we’re going to do it.’ And dictated it to the staff that are actually the ones that are going to have to implement it. You didn’t really have them on board when you were doing that. I think that the challenge is you need to have wholesale logistical changes to how you’re running things.

People think that the problem is if we just switch appointments from telephones to, ‘you have to look online’, that’s going to solve everything. That’s like, no. Look, the reason we’re getting absolutely slammed in GP practices is because patients are hammering the phones. All you’ve done is say, ‘Now you can hammer the phones, and you can have our online forms.’ To you’ve just doubled your problem because now we’re getting hammered from a different avenue which didn’t exist. You need to recognise what is the root cause problem. You need to go right back to the beginning and go, ‘we need logistical wholesale changes, and what are the other logistical, wholesale changes?’

It’s not about how patients are getting the appointments, it’s that there are not enough appointments. Full stop. You can’t get away from that fact. Loads of your resources. Well, that’s what you need to say. I would explain to my patients, and I explained to my colleagues as well, for every patient who complains, I go, ‘This is the local email address and telephone number for the MP. This is the CCG. This is this, and we should be doing citywide about every time a patient says “Well, that’s not good enough.”’ The right response from the receptionist should be, ‘I totally agree with you.’ Instead of that, unfortunately, that stereotype rock while they’re shouting back and you shall not pass. No! Tell the receptionist, agree with the patient. It is rubbish. You shouldn’t have to wait four weeks to see me about something. I agree with you it’s rubbish. But listen, the problem is not us. We really can’t do more than we’re doing.

I think you do see, and we had glimpses of that during COVID that the population of patients, they do get it when they are spoken to and explains. When the government said to patients, you will not see a GP, there will not be hospital appointments, there will be no face-to-face to get your elective surgery, everyone just shut up and accepted it and said, ‘Okay, fine, I’m just going to have to talk to the GP on the phone. I’m never going to see one for the next few months unless it’s XYZ reason.’ The reason that fell apart is because we didn’t learn lessons from that.

Rachel: I think it all goes back to the story that you’re telling yourself because the GPs are telling themselves that they’re failing if they can’t see the patients. The hospital doctors are telling themselves that they are failing if the GPs are getting cross with them, or the patients getting cross with them. If you’re telling yourself that you’re failing at it, you’ll then become very, very defensive and start fighting each other. If instead, you say, ‘Yeah, you’re totally right, there aren’t enough appointments. It’s crap, isn’t it? Let’s do something. Let’s complain together the patients to thee consultants.’ And you pass the problem up with say, ‘We have this massive problem here that needs to be addressed.’ You recognise that you’ve got limits.

One of my big things at the moment is, is about professionals recognising what their limits are, and then say, ‘Okay, those limits are actually good. The fact that I need to sleep. The fact that I need to rest and I can’t see more than 10 hours of work a day are good.’ Then, those limits mean we have to then put in the boundaries. There’s a lot of people talking about how, ‘You just need to get your boundaries right.’ Things like that. I don’t think GPs have a problem with boundaries. I think they say that they’ve got these boundaries. What they have their problem with is the consequences of the boundaries.

Abdullah: 100%! I think there are no consequences, I think, again, it needs to be a wholesale change, need to bring everybody in this journey with you including your patients, and including your local community. You can tell that there’s some understanding patients which recognise the challenges that there are and they’re so grateful, and thankful to see you and speak to you. Sometimes, too grateful and thankful and you go, ‘Okay, it’s my job. I’m here to help you.’ Then, there’s the other ones which are really… They lack appreciation. You know what, you will never going to win that person over, on board so don’t stress yourself thinking, ‘But that person is still disappointed with the service.’ They were always going to be disappointed with the service. Just be honest with yourself. You haven’t done anything wrong.

Rachel: It’s until we stop thinking of those limits of our time, the amount of appointments, and the service as our own personal failure, ‘I’m not good enough. The service is failing.’ Then, you feel dreadful actually. ‘I have 24 hours in the day. I can literally only see this many patients. If I can’t see more that’s not a failure of me, it’s failure of the system.’ You boot it up, you say what’s been happening but then it’s very difficult when you’ve got the mindset. It’s not just doctors I think it’s many other professionals. I’ve seen this in lawyers, and I’ve seen this in you know other people that professionals but they’re often giving a sort of service—delivering a service, seeing regular people that they find. That’s what we talked about in the beginning— drawing that line in the sand is a personal failure and speak to them. Then, they don’t try anything different. If they do try a little thing different, they fail, and that failure is dreadful so they go back to how it always was.

