108
Better Practices! Better Patients! Better Lives! Discover the Possibilities! Dr. Russ L’HommeDieu, MAPT, DPT, Betterness ® Coach

Better Patients Better Practice Better Lives 11 7

Embed Size (px)

DESCRIPTION

The Betterness Institute, Dr. Russ L'HommeDieu, DPT presentation to the Maine Chapter of the American Physical Therapy Association November, 7th, 2009

Citation preview

Page 1: Better Patients Better Practice Better Lives 11 7

Better Practices!Better Patients!Better Lives!

Better Practices!Better Patients!Better Lives!

Discover the Possibilities!

Dr. Russ L’HommeDieu, MAPT, DPT, Betterness® Coach

Page 2: Better Patients Better Practice Better Lives 11 7

Change or GrowthChange or Growth

Traditional approaches to career planning assume that society is static, that individuals do not change, and that work choices are made for a lifetime.

Modified From: Hansen, L. S. (1997). Integrative Life Planning : Critical Tasks for Career Development and Changing Life Patterns. San Francisco: Jossey-Bass Publishers, Inc., p. 10.

Page 3: Better Patients Better Practice Better Lives 11 7

Change or GrowthChange or Growth

But we need only look at the burgeoning literature on career transitions to realize that those assumptions are no longer correct.

Modified From: Hansen, L. S. (1997). Integrative Life Planning : Critical Tasks for Career Development and Changing Life Patterns. San Francisco: Jossey-Bass Publishers, Inc., p. 10.

Page 4: Better Patients Better Practice Better Lives 11 7

Change or GrowthChange or Growth

The most frequent estimate is that the average adult will make five to seven major career changes in a lifetime.

Modified From: Hansen, L. S. (1997). Integrative Life Planning : Critical Tasks for Career Development and Changing Life Patterns. San Francisco: Jossey-Bass Publishers, Inc., p. 10.

Page 5: Better Patients Better Practice Better Lives 11 7

Change is Inevitable

Growth is Optional

Change is Inevitable

Growth is Optional

~ Walt Disney~ Walt Disney

Page 6: Better Patients Better Practice Better Lives 11 7

What is Betterness? What is Betterness?

Bett•er•ness®: (bet-ēr-nes) n.

an accumulation of small, positive changes

that achieves major growth.

Page 7: Better Patients Better Practice Better Lives 11 7

I Discovered Betterness® I Discovered Betterness®

Somewhere Between Here . . .

Page 8: Better Patients Better Practice Better Lives 11 7

and Here !

Page 9: Better Patients Better Practice Better Lives 11 7

The Betterness Cycle of GrowthThe Betterness Cycle of Growth

Adaptation

Assimilation

Action

AccountabilityAcceptance

Awareness

Page 10: Better Patients Better Practice Better Lives 11 7

Uncover, Discover and / orRecover Your

Passion for Physical Therapy

Page 11: Better Patients Better Practice Better Lives 11 7

A Focus on AwarenessA Focus on Awareness

through Appreciative Inquiry

Page 12: Better Patients Better Practice Better Lives 11 7

What is Appreciative Inquiry?

What is Appreciative Inquiry?

Page 13: Better Patients Better Practice Better Lives 11 7

Ap-pre’ci-ate, v.,valuing; the act of recognizing the best in people or the world around us; affirming past and present strengths, successes, and potentials; to perceive those things that give life (health, vitality, excellence) to living systems

Synonyms: VALUING, PRIZING, ESTEEMING, and HONORING.

Page 14: Better Patients Better Practice Better Lives 11 7

Every Organization, Every System, Every Profession,

Every Person, Every Life has something that is working.

Every Organization, Every System, Every Profession,

Every Person, Every Life has something that is working.

Page 15: Better Patients Better Practice Better Lives 11 7

People have more confidence and comfort to journey to the future (the unknown) when they carry forward parts of the past (the known)

The Thin Book of Appreciative Inquiry by Sue Annis Hammond

Page 16: Better Patients Better Practice Better Lives 11 7

If you are going to carry the past with you, shouldn’t it be what is best about the past?

Anything different would simply be . . . .

The Thin Book of Appreciative Inquiry by Sue Annis Hammond

Page 17: Better Patients Better Practice Better Lives 11 7

Graphic from the book “Excess Baggage” by Paul Fellhttp://www.paulfellcartoons.com/books2.html

Page 18: Better Patients Better Practice Better Lives 11 7

Freedom eludes those that focus mainly upon problems

Freedom eludes those that focus mainly upon problems

Page 19: Better Patients Better Practice Better Lives 11 7

Yes, the door is locked, but what is good about the situation?

