Welcome to the Evolution of Medicine Podcast! This week, we’re talking with Jeremie Kubicek, the well-known speaker and bestselling author who has appeared on our podcast twice before to discuss business aspects of functional medicine practice. In this episode, Jeremie discusses strategies for goal setting in 2020—something we’re all thinking about as 2019 winds down, and even more poignant as we prepare to embark on a new decade. What I appreciated most about the conversation with Jeremie is that he shares actionable steps to make your vision for 2020 a reality. It’s not about avoiding the obstacles that will come your way, but planning how you will overcome them. The process is self-reflective and, I think, a necessary exercise for anyone who wants to make positive change happen in 2020. Highlights from this episode include:
- Learning from Mount Everest’s Sherpas to become a leader worth following
- Jeremie’s strategy for identifying pain points, setting your vision for the future and overcoming resistance
- How overcoming obstacles to your vision might be as simple as how you communicate
- Thinking about group visits as a way to mitigate common sources of dissatisfaction for practitioners
- And so much more!
James Maskell: Hello and welcome to the podcast. This week we bring back Jeremie Kubicek, who has been on our podcast a couple of times this year, talking about the business of functional medicine. This week, we’re talking about 2020 and preparing for 2020. We touched on a few really interesting pieces, whether you’re an employee, whether you want to use this in your family, whether you’re a practice owner, whatever your vision is for 2020, you could benefit from hearing about the change equation. We went deep into it, and how to really create change for yourself and how to plan to facilitate that in 2020. It was a really interesting half an hour, valuable for anyone who listens. Enjoy.
James Maskell: So a warm welcome back to the show, Jeremie Kubicek. Welcome, Jeremie.
Jeremie Kubicek: So good to be with you again, my friend.
James Maskell: Yeah, excited to have you on here. And as we end 2019 and we come into 2020, I really wanted to have an opportunity to really look for the practitioners and the leaders who are listening to this, to really make sure that 2020 is a transformational year for them. And so that’s what we’re going to spend today talking about. If you haven’t gone back and listened to the two other interviews that I did with Jeremie on both the 5 Voices and also working with staff and personalities, definitely go back and listen to them to see the tons of value in there.
But I guess, before we get it goal setting for our practitioners, I just wanted to ask you about your book. Because I’ve been following along and seeing that I think your book, The 100X Leader is one of the top business books of the year. And I know that’s quite a high honor. So maybe let’s just start there. You know, it’s called The 100X Leader. How do you think that practitioners in our community can access some of the wisdom of that book, to help to be more effective leaders in 2020?
Jeremie Kubicek: Yeah, I think it really hit a nerve. Obviously. I think the Sherpa metaphor makes sense. For those who don’t know, the Sherpa are on Mount Everest. Those are the leaders who climb. They’re acclimated because they were born at 14,000 feet. So they climb ahead of the climbers, set up the ropes, and then they challenged people to get to the next level. So we use that metaphor of leadership is both two things, it’s performing and it’s leading performers. So, if you separate leadership out and going, how well are you doing it performing, and then how well are you at leading other performers? Most people were like, “Oh my goodness, I haven’t thought of it that way.” So the Sherpa mindset means that if you’re performing, but you have to lead performers and you have to think differently. I think that’s what really hit it. I think Amazon put at number 10 best book of 2019.
James Maskell: That’s really great. Yeah, and I can see a lot of practitioners, maybe they build their own practice and they’re great performers at getting people well, and then there’s a whole new skill set that comes, where like they have a new doctor they have to hire, because now, they’re inadvertently in charge of another performer, right?
Jeremie Kubicek: That’s it. That’s right.
James Maskell: Obviously there’s a mindset shift, but what are some sort of practical shifts in that transition?
Jeremie Kubicek: So to get to 100. 100 means healthy, and X means multiplication. So the shift, for you, the Sherpa on the mountain needed to be the most healthy on the mountain. You don’t want an asthmatic Sherpa, right? So you want like a, you want the doctors be healthy themselves. So what do you need to do to get healthy? That’s what we found is a lot of doctors, or a lot of people will either dominate themselves or abdicating, because they’re tired. They’ll protect. So learning what support looks like for yourself and learning what challenge looks like for yourself is the beginning.
Then looking at moving from a plus person to an X person, it’s going, “What systems do I need to multiply? What processes do I need to multiply? What can I do to intentionally transfer the wisdom, knowledge, skills that I have into the people I lead, with the same amount of time?” Like we all have the same amount of time. And some people maximize their time. So if you want to become more effective, then you’re actually always working to transfer and multiply. Most people, we have to make the donuts, we’ve got all these patients we have to get to, we have the drip, all the forms we have to sign, blah blah, blah, blah, blah. So we let the circumstances really dictate us, and maybe not cause us to be the most intentional.