Abdullah: Or that I think, then they should reflect on whether they’re doing what they really love or what they’re passionate about. When we talk about how much time on or lines in the sand. I can’t reflect on that in my business at all. There’s nothing in my business that says, ‘Oh, I shouldn’t do more than five hours.’ Or ‘No, because I love it. I’m passionate about it. The more effort I put in, the more energy I put in, the more I get out of it, the more I see my team grow and thrive and we’re pushing in the right direction.’ Why do we have that kind of burnout? I want to run away from this problem mentality in medicine. Why are you not saying, ‘Actually, I’m really enjoying this. I love this. I’m looking forward to this.’

There’s got to be something about that as well. Why are we not enjoying it as much as we should enjoy it? Why do we not have that variety in our day that when you do turn up? Because everything we’ve said now is about the doctor’s perspective, and obviously, we’re talking about our colleagues, but be in the other person’s shoes. Imagine you’re the patient. I’ve waited three weeks to see this doctor, and they don’t recognise that their patient number 300 to be seen this week. This doctor needs to reset their compassion back to the beginning to see patient number 300. It’s very hard to reset your compassion back to zero when you see patient number 300. This patient has mould and thought about how they’re going to word things, and how they’re going to describe their symptoms. They come in, they’ve got a frowning doctor—shattered, hungry, dehydrated, probably a bit of AKI in there as well because they’ve not been to the toilet for 12 hours. That doctors got no compassion, no time, ‘What is your problem? What do you need? Go!’

You’re defeating the whole purpose of what you’re trying to do which is, ‘I don’t want to fail. I want to deliver a good service.’ But it’s inevitable because you’re going to be shattered. You’re going to not have compassion. You forget that the name of the game is to turn up bright-eyed, bushy-tailed, keen to solve people’s problems, help them, listen to them. Sometimes, you know their diagnosis in the first 10 seconds. You could prescribe the medication the next 30 seconds, but just let them empty their chest a little bit, say a little bit, feel like they spoke to somebody, somebody heard them. That’s part of medicine. That’s why people probably like the medical students are they like the registrar’s because they give them that time. Then, the partners always scoff.

I remember when I was training, the partners would always scoff. Obviously, you listen to them, that’s when they like you more. It’s like, ‘Yeah, do you guys not? Why do you not? Do you not reflect on that? Why are you slamming through patients so quickly? Why you’re not giving them the compassion?’ Something’s got to change there because it means you’re not even delivering the service that you wanted to deliver. I think there’s a lot of, coming back to what you asked earlier, what could you change? I think more than 10 series of podcasts to even cover that one.

Rachel: I think we probably could solve all the problems in the healthcare service right now. But I’d just like to go back to how you get the change. Of course, there’s loads of stuff about change management, about getting people on board and things like that. Now, it just strikes me that you’ve been particularly tenacious in getting these changes. I know you’ve said to me, one of the phrases that really triggers you is, ‘That’s the way that it’s always been’. We’re just going to carry on like this. How do you maintain that mindset, that tenacity?

Abdullah: I think because you have to pick your battles, and there’s so many problems in any system, let alone the healthcare system and let alone working in a GP practice outside of the GP practice. There are so many challenges, and you need to pick your battles. I can let a lot of things go by, and I can get on with a lot of things. When I hear the phrase, ‘That’s the way it’s always been’, I start frothing at the mouth because it’s just come on…. If you told somebody, ‘That’s where it’s always been’, it means you recognise it’s crap. You don’t have the energy, or the now’s of how you’re going to work with other people to fix this. We need to just pump the brakes, stop and fix that thing that you just said, ‘that’s why it’s always been’ because there’s nothing more destructive than hearing an organisation recognise that they’re crap. It just means that there’s no hope. I think when there is no hope. That’s where you get complete and utter, utter despair because people just, ‘Well, that’s the way it’s always been.’