Yes, the door is locked, but what is good about the situation?

Page 20: Better Patients Better Practice Better Lives 11 7

Can You Imagine a System of “Problem Solving”

That Focuses on What is Best about the situation?

The Things That are Working!

Can You Imagine a System of “Problem Solving”

That Focuses on What is Best about the situation?

The Things That are Working!

Page 21: Better Patients Better Practice Better Lives 11 7

In-quire’ (kwir), v.,1. The act of exploration and discovery.

2. To ask questions; to be open to seeing new potentials and possibilities.

3. To increase in value

Synonyms: DISCOVERY, SEARCH, and SYSTEMATIC EXPLORATION, STUDY.

Page 22: Better Patients Better Practice Better Lives 11 7

If you are going to carry the past with you, shouldn’t it be what is best about the past?

When I asked this question . . . .

Page 23: Better Patients Better Practice Better Lives 11 7

Did it make you Stop and Think? Did it make you Stop and Think?

The Act of asking questions influences the way we think.

The process of growth actually begins the moment a question is asked.

Page 24: Better Patients Better Practice Better Lives 11 7

"Does teaching consist in putting questions?"

Indeed, the secret of your system has just this instant dawned upon me.

Oeconomicus (The Economist) as translated by H.G. DakynsDownloaded: 10/24/2009 2:28 PM http://ancienthistory.about.com/library/bl/bl_xenophon_economist19.htm

Page 25: Better Patients Better Practice Better Lives 11 7

I seem to see the principle in which you put your questions. You lead me through the field of my own knowledge . . .

Oeconomicus (The Economist) as translated by H.G. DakynsDownloaded: 10/24/2009 2:28 PM http://ancienthistory.about.com/library/bl/bl_xenophon_economist19.htm

Page 26: Better Patients Better Practice Better Lives 11 7

and then by pointing out analogies to what I know, persuade me that I really know some things which hitherto, as I believed, I had no knowledge of.”

~ Socrates

Oeconomicus (The Economist) as translated by H.G. DakynsDownloaded: 10/24/2009 2:28 PM http://ancienthistory.about.com/library/bl/bl_xenophon_economist19.htm

Page 27: Better Patients Better Practice Better Lives 11 7

Einstein recalled how, at the age of 16, he imagined riding on a beam of light and that the thought experiment had played a memorable role in his development of special relativity.

Page 28: Better Patients Better Practice Better Lives 11 7

The Genius is in the Creation of the Question

The Genius is in the Creation of the Question

“What would the universe look like if I were riding on the end of a light beam at the speed of light?”

~ Albert Einstein

Page 29: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Future orientated approach

Appreciate "what is“

Imagine "what might be“

Determine "what should be“

Create "what will be"

Page 30: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Problem Solving"What’s the problem?"

Future orientated approach

Focuses on past problems

Appreciate "what is“

Imagine "what might be“

Determine "what should be“

Create "what will be"

Identify problem

Conduct root cause analysis (blame someone)

Brainstorm solution and analysis

Worry about how can we do this

Page 31: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Is a process that makes you feel Energetic

and Imaginative.

Page 32: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Problem Solving"What’s the problem?"

Is a process that makes you feel Energetic

and Imaginative.

Is a process that makes you feel Negative

and Easily Defeated.

Page 33: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Success breeds Success

Focusing on past success leads to hope

Hope frees you to be imaginative and creative

Page 34: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Problem Solving"What’s the problem?"

Success breeds Success

Misery Loves Company

Focusing on past success leads to hope

Focusing on problems leads to fear.

Hope frees you to be imaginative and creative

Problems are scaryFear will hold you back

Page 35: Better Patients Better Practice Better Lives 11 7

"Fear is the path to the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering."

~ Yoda

Gratuitous Yoda Quote

Page 36: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Life is a mystery to be uncovered and

discovered

Possibility ThinkingHolistic

Page 37: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry"What works around here?"

Problem Solving"What’s the problem?"

Life is a mystery to be uncovered and

discovered

Life is to be dissected and the “problems” cut away & thrown

away

Possibility ThinkingHolistic

Deficit Thinking Reductionist

Page 38: Better Patients Better Practice Better Lives 11 7

Your Words Make Your World

Your Words Make Your World

Page 39: Better Patients Better Practice Better Lives 11 7

Your Words Make Your World

Your Words Make Your World

Human systems move in the direction of what they focus on, what they vision, what they think about.

