Give Yourself a Raise: Goals and Systems in Your Radiology Career, Part 1

In previous columns, I’ve referenced the adaptive value of prioritizing systems over goals. The concept is far from new to me; I think I’ve always instinctively lived that way. As with so many things, however, hearing it verbalized by someone else crystallized it for recognition by my conscious mind.

That someone is Scott Adams. He’s fleshed out the idea in a couple of his books (notably Loserthink and How to Fail at Almost Everything and Still Win Big), but offers a pithy challenge/summary: Goals are for losers, systems are for winners.

This can seem like a slap in the face. An awful lot of conventional wisdom out there urges us to set goals, so we’ll have things to work towards. We’re pretty thoroughly indoctrinated with goal-setting before we finish our first decade of life.

A slightly longer-winded explanation he offers: “Goal-oriented people exist in a state of continuous pre-success failure at best, and permanent failure at worst if things never work out. Systems people succeed every time they apply their systems, in the sense that they did what they intended to do.”

For instance, let’s say you’re in the common position of wanting to lose weight. The scale says you currently weigh X, and you set a goal of weighing X minus 20. Maybe you give yourself a deadline: Gotta do it by swimsuit-season.

The problem: No matter what you do, until you cross the finishing-line and the scale confirms you are now X-20, you’re in that state of failure mentioned above, “pre-success” or otherwise. Doesn’t feel good. Can actually drain your motivation. And, if you set a deadline, each day that brings it closer intensifies those unhelpful sentiments.

Further, suppose you do manage to achieve your goal. Hurrah, you high-five yourself and scratch that item off your mental to-do list. No longer pursuing that goal, you might not maintain the behaviors that brought you to it. What happens? A few months later, you’ve regained the weight, which feels an awful lot like failure.

More adaptive is to focus not on the finishing-line of that goal, but a course you can chart that will take you in that direction. A system that, if adhered to, will achieve what you want or a good measure of it. You know that losing weight can result from burning more calories than you consume, getting sufficient sleep, etc.

So you incorporate such measures into your daily routine. That feeling of success, of “I can do this,” is no longer reserved for getting on the scale and seeing that magical number. Now, you can feel it whenever you do your daily exercise-routine, eat a non-overindulgent meal, get to bed on time, etc. Those little tastes of success feel good and help you stay on track…even after swimsuit season has come and gone.

And if you have a lapse? Miss some or even all of your regimen one day? That’s just one iteration of your system; it doesn’t leave you feeling like the whole thing has collapsed. It might even motivate you that much more strongly to get back on the horse the next day.

Another Adams quote: “A goal gives you one way to win, whereas a system can surface lots of winning paths, some of which you never could have imagined.” Suppose you get to swimsuit-season and your scale still shows a higher number than you’d like…but you look in the mirror, and realize that your system/regimen has redistributed your weight such that you look and feel better than you’d have thought possible. Not to mention the other benefits of getting more sleep, eating healthier, etc.

The lowest common denominator of most effective systems I can think of: Identify what works, and what detracts. Do more of the former, and avoid the latter. An iteration of a good system incrementally brings you closer to the things you want (even if you don’t initially recognize them), and keeps the things you don’t further at bay.

Good systems are, in effect, a personal (or team-based), super-accelerated form of evolution. “Survival of the fittest” behaviors to get you ahead…of where you were before, or relative to competitors.

So, how does this circle back to your radiology career? Really, how could it not?

Don’t, for instance, adopt the “goal” of zero misses on QA…because, if you do, every time somebody takes a shot at you, however petty, your failure-alarm will go off. Your only sense of success would be a pristine record each month/quarter/year. As bad as setting goals can be, making any of yours synonymous with perfection is downright toxic: All it takes is one bad moment to render you imperfect, and thus a failure.

Instead, develop systems of minimizing your “misses.” That includes honing your accuracy, but it can also mean learning turns of phrase that render your reports more difficult targets for nitpickers to play “gotcha.” And learning how to effectively defend yourself when disputing a case for the QA-committee.

Setting goals for productivity can also be a bad move. If you determine a need to read X number of cases, you’re living in failure until you hit that X. Worse, if you’ve divided your time by X to see how many minutes you have per case to remain on-target, you have that many more episodes of potential failure each hour.

Instead, develop a system that optimizes your performance. Find PACS hanging-protocols that best suit your style. Develop dictation-macros that speed your reporting. Keep your most-frequently used references bookmarked for easy access. And get disciplined with your work-cadence: Minimize avoidable interruptions, including self-inflicted ones like checking stocks, social media, etc.

And yes, this column’s title did mention giving yourself a raise in the context of all of this…I’ll be delving into that next week.