It’s like, ‘What? So, that’s it? That’s it for life? We’re just going to keep doing this, going around in circles?’ For me, that always triggers me when somebody says that, and then I get in this mentality of, ‘Right, I’m not going to settle for this, and I’m going to do whatever it takes.’ I think when I’ve had those kinds of moments in my career, or even outside of my career. That’s the attitude I always go in with is I’m not going to let this go until this is solved. There’s a lot of things which are not optimised. There’s a lot of things that could be better. Again, that’s probably for other people. I let it slide. I’m not going to lose sleep over it. But when somebody says, ‘That’s the way it’s always been’, there’s a big problem there. That’s the one that I would focus on trying to solve. Probably by trying to solve that fix lots of other issues along the way as well.

Rachel: That’s what it’s always been, and we can’t change. We’ve tried. I mean, when you get that bit between your teeth, that’s what I’m going to focus on. I said, ‘Well, where there’s a will there’s a way. I’m not going to settle.’ How’d you know which things you literally can’t change, you’re just going to leave? How do you know which battles to pick?

Abdullah: I think everything can be changed. I would say in terms of knowing which kind of battles to pick, it’s where you’ve got buy-in from people around you. It’s like if you’re seeking feedback from users, it’s the same thing. You talk to your colleagues and you say, ‘Did you know we’re doing so and so?’ And like, ‘Yeah!’ ‘What did you think about that?’ ‘Yeah, it’s pretty rubbish.’ ‘If you guys ever attempted to do things differently there?’ ‘Well, we did think about so and so.’ When you do that kind of feedback, and you gauge the warmth for what the issue is, and how passionate people are about fixing it.

A lot of things we do again, as medics is, we can go down this really dark tunnel of coming up with your brilliant ideas. After you’ve come up with an idea—and this is the same in the world of technology actually—you come up with this brilliant product, and then you try to hard clamp it onto your issue like, ‘This is what I’ve built. What I’ve built, I think is going to fix what we’re doing.’ You’ve gone the wrong way around. You need to start with what is the problem, analyse the problem, and then build what’s going to fix that problem. I think a lot of, again, the e-consultation thing, ‘We’re going to do this thing where patients can send in messages, and we’re going to have it so well organised.’ And then we go, ‘Whoa! Was that the real problem here?’ The real problem wasn’t patients getting appointments. The problem was there are not enough appointments. All you’ve done is create another problem now, where we’re drowning in how much demand there is for the service. That’s a really dangerous way of going about things.

I would always say, start with the problem. Try to get the kind of buy-in from others. Get the warmth of what is their top three problems, and then together collectively bring people and say, ‘Right, so we’ve all agreed, that’s the main issue. What are we going to do to fix that issue?’ Rather than go the other way around and off, ‘Well, I heard about this thing which I think is going to work. Let’s try that.’ Now, you’ve just created another issue for yourself.

Rachel: That’s very much the Simon Sinek ‘start with why’ thing isn’t it? Why are we doing what we’re doing? Then, how are we going to do it? Why do we have this problem? What is the problem we’ve got? Patients demand—that is the problem right now. Actually, providing more appointments isn’t going to help. It’s actually fixing that problem at the top. But those seem like really big problems to address. How can someone who is working in a workplace, maybe they’re part-time, only doing two sessions a week, they can see that there are all these myriad of things that need to be changed. They might not be the boss. They might not even be on the management team. They might be just sort of doing a job, but there’s loads of stuff. Where would they even start?

Abdullah: I think, wherever you are, however you’re working, whatever capacity, you’ve got to see whether that is the right place for you and whether you’re working with the right people as well. I would say,, even for example, when I’ve worked in practice for a few hours a week, or a few weeks in the month, thankfully, the places that I’ve always worked that know me by name, all the staff know me. Because of that, I feel very warm and very invited and, ‘Is there anything you think we could do differently?’ When you hear those kinds of conversations, you’re in the right kind of environment. You’re in the right place. You try to help out. You try to contribute where you can and you galvanise the team around you.

I think if you are an open-minded and wise GP partner, you will recognise that everybody is coming to this practice with their own history, with their own lived experiences. It takes from those people’s experiences, and you try to improve your practice, not just for the patients but for yourself as well. If you turn up to a practice and they’re not listening to you, they’re not interested. That’s the way it’s always been. Look, don’t beat your head against the wall. You don’t have to hold the world to rights and change everything. Walk away from the practice. Walk away from that career. Walk away from that environment. There’s no point in you killing yourself with somebody or some organisation that is not willing to change or trying to improve things. The only person who’s going to end up on that pile that heat at the end of used and discarded is going to be you and your mental health, and your physical health.