Page 40: Better Patients Better Practice Better Lives 11 7

“Whether you think that you can, or that you can’t, you are usually right.”

~Henry FordYour Thoughts Determine Your Reality

Page 41: Better Patients Better Practice Better Lives 11 7

Your Words Make Your World

Your Words Make Your World

The formation of your reality begins as your five senses collect information about the outside world.

The Betterness® Weight Loss Solution by Dr. Russ L’HommeDieu, DPT

Page 42: Better Patients Better Practice Better Lives 11 7

Your Words Make Your World

Your Words Make Your World

The data is then processed internally, filtered by your beliefs and fed back to you through the voice of your inner monologue and the whispers of your unconscious mind.

The Betterness® Weight Loss Solution by Dr. Russ L’HommeDieu, DPT

Page 43: Better Patients Better Practice Better Lives 11 7

Your Vocabulary Creates Your Reality

Your Vocabulary Creates Your Reality

This mixture of external facts and internal talk combines to form your world. It is the truth according to you and about you and it is the only truth you know.

The Betterness® Weight Loss Solution by Dr. Russ L’HommeDieu, DPT

Page 44: Better Patients Better Practice Better Lives 11 7

Your Vocabulary Creates Your Reality

Your Vocabulary Creates Your Reality

Like secret powers that work 24 hours a day, the specific words you think direct every aspect of your life.

(Past, Present and Future)

The Betterness® Weight Loss Solution by Dr. Russ L’HommeDieu, DPT

Page 45: Better Patients Better Practice Better Lives 11 7

A vivid imagination compels the whole body to obey it.

~ Aristotle

Page 46: Better Patients Better Practice Better Lives 11 7

Appreciative InquiryAppreciative Inquiryuses the art and practice of continuously asking carefully worded questions that strengthen our capacity to recall and to build on past and current successes.

Page 47: Better Patients Better Practice Better Lives 11 7

Appreciative InquiryAppreciative InquiryThink

“Muscle Recruitment”

For the mind.

Page 48: Better Patients Better Practice Better Lives 11 7

Appreciative InquiryAppreciative Inquiryit is a system that enables you to guide inevitable change into incredible growth by helping you to align your strengths so as to make the weaknesses irrelevant.

Paraphrased from a conversation btwn Peter Drucker and David Cooperrider 2003

Page 49: Better Patients Better Practice Better Lives 11 7
Page 50: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 51: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 52: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 53: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 54: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 55: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 56: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 57: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 58: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 59: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 60: Better Patients Better Practice Better Lives 11 7

I am NOT just

pumping sunshine!

I am NOT just

pumping sunshine!

Page 61: Better Patients Better Practice Better Lives 11 7

Positive Action

Positive Action

Some main areas of research:• Placebo: Positive Self

Expectations influence positive outcomes

• Pygmalion: Positive Expectation of others influences positive outcomes

• Heliotrope: People grow towards hope and possibility

Positive Vision

Page 62: Better Patients Better Practice Better Lives 11 7

NegativeAction

NegativeAction

Negative Vision

Page 63: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry is less about ignoring the negative

and more about . . .

Appreciative Inquiry is less about ignoring the negative

and more about . . .

Page 64: Better Patients Better Practice Better Lives 11 7

Focusing on what is important.

Focusing on what is important.

Page 65: Better Patients Better Practice Better Lives 11 7

Focusing on what is important.

Focusing on what is important.

•Focusing on the positive gives us energy and excitement to achieve more.

Page 66: Better Patients Better Practice Better Lives 11 7

Focusing on what is important.

Focusing on what is important.

• Research shows that the meetings of the most successful organizations have 2 positive statements for every one negative.

Page 67: Better Patients Better Practice Better Lives 11 7

Focusing on what is important.

Focusing on what is important.

Your success will be enhanced by an unbalanced -

(2:1, Positive to Negative) inner dialogue.

Page 68: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry asks you to re-frame the negative to

approach issues from a more productive perspective.

Appreciative Inquiry asks you to re-frame the negative to

approach issues from a more productive perspective.

Page 69: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry is a

PARTICIPATION sport!

Appreciative Inquiry is a

PARTICIPATION sport!

Page 70: Better Patients Better Practice Better Lives 11 7

My aim is to help you all to get more out of physical therapy by

tapping into the collective wisdom within this room and use that brain trust to guide you to a higher level

of self discovery

My aim is to help you all to get more out of physical therapy by

tapping into the collective wisdom within this room and use that brain trust to guide you to a higher level

of self discovery

Page 71: Better Patients Better Practice Better Lives 11 7

“The act of inquiry requires sincere curiosity and openness

to new possibilities, new directions and new understandings.”

