//Allow shortcodes in widgets add_filter ('widget_text', 'do_shortcode'); function year_shortcode () { $year = date_i18n ('Y'); return $year; } add_shortcode ('year', 'year_shortcode'); Behavior Change Principles to Grow Your Practice and Bolster Patient Adherence - Evolution of Medicine

Chris McChesney is a behavior change expert who wrote The 4 Disciplines of Execution. His fascinating perspective offers practical tips about how to manage “The Whirlwind” of competing priorities and make meaningful strides towards focused goals. James dives into the business-oriented concepts exploring their applications in the Business of Functional Medicine series on the podcast.

Listen to the full episode for insights that will help you build your own practice, improve patient relationships and trust, and encourage positive behavior change.

Highlights include:

  • The real reason for resistance, and why it’s not necessarily bad
  • Strategies to encourage behavior change (for patients)
  • Clinical pearl: acknowledge that patients experience their own Whirlwinds
  • And so much more!

Resources mentioned in this episode:


Behavior Change Principles to Grow Your Practice and Bolster Patient Adherence | Ep 270


James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective, functional, and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello, and welcome to the podcast. This week, we welcome behavior change expert Chris McChesney. This is part of our ongoing series called the Business of Functional Medicine. And on this podcast, you’ll see that there’s something for everyone. If you are building your own practice, you will learn from the master. This guy wrote the book, The 4 Disciplines of Execution, some of the concepts from that book, like wildly important goals, WIGs, and the whirlwind has made it into popular culture. I’ve certainly heard about it a few other times before, but even if you’re a clinician, he’s a behavior change expert. So we really got into what this book can teach us if we want to have our patients change their behavior. So I think there’s a lot clinically in there, even though this is not really a clinical podcast. I recorded this podcast live in front of an audience of about 100 people where I saw Chris speaking a few weeks ago and I had the chance to do a live podcast recording. There’s some great stuff in here. I think you’ll enjoy it, whatever situation you find yourself in, and I’d love to hear your feedback, enjoy. So a warm welcome to the Evolution of Medicine Podcast, Chris McChesney, welcome.

Chris McChesney: Thanks, glad to be here.

James Maskell: So I’m super excited to jump into this content, particularly for the doctors who are in our community and I guess where I want to start with and something that’s come up and I know a lot of people have heard this phrase, which is the wildly important goal and the WIG. And so can you just talk us through what that is and why it’s critical to your whole thesis?

Chris McChesney: Yeah, so the work that we did was around helping organizations and small teams execute on a goal that required a change in people’s behavior, which just as you say that, people acknowledge, “Yeah, that’s really hard.” One of the things that became very clear early on was that you have to delineate between all of the activities required to keep an operation going, or you might even say on a personal level, all of the activities required to just keep your life going. And the little nickname we have for that is the whirlwind, because it’s urgent and it’s nonstop and it’s constant, but this WIG, we had to come up with a term, WIG stands for Wildly Important Goal, is the one thing, in addition to that day-to-day whirlwind that we feel is absolutely vital and we want to have a breakthrough result. And rather than trying to prioritize a dozen things that we think are very important and constantly fighting for top position, getting people to say, “Okay, if everything held, if I could just maintain everything, what’s the one area where I want to have a significant breakthrough?” That seems to play.

James Maskell: So how many WIGs should every organization have or any organization, whether you’re talking about a small doctor’s office or an integrative center inside a hospital, how many WIGs?

Chris McChesney: It actually varies greatly. The pinch point is where the work gets done. So per group, per team, it’s one in addition to the day job. So the organization could have several, but if for instance, if I’ve got a practice and I’ve got a support staff and I’ve got maybe a testing center and then I’ve got the physicians, each group would have no more than one significant breakthrough in addition to the other metrics that they maintain.

James Maskell: Interesting, okay. So, most of the people that listen to this are practitioners or physicians or providers of some sort. And I would just, I wonder if you’ve ever dealt with this population, because one of the things that’s unique to them is that the whirlwind is very specific in that they walk into the office and there’s a list of patients that they’ve got to see. In most cases, no one else can see that patient, they’re doing the work of the clinic. How does that affect the strategy and what are some strategies to sort of create more time to get out of the whirlwind and into the WIG?