As a byproduct, unfortunately, your family will suffer as well because they never see you. When they do see you’re tired and stressed, and now you’ve put on weight and now you feel miserable because you’ve let yourself down as well. Okay, that’s fine, but you need to know that. ‘I’m going to give this a month, two months, and then that’s my line in the sand. If they don’t listen, they’re not even interested in engaging in conversation. But I can’t demonstrate that I’ve given any kind of value-add to this project or where I’m working.’ That’s fine. Go find something else. I think that’s what people don’t do, unfortunately, is going back to the kind of surgical career, or that conveyor belt.

When times were crap as an SHO, don’t worry. When you’re a registrar, it’s better. Then, you talk to the registrar guys, ‘How’s it going?’ ‘It’s rubbish!’ But dont worry, when you’re a consultant, is better. When you talk to a consultant like me, ‘How’s it going?’ ‘To be honest with you, I’m not having a really great time. I’m going through the middle of a divorce. I’m doing 80 hour weeks. [inaudible] again that private practice which I was really looking forward to doing.’ ‘Okay, so this is not going to be for me.’ People need to recognise that quickly that some environments are not going to change, or if they are going to change, you’re gonna have to sacrifice so much for it. Is it worth it? Only you can answer that question. Is it really worth your life to sacrifice that change for that little practice in Cornwall, or that hospital department in London, whatever it may be?

Rachel: Yeah, I 100% agree. I’ve lost count of the times where people have said to me yet if only they would change, it would be better. I’ve got these ideas, they don’t want me to do it, and they have genuinely tried. There’s just been [inaudible], ‘No, I’m not going to do it.’ It’s about remaining in your zone of power. What can you control if you can do something and other people say, ‘Yeah, that’s great, do it. But you cannot force someone else to be open-minded to change, to want to change. If someone’s just sitting there and they’re just going to last six more months, then they’re out of there or whatever, then they are not necessarily going to want to make something that’s going to be very disruptive and slightly painful to go through.

I 100% agree. Change what you can change. Sometimes, that is changing your workplace because if you’ve got very intransigent colleagues. So many times it’s, ‘Oh, well! We think that person who’s a complete blocker and a barrier, they’re probably going to retire in the next couple of years. We just have to hang on until then. You think, ‘Two more years, you don’t even know if that person is going to retire. Actually, if the rest of the environment is allowing that person to carry on, and no one else wants to change, then really?’ It’s always quite gobsmacking the way that we always stay where we’re comfortable because we think things might change in the future. Actually, I don’t know. In your experience, do they change that much?

Abdullah: No. Of course, they don’t because as you say, they’re serving a purpose. We’re all different. Other people have different thresholds of what they think is a good job. Some people will be like, ‘Well, we didn’t kill anyone this week, we did a great job.’ That’s fine. That’s your standard, and that’s your line in the sand. That’s not mine. For me, the thing that I always… I’m one of the NHS clinical entrepreneur mentors as well. A lot of the guys that I speak to, they’re always going on about, ‘I want to make this much money’ or ‘I want to do this’ or blah, blah, blah. That’s fine. One thing we haven’t spoken about is time, and time is more valuable than any of these numbers you’ve just been speaking about.

If you think about it, the only reason we drive ourselves reading and earning potential is because we want to win back time. We want to stop doing that kind of running in the sand. When you talk about those people that are sad, they’re going, ‘I will invest two years waiting for this person to retire.’ Do you know how valuable two years is? If somebody gave you a boatload of cash and said, ‘Would you want this cash that’s at the end of two years, would you rather just have the two years make the change from today?’ I think you’ve found a lot of people like that ‘I’m just happy to make the change today, I’d rather save the two years of pain and uncertainty.’ I think a lot of people do not value time as much as they should. We only really look at other values, even monetary values. I think we’ve got the wrong idea there.