“The act of inquiry requires sincere curiosity and openness

to new possibilities, new directions and new understandings.”

The Power of Appreciative Inquiry by Dana Whitney & Amanda Trosten-Bloom

Page 72: Better Patients Better Practice Better Lives 11 7

We generally don’t engage in deep inquiry about the things we know (or think we know)

well . . .

We generally don’t engage in deep inquiry about the things we know (or think we know)

well . . .

Page 73: Better Patients Better Practice Better Lives 11 7

It is hard to focus on learning when your mind is stuck in a state of knowingIt is hard to focus on learning when your mind is stuck in a state of knowing

When you say or think the words, “I Know,” it’s like driving with the parking brake engaged.

Page 74: Better Patients Better Practice Better Lives 11 7

Teaching Balance Teaching Balance

Think about this: Have you ever really taught balance?

Page 75: Better Patients Better Practice Better Lives 11 7

Teaching Balance Teaching Balance

or must balance beExperienced?

Page 76: Better Patients Better Practice Better Lives 11 7

Teaching Balance Teaching Balance

Life balance is NO DIFFERENT!

Page 77: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry is a PARTICIPATION sport!

Appreciative Inquiry is a PARTICIPATION sport!

• Please write down all the concerns that you have that may stop you from fully participating today.

Page 78: Better Patients Better Practice Better Lives 11 7

Appreciative Inquiry is a PARTICIPATION sport!

Appreciative Inquiry is a PARTICIPATION sport!

• When you get to the end of your list write:

“I will set these concerns aside for the day.”

• Don’t let excess baggage weigh you down

Page 79: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

As you read your practice act, think about these questions:

1 What is good about PT for me?2 What do I love about being a PT?3 What do I want PT to become for me?

Page 80: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

Highlight 3 to 5 phrases within your practice act that, if properly explored, will make physical therapy more effective, more energizing and more fun for you.

Page 81: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

Imagine the Possibilities!

Page 82: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

The administration, interpretation and evaluation of tests and measurements of bodily functions and structures for the purpose of treatment planning . . .

Downloaded: Tuesday, October 13, 2009

from http://www.mainelegislature.org/legis/statutes/32/title32sec3111-A.html

Page 83: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

to detect, assess, prevent, correct, alleviate and limit physical disability, bodily malfunction and pain from injury, disease and any other bodily condition . . .

Downloaded: Tuesday, October 13, 2009

from http://www.mainelegislature.org/legis/statutes/32/title32sec3111-A.html

Page 84: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

the planning, administration, evaluation and modification of treatment

and instruction . . .

Downloaded: Tuesday, October 13, 2009

from http://www.mainelegislature.org/legis/statutes/32/title32sec3111-A.html

Page 85: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

and the use of physical agents and procedures, activities and devices for preventive and therapeutic purposes . . .

Downloaded: Tuesday, October 13, 2009

from http://www.mainelegislature.org/legis/statutes/32/title32sec3111-A.html

Page 86: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

and the provision of consultative, educational and other advisory services . . .

Downloaded: Tuesday, October 13, 2009

from http://www.mainelegislature.org/legis/statutes/32/title32sec3111-A.html

Page 87: Better Patients Better Practice Better Lives 11 7

The Physical Therapy Practice Actfor the State of Maine

The Physical Therapy Practice Actfor the State of Maine

for the purpose of reducing the incidence and severity of physical disability, bodily malfunction and pain.

Downloaded: Tuesday, October 13, 2009

from http://www.mainelegislature.org/legis/statutes/32/title32sec3111-A.html

Page 88: Better Patients Better Practice Better Lives 11 7

Appreciative InterviewsAppreciative Interviews

Find a partner you DO NOT know well and sit next to them

Allow 10 minutes for each person to ask the interview questions

Listen intently and take good notes

You will need them

Page 89: Better Patients Better Practice Better Lives 11 7

Mini Interview QuestionsMini Interview Questions

Tell me about a peak experience or high point in your professional life…a time when you felt most alive, most engaged, and really proud of yourself and your work.

Page 90: Better Patients Better Practice Better Lives 11 7

Mini Interview QuestionsMini Interview QuestionsWithout being humble, what do you most value about:

• Yourself, and the way you do your work. • Your interactions with patients and / or other

PTs.• Your profession and its larger contribution to

society or the world?