Chris McChesney: As I was preparing for this and thinking about this, we recently worked with a series of veterinarian offices and practices. And interestingly enough, probably no surprise, a heavy focus for theirs was on the preventative side. And what they realized was it that wasn’t just something that the vet at the practice, even at the smallest practices, could really do without the full buy-in of the staff. And so there was a number of behaviors that were absolutely critical from the support team around the vet if the vet was going to really make meaningful progress on getting their patients to take the preventatives and do some of the behavioral things associated with better health of the animals. And so, as you were telling me, I thought, that’s an odd corollary but it, in many ways where we had the best luck is where those practices really engaged the entire practice around very specific outcomes. And each team had a very specific wildly important goal and lead measures and these very basic disciplines and could see that they were making progress. That was another critical aspect of this, small, visible celebrated wins were critical.

James Maskell: So when you’re… I’ve walked into enough doctors’ offices to know that this isn’t normally happening or this is not the regular, how do you take a physician entrepreneur and I guess, make it easy for them to engage those staff in that kind of conversation?

Chris McChesney: I think you have to start by giving the day job it’s due, giving the whirlwind it’s due. And you almost feel people’s blood pressure go down a little bit when you just acknowledge, look, 80% of your energy, it’s just going to get sucked. If you’re lucky, 80% of your energy, it’s just going to get sucked up, just maintaining the operation. And that’s okay because that’s job one, right? Every leader, job one don’t break it. Let’s keep everybody happy. Let’s keep this thing running. That’s not a small thing. And then recognizing, okay, so in addition to the enormous energy spent maintaining and keeping this thing alive, I can steal a little energy from…it is literally what it feels like, I can steal a little…almost think of it like a currency. How do I want to spend that 10 or 20% of the energy? And this is what you have. And so, the support team at a small practice has a scoreboard in the back and they’re tracking every time they get somebody to commit to a preventative sequence and they’ve got little trackers and they’ve got little things that they do.

Chris McChesney: And it’s in the background, it’s not the dominant thing. The dominant thing is the day job. But what we found is that if there’s this little, and it sounds interesting to call it a game, but what we found is the closer it comes to feeling like a game, the better the engagement than it is, and the more character… And we didn’t start off with this supposition, this…over time, we started to see, it just feels like a game, like a small winnable game in addition to the day job. And it has to have these two characteristics. It’s got to feel like, “Hey, if we achieve this, it’s kind of a big deal, right? It’s not everything, but it would really help.” And second, “I think we could do this.” And so if it has those characteristics, but it’s in the background and even though it only represents maybe 10 or 20% of the effort, it has disproportionate effect on the morale and engagement of the team as well.

James Maskell: One story that I’ve heard over and over and over again in this industry over years is that when a clinic has made a shift from conventional care to now looking to do this new mode of care, there’s always one person on the front desk who’s just relentlessly trying to make sure that doesn’t happen or is very unwilling to make the change to this new role. What is your recommendation for how to make that shift when people inside the organization don’t want to change?

Chris McChesney: This is something we almost always deal with. And we sort of have people picture a bell curve, whenever there’s a breakthrough result that requires a change in human behavior, it’s about adoption. And there’ll be a couple people, this is typically what you see, there’ll be a couple people that get on board fast. They might be out ahead of you. They’re instantly on board. We call those the models, they’re modeling it. Then there’s another group of people that are the not-yet’s. And the not-yet’s like the idea, but the behavior’s not changing. They’re just not yet there. And then there’s the never’s and the never’s for some reason want to fight you. So here’s rule one. The trick to this thing is not the never’s. The trick to this thing is the not-yet’s. That what ends up happening is the never’s from a leadership position end up stealing all of your energy, because there’s such an adamant outspoken resistor.

Chris McChesney: But their behavior’s really not much different than the not-yet’s. And if the not-yet’s come on board, the not-yet’s sometimes take care of the never. The never will either opt out or they’ll come along, once they see the not-yet’s coming on board. So that’s the one thought. There’s another thought I have on this too. We came across some research lately about resistance in general. And the idea that it has actually more to do with ambiguity and uncertainty than it does change itself. And this group, the name of the book that turned me onto this was called Nonsense: The Power of Not Knowing and this Jamie Holmes, his research really points at the fact that we think people resist change. The truth is people initiate change quite a lot, what they resist is the uncertainty associated with the change.