Rachel: Totally. I’ve been reading a bit about time poverty and how… Money is useful to a point. You cannot get time back. A brilliant book out at the moment called Four Thousand Weeks by Oliver Berkman because most of us have give or take around about 4000 weeks on this planet. That is it. If you are squandering that on a job that you’re not quite sure will change, it’s going to take out years of your life. I think there’s a difference isn’t there between saying, ‘I choose to stay in this really difficult tricky training job for three to six months so that I can get experience of this thing and ticks and boxes on my forms and whatever, and progress to do what I want towards what I want to do.’ If it’s just, ‘Yeah, I’ve got to hang out here for another three years because this might change in the future just in case but it’s making me completely miserable now.’ Then, it’s like what are you doing with yourself?

I think as professionals we are very good at using our time to make money for the future. For this future, which sometimes never comes, it never comes. It never comes. One of the best careers advice I’ve had from people is you just need to enjoy the journey. Enjoy finding out what you want to do. Enjoy going to the goals. It’s never really the goals that are really great. It’s the journey towards getting there. I don’t know what it’s like because obviously, you run all these amazing med-tech businesses, and I guess, it’s really great having that product that’s working in front of you. But if the only satisfaction you got in life was right off develop that product, and that’s a bit rubbish, isn’t it? Presumably, absolutely love the process of developing it and in doing it.

Abdullah: Yeah, of course! Because that’s… I think that’s the difference is that’s the challenge which I can control the most aspects of. I always say to the team, ‘When we’re doing well, we’re doing well. And when we’re doing crap, doesn’t mean all of a sudden we become dumber.’ Everybody goes through challenges. No such thing as a perfect job. You want to know that you have been able to influence that journey, that job, that experience. I think that’s the bit that we get most frustrated about is what you’d want to change, but you can’t influence things at work.

I think for a lot of people—yes— if you’re so passionate about specific medical careers, then that’s great because eventually, you’ll get to the point where you fully qualify, you’re a consultant, you’re the boss, and you’re in charge of your time. Again, you have to be really honest with yourself, ‘Are you really happy with what you’re doing? Are you really going to be happy with what you’re doing?’ It’s that fallacy of, for example, people think, ‘Okay, I have money, so I can afford house. And I have more money, I can afford a bigger house, and now I’m not going to be in debt.’ Not really! You have a bigger house, you’ve got bigger debt. Now you’ve got a bigger house, you’ve got more furniture. You’re going to be even more in debt. This kind of it’s always catching up with us. It’s always chasing us.

I think you’ve got to get yourself in a position where you are in control of your own destiny, and there’s a really warm feeling inside when you wake up and you realise, ‘What am I going to do today?’ I do think people can achieve that, and I wouldn’t want your listeners to ever think, ‘Oh, Abdullah did this’ or ‘That happened’. Honestly, we all have the same medical degree. I cannot code. I’m purely a doctor. I genuinely don’t have any other skill set other than that. All I’ve done I think maybe differently from my colleagues is I’ve challenged things and I said, ‘Well, I’m not happy about that, so I’m going to go take my toys and go play here instead.’ That’s worked out quite well for me, and it might not work out for you the first time, the second time, the third time.

Recognising the position you’re coming from is not good enough. It’s the starting point. Recognise that, it’s not good enough. Start challenging yourself and trying things because honestly, when you’re in that sweet spot, you know that this is as you say, the journey is what you’re enjoying, how you’ve created your environment around you to serve what you’re trying to do.

Rachel: I think what you’ve done is you’ve gone, ‘Okay, I’m going to take that risk and take that risk of doing that. I might fail. In fact, I have failed several times, and that’s how I’ve learned that that’s not what I want to do. I want to do this.’ I think it’s exactly the same in our jobs. Not everybody wants to get off and be an entrepreneur and work for themselves, and develop these products. Actually, it’s a risk changing where you work. It’s risk taking on a slightly different role. It’s a risk maybe cutting down a little bit, so you have enough time so that the work fits in. All of these things are risks. We need to take that risk to see if we like it or not. If we don’t like it, don’t get, ‘Oh my gosh, I failed. Awful!’ Just going to go back to that. It’s like, ‘Great. I’ve learned I don’t like doing that.’