Page 91: Better Patients Better Practice Better Lives 11 7

Mini Interview QuestionsMini Interview Questions

What unique skills and gifts do you bring to your patients and your profession?

Page 92: Better Patients Better Practice Better Lives 11 7

Mini Interview QuestionsMini Interview Questions

When do you feel most alive, excited or most energized as a PT?

Think of moments in your professional life where you seemed to have boundless enthusiasm and energy or moments that were filled with joy and laughter.

Page 93: Better Patients Better Practice Better Lives 11 7

Mini Interview QuestionsMini Interview QuestionsWhat made it an exciting experience?

Who were the most significant others?

Why were they significant?

What was it about you that made it a peak experience?

Page 94: Better Patients Better Practice Better Lives 11 7

Mini Interview QuestionsMini Interview Questions

effective, energizing, fulfilling and fun . . .

what would they be?

If you had just liberated the magic PT genie and you had three wishes that would make your practice of physical therapy more

Page 95: Better Patients Better Practice Better Lives 11 7

Interview Your Partner 10min

and then switch

Have Your Partner Interview You for the NEXT 10min

Interview Your Partner 10min

and then switch

Have Your Partner Interview You for the NEXT 10min

Page 96: Better Patients Better Practice Better Lives 11 7

Identifying ThemesIdentifying ThemesIn small groups of 6 to eight people

Take 3 minutes each to share your partner’s highlights, focus on the great stories, along with inspiring best practices and ideas. Then, as a group, continue to discuss stories and determine factors that contributed to high point experiences.

Page 97: Better Patients Better Practice Better Lives 11 7

Identifying ThemesIdentifying ThemesLet’s take 20 Min to Share themes

and stories with entire groupEach small group shares one or two great stories with the whole group – stories that represent the essence of what the small group has been learning.As we talk, we develop themes and make a master list of theme your vision statements

Page 98: Better Patients Better Practice Better Lives 11 7

Identifying ThemesIdentifying Themes

We will now take the next 15Min to choose winning themes.

Please place a dot next to each theme that you feel is closest to you vision for your professional life.

Page 99: Better Patients Better Practice Better Lives 11 7

Winning ThemesWinning ThemesChoose ONE theme that you would

like to explore a little further.

When I read that theme raise your hand.

We will then re-organize into groups based on these themes.

Page 100: Better Patients Better Practice Better Lives 11 7

Fun with Winning ThemesFun with Winning ThemesWe will now take the next 15Min to

design a way to communicate the statement –

“Tell us what it is like to live this vision.”

Focus on the positive, think as if the vision were true right now.

What would a perfect day be like living this vision?

Page 101: Better Patients Better Practice Better Lives 11 7

Define your VisionDefine your Vision

I challenge you to make the most out of the time we have spent together by writing a personal vision statement which will serve as an image of your dream for the future.

Page 102: Better Patients Better Practice Better Lives 11 7

Define your VisionDefine your Vision

Your vision is a positive statement in which you imagine your dream is happening in your life right now.

Page 103: Better Patients Better Practice Better Lives 11 7

Define your VisionDefine your Vision• Make your vision is a positive

image that will inspire or direct positive action.

• Just as a golfer might imagine or visualize the perfect shot, so our vision statements might help us imagine the optimal way of organizing and conducting our professional lives.

Page 104: Better Patients Better Practice Better Lives 11 7

Define your VisionDefine your Vision

It should capture the imagination and inspire you to stretch further to make the vision for the future expressed by the proposition come true.

Page 105: Better Patients Better Practice Better Lives 11 7

Deliver your VisionDeliver your Vision

When I lost weight, I focused my goals into four primary areas.

Think Better, Eat Better, Move Better and Live Better.

These areas have become the basis of my weight loss system and my book.

Page 106: Better Patients Better Practice Better Lives 11 7

Deliver your VisionDeliver your Vision

Segmenting my vision into focus areas helped me to set more attainable “Betterness” goals.

I encourage you to define 3 or 4 focus areas that make up your vision

Page 107: Better Patients Better Practice Better Lives 11 7

Deliver your VisionDeliver your Vision

To determine your focus areas, it may help to think about these questions,

“What is the smallest possible change I can make in my life that would bring me closest to my vision?”

Page 108: Better Patients Better Practice Better Lives 11 7

Deliver your VisionDeliver your Vision

“Is there a word or words to describe that particular aspect of your life into which that singular change can be placed?”

It may help to refer back to your original themes -