Chris McChesney: And if you think about that, that’s actually kind of good news. Because if I’m a leader, I can’t do anything about the fact that things are changing, always going to be doing new things. And if somebody resists change at face value, they’re no good to me, but there are things I can do about uncertainty and how do we define this in a way… And that doesn’t always help, but starting to tackle the problem from a… This is really kind of what we get at with the disciplines is the disciplines take this sort of inherent ambiguity deer-in-the-headlights feeling associated with a new goal and they break chunks it down into really actionable concrete steps that don’t feel… They don’t give that allergic reaction to uncertainty. And so we think that’s worth thinking about. So, one, focus more on the not-yet’s than the never. And two, go to work more on reducing uncertainty, getting very clear with people, what it means, what it looks like, what do we do get very specific. Don’t just assume that people are fighting for the sake of fighting.

James Maskell: I really want to dive really deep into what you just said when it comes to patient care because I think you’re unlocking a lot, but this is the business of functional medicine podcast. So I just want to make sure that we’re hitting some of the buttons here. Could you just go into, for the practitioners who haven’t yet read The 4 Disciplines of Execution, what are those four disciplines briefly and how do they relate to being a physician entrepreneur?

Chris McChesney: Yeah, so it probably could relate at a couple of different levels and I’ll just, this is the shortest version right here. It’s a series of steps you take against the breakthrough result. It’s not how you run your practice, it’s not how you run your life, but when you want to achieve something and you know that something is competing with the day job, these four disciplines come in. The first ones get very, very clear on exactly what success looks like. That’s the first discipline, focus on the wildly important, that’s where you define that outcome, that finish line, wildly important goal. What does success look like? The second one is called act on the lead measures and that’s where you really identify those behavioral things, this is where the rubber meets the road, what are the behavioral things I’m betting if I did would get me to that outcome? And it’s important that outcome not be too big or too broad.

Chris McChesney: So we talk a lot about the power of small wins, just getting some traction in these people’s lives or getting the practice…don’t underestimate the power of a small win when you called the shot, you said, this is what we’re…either in a person’s life or sometimes we go too big and so that very specific, wildly important goal…and then the behaviors that we said, if we really did theses, it may not be anything new, maybe something we already know how to do, but if we actually did them consistently, I think we’d get that result. And that’s the first two disciplines sort of set up this bet. The third one is I got to track it, I got to see it. There’s something like 12 billion receptacles in the brain and 11 billion of them are dedicated to visual. Aptitude, right?

Chris McChesney: And so I need some way to visually know, how am I doing? Am I following through on those lead measures? Is it getting the lag? What we see is the minute people can see it, it somehow becomes real to them. And then the last one is this cadence of accountability. We recognize that the day job’s going to pull you off all the time. And you got to be accountable to somebody else. Self-accountability, you’re a rare person if you can make that work.

Chris McChesney: And that there’s someone…and this is why I like these groups that you were telling me about, I think could really be powerful instruments if they’re set up in a way that the outcomes are achievable. And people feel so that we boil those four steps down…so the fourth step is making these commitments to someone else on a weekly basis to ensure we do the stuff. But I really, in my mind, I boil this down to two things. Does it feel achievable? And does it feel like a big deal? As long as we’re hitting those two things, whether it’s for the physician, whether it’s for the practice, whether it’s for the patient, this is where we see human beings start to move. And the minute we miss on either of those, the minute it feels a little fuzzy on whether we can get it done or I’m not sure it’ll make a difference, we’re dead in the water.

James Maskell: Yeah, well look, if you’re a long-term listener to the Evolution of Medicine Podcast, I’d highly recommend you go back a few weeks and listen to the session that we did with the four practitioners that were part of our Practice Accelerator, because they joined the Practice Accelerator in 2017, and every week for five years, they get together and hold each other accountable. And that has taken them all on their own individual journey, different niches in medicine, different parts of the country, different business models. But ultimately their business has transformed by having that peer-to-peer accountability and that’s something that we set up inside our Practice Accelerator. So if you want to listen to that, it’s a few episodes back in the podcast, but I really want to dive in today to this group medicine because you—

Chris McChesney: Can I weigh on what you just said?

James Maskell: Yeah, sure, yeah.

Chris McChesney: —about that this group? And a lot of times, so in the 20 years of work that we’ve done with 4,000 different organizations, one of the…we look for patterns. And one of the patterns we found was that when organizational leaders had big, giant results and that we’ve got various quotes that sound almost identical, they all talk of about, it didn’t happen the way they pictured it would happen, the results. And what they always drew back to was incremental, small changes carried them a long way. And so if you’ve got these practices that are working together in this way, and there’s just little improvements over time, this is really…that discipline of staying, even if you can’t connect the dots, even if you don’t see where it’s going, it’s continued to produce…those disciplines continue to produce dramatic results in ways that people couldn’t…they couldn’t connect the dots visually, but they get there.