I had a very interesting experience. Quite a while ago, three or four years ago, when someone sat me down for a bit of sort of coaching. It was like, ‘Okay, what does the successful life look like to you?’ ‘Well, I’ll be—I’ll have achieved this.’ And they’re like, ‘No, that’s not what I asked. What does this successful life look to you?’ Literally, what are you doing in this week of a successful life? I keep asking myself, ‘What does a successful life look like?’ To me, it looks like enough time to be present for my kids, to see my parents, to hang out with friends, to do enough exercises and hobbies, and really enjoy what I’m doing during the day as well with something that gives me a bit of purpose and of mastery and autonomy as well. If I look at what that life looks like, you just have time to do that. I don’t think I’m entirely there in terms of managing my diary.

If you’re looking at what does this successful life look like, that’s very different to what does a successful achievement look like to me because we chase achievement and we chase status. At the end of the day, there’s plenty of really miserable people that have reached the end of their careers. Like you said, several failed relationships and haven’t really got anything. They got huge amounts of money. They’ve been hugely successful in their lives, but actually—well successful in their business. Are they really successful in their life? It’s really difficult conundrum.

Abdullah: I totally agree. I think that’s there’s a lot of mindset that needs to change. We need to stop beating ourselves up about it or stop worrying what other people think about us or think about our decision making. I think it’s good to challenge things. I think it’s good to try things. I think people recognise that they’ll like things more than they realise once they try. It’s like any kind of buggy. I can tell you from my kind of four-and-a-half, five years experience of going down the entrepreneurial route. In the first six months, I recognise this is actually something good. The next year that passed, I actually, ‘These are the things we did wrong. There’s things I want to do better. This is how we’re going to grow.’ I think once people start in the hardest bit of starting, once you start, you’ll gain that momentum, and you’ll gain that confidence. Even when people challenge you, ‘What are you doing?’

To be honest with you, only in six months, I’ve got to make myself this much happier. You don’t need to demonstrate to people, ‘I’ve done this’. As you say, it’s not about trophies, it’s just about saying, ‘But look how much happier I am.’ I think something I always joke with my friends is my hair stopped falling out. I could start playing football again and playing squash. I felt better. I felt more alive, and I had more time for my family. You can’t put a monetary value on those kinds of things. I think people need to look at themselves as well. I’m sure when they’re listening to these kinds of podcasts, you’re not a million miles away from being there. You’re not in this kind of pit of despair, I wouldn’t even know where to start. It’s probably just around the corner, to be honest with you. You just make one change that will lead on to the other changes, and then you’ll get to where you want to get to.

Rachel: What would you say to people that have these stories in their heads of, ‘Yes, but I should keep going exactly how… I ought to!’?

Abdullah: If you absolutely love it, and you’re passionate about what you do, go for it. More power to you. You want to be the professor in the hospital, and publish all those papers, and travel the world, and run the department, and be at the beckon call of all the colleagues and patients, power to you because that’s your version of success. That’s the version of the life you want to live. I’m very happy for you. But it’s the doctors that moan that kills me.

I don’t know if you’ve seen this video on YouTube—there’s a child grabbing onto a rope in some water, crying their eyes out. The seabed is just below them. If they just put their feet down or touch the seabed. And they’re crying because they’re too scared to put their feet down. For me, it’s the same with medics in general. This is obviously a sweeping statement. Why are you so upset? Why are you moaning so much? Why are you crying? Do you know how much variety there is available here for us? Do you know how many things you can do out of our programs—part-time, change career, switch into this, go to that, apply for some kind of secondary role, be a non-executive director there, be an advisor there?

Once you do that little thing you’d like, ‘Actually, I really enjoyed being an advisor there. Now, I’m more interested in charity work which I didn’t recognise before.’ That’s now going to be your new career destination. It’s about just don’t feel this pressure of, ‘I need to pursue something.’ Pursue it if you love it. If you don’t love it, then don’t pursue it and try different things.

Rachel: I think a lot of the time, we fear the loss of the status and the identity which goes with doing a recognised medical role and…

Abdullah: Big fish, small pond. Big fish, small pond. The professors and the consultants, and this is so and so. Yeah, big fish in a very small pond. The second she walks out of that department out of those double doors of the hospital, nobody gives a crap who she is. Don’t worry about that. She’s not not a walking God. The big fish, small pond. There’s a lot more to life than the four walls of a hospital you practice.

Rachel: No one really cares about what your title is. When you’re sat around dinner with friends. I mean, they just care about who you are.