James Maskell: Yeah, one of the most interesting things for us, we didn’t even know that was happening, we set them on the path, and we did a few sessions with them at the beginning, but they just decided they would do it at eight o’clock every Tuesday morning for five years, they met. And they’ve seen their growth in their practice since then. So it’s really powerful, but I want to come back to the patient care side because one of the things that I know is not happening in conventional care and should be happening in functional medicine care but often isn’t is the acknowledgement that the patient has a whirlwind. And I just want you to talk about that because ultimately the patient isn’t… I think the doctor just thinks, “Well, the patient…this is the most important thing; they’re coming to me. They’re just going to adjust their life to facilitate it.” But we’re in the business of behavior change and ultimately, I want to just talk about what it means to the patient to acknowledge that the whirlwind exists.

Chris McChesney: This question really excites me. Even though this has not been our focus, the biggest flaw that organizational leaders make, I believe, when it comes to execution, applies to this question and here’s the flaw. We think that human beings will do something if they only understand how important it is. And nothing could be further from the truth-

James Maskell: 100%.

Chris McChesney: You with me on this?

James Maskell: Yeah, no, 100%.

Chris McChesney: And look with our kids, look, if I could just get it through your skull, how important this is, you’ll do it. No, they won’t. Importance does not… This is the bottom line: Importance doesn’t dictate human behavior, urgency does. We are creatures of stimulus and response. And so having a mechanism, we don’t overcome this, the disciplines, it just sort of… All these disciplines do, and we can apply this on the person level, all they do is make things that we know are really important but not urgent, feel urgent, right? So it’s not like we overcome the urgency addiction, we just get on board with it. So it really comes down to, are there mechanisms, so if we go down to the patient, are there mechanisms that we’ve created, systems that we’ve created with the patient or for the patient that create urgency stimulus. If they think it’s important, but to just assume that it’ll happen because they know it’s important is a complete misnomer.

James Maskell: Well, I’m glad that’s coming from so much experience because I’m literally seeing that all day, every day inside medicine—

Chris McChesney: And it defies logic one level, but except our eyes tell us, this is absolutely part of human nature.

James Maskell: I want to come back to that, the not-yet’s and the yes’s. So I’ve been very much involved for the last few years and ongoing for a long time talking about the power of group medicine, right, putting patients in groups. And one of the things that we came to understand as we put patients in groups and delivered a longer episode of care, like six months, right, a diabetes group, a pain group, urinary incontinence group, all these different groups, we learn a lot from it. But in these groups, there are definitely the no’s, they don’t always sign up, but some of them do just to mess with you. That there’s definitely a lot of have not-yet’s and then there’s a lot of people who are yes’s.

James Maskell: And what I’ve come to realize about the practice of functional medicine is that most practitioners when they get frustrated with their practice is because they’re getting a lot of not-yet’s and their successes are all these yes’s, the people that just come through one-on-one and they’re like, “Oh, these are the guys that end up being the testimonials or their way website. These are the people that can just move forward and execute.” And what you said, I want to get into the not-yet’s because what we’re talking about is complex chronic illness, so they’ve probably tried trying to lose weight, exercising, eating differently before, and maybe it hasn’t worked. So that information is not making a difference because there isn’t… It’s not clear what’s going to happen when they implement some of these new things. And that uncertainty-

Chris McChesney: Yeah, plays in as well.

James Maskell: Is what I was just talking to you about. So I’d love to just unpack that.

Chris McChesney: Yeah, so let’s talk about this. So, in a newsletter that I’ve got, I recently drew out a very personal story on this point. My mentor at FranklinCovey that started this whole execution practice, he died three years before the first book came out. Jim Stewart didn’t have to die. He had a complex illness and they told him, if you can’t quit smoking, you are going to die. So this is that in this space of behavioral change. Jim couldn’t do it and he smoked right up till the time that he died. And so what you’re talking about where this idea that just because I know it’s important, but there’s this little logical fallacy that’s really easy to get into where it’s sort of the tomorrow myth and the tomorrow myth goes something like this, right, “Either today, I’ve screwed things up so bad, then there’s no hope, so what’s the point in changing. Yeah. Or if I haven’t screwed things up so much, and there is hope, I could probably do that tomorrow so I don’t have to change today.” And there is a certain sick logic about it that’s actually…

Chris McChesney: And this is what Jim… Jim followed some form of that logic right to the grave. And so if you say, “Okay, so how do we break that?” Yeah, it’s about the big goal. Yeah, it’s about the big objective, but it really, you have to take the accountability down into small bites. And so this is where the group thing I want to say has been absolutely essential to our work and where we see execution happening the best is when there’s peer accountability. We see stronger… We have this little joke that people don’t like to disappoint their bosses, but they get over it. But they’ll stay up all night not to disappoint a peer group.

And once they’re… I wouldn’t even… If you get that peer dynamic, the never’s kind of come along a little bit as long as what they’re committing to is very achievable, very small, but you can say, yes, I did it. So it’s usually half as much as we think they probably ought to be doing but if we can just establish this little integrity routine where when I make a commitment and I’m careful, when I make a commitment to this group, I do it no matter what that… It takes a little while, but after a few of those sessions, we get some great breakthroughs, but this whole work for 20 years, it’s all been on the back of little peer groups, making commitments to things that would move the ball forward.

James Maskell: Yeah, I think one of the things that, to that point to make it incremental, one of the things that we’ve seen is that when doctors run these groups, the first thing they want to do is to bestow their expertise to everyone in the most aggressive way possible, which is like, “Hey, I know so much about leaky gut, and I’m going to tell you all about it right now. And I’m just going to fire-hose you and hope that it works.” And what we found having done now hundreds of groups, we actually take a month to help people acknowledge the whirlwind, set the goals for the whole six months, create the accountability through a progress partner, really give time for people to do that because ultimately, they’re not ready to jump into something else. And to answer your question, the thing you said about either they’re never going to get better, or they could do it tomorrow, the question that we’ve asked them, which I think is really powerful is when are you going to be better supported to make these changes than today?

Chris McChesney: Yeah, and I think that’s a really powerful thing that you just identified that the mistake that’s so easy for the physician to make, which is to think, “Well, if I could just get everything in my head in their head,” it’s one of the most common mistakes that executives make as well. It’s a really easy mistake. If you could just see the world like I see it, if I could just show you what I see, you’ll change. But that’s not human behavior. And what’s required is more of a pull than a push. And so even if you just think that way, how… When I make this work through compliance, commitment only comes by sort of inviting people in. And I would also think about with recommendations, menus, getting them to engage in some way.

Chris McChesney: So okay, if this is the output, there’s probably four things you could work on. Do you want to pick one of the four? Do you want to pick two of the four? Which of these feel… Start to… May sound crazy but start to pull them into defining what this plan looks like. If it’s just one directional, if it’s just from you to them, if it’s just a prescription, then you get compliant behavior and usually not very much of it, but that would be the other dynamic is the more you can pull them into creating the solution, the better the stuff goes.

James Maskell: Well, I think one of the things you identified there is why the health coach has become more popular, right, they can afford to spend more time with the patients. They can go through this process, they can draw it out from them. But I think, I just want to, I guess, bring it back to the team, because it seems like the whole team in the practice has a role in acknowledging the whirlwind, helping them understand what’s next. Some practices have MAs coaches, what do you think is…to what degree do the physician entrepreneurs need to engage people beyond themselves? They’re the most busy people, how do we get the other people to play a role in making sure that this whole thing works?

Chris McChesney: The most work we’ve done with the four disciplines with the 4,000 organizations we’ve worked with has been in hospitality, the hotel space. The second most prevalent group we’ve worked with has been hospitals. And at the hospital level, we’ve gone after goals around clinical results, we’ve gone goals around patient satisfaction, and we’ve done goals around cost cutting. In all three cases, the physicians alone were not enough. So I don’t know the specifics of everything that’s involved of everything that the staff has to do, but we’ve never worked on one of these goals in the healthcare space where it wasn’t a coordinated effort and everybody was on board and those people often, their whirlwinds is as intense as yours is. And so again, I think it comes down to this question, if all I need is compliance, then you don’t need these disciplines. If I just need you to do a couple things and just do them, there’s lots of things we have to just do because it’s like the law-

James Maskell: Like taking medication, right?