Abdullah: Exactly. Honestly, nobody cares when you go down to the supermarket. Nobody cares when you’re on a plane. Nobody cares when you’re going to the cinema. Nobody cares. The only person you are doing this to is yourself and the people around you that care about you. Do it for yourself, and maybe for the people around you as well.

Rachel: I think we just keep on talking about this for ages and ages. If you have to give people three top tips about if some way you can see something really needs to change, something could be improved. Actually, you’re in the right place. You’re in the right place of work and you’d really like to try doing that. What would your three top tips be?

Abdullah: First of all, don’t be a moaner. Nobody likes a moaner, and nobody likes a complainer. The first thing I’d say is just hold your tongue, even though you’re fully justified in moaning, complaining, going off the handle. Don’t lose the battle immediately by doing that. I think the second thing I would say is gain your allies. Win people around you, bring people to your cause, you’ll probably recognise that or they’ll recognize that they actually agree with you, and you should be working on this together. But you just need to focus their efforts to join you in what you’re trying to do. Then the third thing I’d say is you need to take everybody on that journey with you, even though you might be the decision-maker or you’ve convinced the decision-makers, it’s never going to work if the people on the ground are not with you on that journey. I think you need to have that kind of stepwise approach of, ‘Have we answered everybody’s question? Have we looked at what the repercussions are? Have we set timeframes for how long we’re going to test this for? Have we decided how we’re going to implement these changes long term if we wanted to do these things? What are the goals we’re going to measure this by so that we can decide whether this was a success or a failure?

If people break problems down into those kinds of steps, they’ll recognise that much salt was in that. That’s a low hanging fruit for us, maybe we should go for that one first. Because sometimes building momentum is a good approach. Go for the easy wins. Get the easy wins under your belt. Get the momentum going, and then you can turn to that big challenge—that big task, and you’ve got momentum behind you and everybody else behind you and say to them, ‘Look, guys! Look how we just succeed! Look at how many changes we brought about in the last six months. We can tackle this as well. We can do this as well. You’ll see that everybody will join you on that journey because they believe in you and believe in what you’re trying to do.

Rachel: I would say three sort of personal tips in terms of being successful in enjoying your life. I would say map your life out. Map what you’d like your ideal working week to look like what does this successful week look like to you. We’ll provide a download called the THRIVE week planner that people can get if they want to do that. Measure your success by happiness, and meaning and purpose, not by money, as well. Work out where you’re headed, what do you want people to be saying about you, at your funeral or at your time and what are your values in life, and then live consistent to that. Don’t be frightened to change what you can change. Sometimes that might be where you’re working.

If you cannot control what other people do, you absolutely can’t. If you have tried, and you can’t get people to come with you, then you might be in the wrong place. I think a really good book is all about icebergs and penguins. Isn’t it called Our Iceberg Is Melting? I think that the penguin—but that’s a really good book about change, and how to bring people with you which I’d really recommend as well.

Thank you so much for joining us. If people wanted to find out more about you, the various things that you’re running, and how can they contact you?

Abdullah: Yes, I’m always happy to help people, support people if people just want to chew the fat and talk about some ideas what they’re going through. I think something I said to you is I’m passionate about trying to be the person I needed 10 years ago. That’s something that I’ll try to encourage people. It gives you a lot of satisfaction knowing you’re helping somebody who was you effectively 10 years ago. If anybody wants to reach out to me, LinkedIn is a good way to reach out to me, and you’ll find my name there—I’m going to help you actually. I think I’m the only one. On Instagram, if anybody wanted to reach out to me there, I don’t know whether your users use Instagram at all. But I’m ‘theantidote’ as well. I think I’ve sent you the link if people want to find me there.

Rachel: Perfect. That’s great. Thank you so much. That was absolutely brilliant. We’re sure we have to get you back another time. There’s lots more to talk about. But thanks for sharing all that.

Abdullah: Very kindly. Thank you, Rachel.

Rachel: Thanks, bye.

Thanks for listening. If you’ve enjoyed this episode, then please share it with your friends and colleagues. Please subscribe to my You Are Not A Frog email list and subscribe to the podcast. And if you have enjoyed it, then please leave me a rating wherever you listen to your podcasts. So keep well everyone. You’re doing a great job. You got this.