Chris McChesney: -will we do them? Yeah, but I mean saying within the staff, if I just need you to do a couple things and if that’ll do it, then yeah, you don’t need these disciplines. But if you’re sitting there and you’re thinking, no, I actually need them engaged, I actually… This is the kind of thing, this is the kind of change in our practice I actually need them to care about, then I’ve got to get it down to a result, some sub-result that they can achieve, and I’ve got to pull them into owning that, right? That’s the commitment formula. If I just need compliance, I can just, “Hey, just do this,” but that’ll only get you so far. And I think this has all the markings of something where if you were serious about it, you would need the whole staff committed to wanting to get behind it.

James Maskell: I mean, this is why I think there’s been so much friction to move from conventional medicine to functional medicine is because, in conventional medicine, right, the drugs are compliance, right? Just take the drugs, there’s a whole thing to support you there, the front desk people, it’s like just bill their insurance. That’s all you do, just bill the insurance and tell them the doctors running behind, that’s your job. Then but when you come to the function medicine model, suddenly the patient needs support and behavior change, the team need to facilitate that in the patients and so they need it. And so this transformation, in a sad way, rest on the shoulders of the physician entrepreneur who’s the busiest person in the world. And so I think that there’s-

Chris McChesney: You’re making a great, great point, which, I mean, the whole notion of this type of medicine hinges on a commitment level, right? I mean, if you really want to get into the preventative side… On the functional side, it by definition requires behavior change. It requires them to be committed and on board. And so you could sort of look at it, it’s like, if you go here, if you’re serious about this, you’re sort of moving from a compliance universe into one where, yeah, we got to get people’s hearts and minds and they only volunteer their hearts and minds.

James Maskell: Yeah, well look, I really, I’m glad that we connected because I think there’s a lot more to do in the world. Obviously, there’s a lot more to do to turn the ship of medicine around. I just wanted to say, I guess, and one thing I want to say is that I’ve heard people say that engagement is the next blockbuster drug, right, in medicine, right, in patient engagement is the next blockbuster drug. And no one really knows how to do it. And we’re right at the beginning of I think working out the pieces that facilitate that so that the application of your work into something that takes up 20% of GDP and is probably the biggest thing that could curtail America as we live in it today because of that exponential cost I think is actually right in your zone and maybe- [crosstalk 00:29:56]

Chris McChesney: Well, I would say that to you. We’re fascinated by the fact that we don’t have a monopoly on these principles. And it’s interesting that even though you weren’t dialed into our work or vice versa, you came to a lot of the same conclusions we did, even in terms of the structure and the group accountability. And what we would say is while engagement and getting this type of engagement might feel overwhelming, it’s not, but it behaves on principles. And for instance, if you… For centuries, for millennia flight was kind of impossible, the idea that people could fly, but we figured out four principles, lift, thrust, weight and drag, right? And once we figured out those principles flight was no longer impossible. We would say when it comes to this element of human engagement, that there are four principles and it’s focus, leverage, engagement, accountability, and the proper application of that gets human engagement. And so it, I don’t think it’s an impossible task, but I think it’s a fairly unforgiving one. Just like you botch lift, thrust, weight or drag, that plane’s coming down. We have to understand why people engage when they engage and we’ve got to adhere to those principles.

James Maskell: Awesome, well, look, I think a lot of the things you’ve shared in here are, and I want to use this phrase very specifically, are good ideas, right, and when doctors go to conferences, they listen, and they hear other good ideas. And I know for myself, I’m full of good ideas, but I’ve come to a realization of discipline of execution that you got to do all of them. I guess as a final word to doctors who are out there who want to build strong, sustainable community practices that can reverse chronic illness in their community and be a part of a movement to transform the practice of medicine, what would you say to as a sort of a final thought to those doctors who are on those frontlines, who are maybe struggling with some of these areas of execution, but to get them bought into what’s possible?

Chris McChesney: Don’t try and eat the whole elephant upfront. Identify the first 50-meter target and put ridiculous energy against the first small achievement. Also, I got a recommendation for a TED Talk on that I think fits everything we’ve been talking about. It’s a great TED Talk on trial and error by a British economist named Tim Harford. If you just Google, TED Talk trial and error, it’s just a really beautifully laid out piece on where innovation and progress really come from. And I think it fits in nicely with what…maybe you can connect the link in the podcast.

James Maskell: Yeah, we’ll put the link in the show notes. Well, look, Chris, thanks so much for being part of it. Actually, I think we’ve done over 250 podcasts. I’m not sure if we’ve ever done a podcast live in front of a studio.

Chris McChesney: Yeah, we’ve got a studio, so make some noise people. Woo!

James Maskell: Thanks for listening to the evolution of medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.

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