James Maskell: Yeah, absolutely. I can certainly see that. Well, look, I think that’s actually a great lead into what I wanted to talk to today. Which is, we’re moving from the end of the year into 2020 and obviously at the end of every year, it’s nice to look back and see, how do I want to do things differently next year? At the end of a decade it might be even more poignant, right? To do that again. But more than anything, like in October, for the first time ever, in the Journal of the American Medical Association, there’s something that came out that said, basically, functional medicine is better than conventional medicine. Right? And so we might be on this moment where like, “Hey, there’s a shot that we can win.” And like this will just become the standard of care. And the first thing that I ever said on the Functional Forum is that we need to start acting like we’re winning and stop acting like we’re losing. Because this is the way that things are going.
And maybe now, six years later, people see that confidence as well-founded. And ultimately, yet, we have to go from a plus to an X, because we need to scale this up. And I guess I just wanted to bring you back to talk about this, because I just feel like for our whole community, whether you’re a practitioner working in a practice, whether you’re a business owner who’s running a practice or whether you’re just someone in the ecosystem that wants functional medicine to thrive, we need to upgrade our thinking process and we need to upgrade our action, to facilitate this in the next decade.
And this is our decade. You know? It’s just all happening, just before, the world needs this more than ever before. The structures are now in place to deliver this like group visits, which we’re really focused on. So okay, that the architecture is there, to a certain degree. Now we just go to like step on the gas and make it happen, and not have a huge explosion. Because, we didn’t really know what we were doing when we accelerated. And so that’s why I wanted to get you in to share your wisdom and help people access what’s going to be required in this next phase.
Jeremie Kubicek: Yep. And so to do that, we’ve got to change the mindset. Like you said, I love it. Act like you belong. Act like you’re winning. I love that. So if we think about all those are listening, going, “Okay, start planning and thinking differently from mindset shift.” So the process I like to use is called the Change Equation. This change equation has been, there’s lots of different formulas that was built, I don’t know, in the 50s or 60s. But it goes like this, and this is my version, I’ve modified it as well, just kind of added to it. Change = DxVxN>R. I’ll explain it. Change equals D, dissatisfaction with your status quo. So the first thing I would do for anyone listening. I would list all of the things you’re dissatisfied with at the end of 2019. That sounds very negative, but it’s actually very, very cathartic because if you make your list, it could be three things.
It could be five things, and it’s like I’m just satisfied with my level of employee engagement. Okay? I’m dissatisfied with insurance, blah, blah, blah. I’m dissatisfied with my schedule. there’s all types of things that you can be dissatisfied with, but to look into 2020, it’s important that you start with D, then you have to multiply it times V. V is vision for your future. So what is your vision? And what I’ve found, the best way to describe vision is actually the Spice Girls, which I know come from your home country.
James Maskell: Very proud.
Jeremie Kubicek: Yes. What you really want. What you really, really want. That’s what vision is. What do you really, really want? So, this is what I want my vision. So what happens, James, is that if you have dissatisfaction higher than your vision, that creates hopelessness and frustration, and you have to move your vision up. And that vision has to be higher than dissatisfaction. So if you really, really want to be the leader in functional medicine in your city, or your area, or you really want to see your business go from X to Y, that is what your vision is. What is your vision? What do you really, really want for 2020? So you make that, then you multiply that times N, which is what’s naturally next.
So, okay, in order to get to that vision, then I’m going to need a what? I’m going to need to find a new person for this, I’m going to need to change my systems to that. I’m going to need to add…see where I’m going? So that becomes the formula for change, where you have vision that’s higher than your dissatisfaction. So, for some of you, you may not have a lot of dissatisfaction. Probably most of you do. And your vision might need to be dusted off a little bit and you might need to do a little bit of homework. So let me stop there and let you add any feedback before I get into the other part of it.
James Maskell: So how do you make this work? Because, you know, listening to this, I’m just thinking about it. There are definitely entrepreneurs, right? Physician entrepreneurs and other entrepreneurs who listen, who run their own practice and who, maybe, see themselves as entrepreneurs or maybe just see themselves as self-employed, right? But then you’ve also got a lot of people who are employed physicians who just want to want to play that role, but don’t see themselves as entrepreneurs. And I think I tend to always think in the entrepreneur mindset because that’s who I am. But I know that as this industry grows, there’s going to be a lot more physicians with jobs, doing functional medicine. So how do you apply that to that?
Jeremie Kubicek: This really doesn’t have anything to do with entrepreneurs or not. Anyone, a stay-at-home mom. What are you dissatisfied with? What’s your vision? What do you naturally need to do to change that thing? So it really has nothing to do with entrepreneurship or not. It really is in what can you control? So you can control what you control. So to go, “Hey, I run a practice inside a system, and I have four nurses and an office administrator.” Great, there you go. So what are you dissatisfied with? List those things. Because what happens is they have less control over you. When you list your dissatisfaction, you’re like, “Huh, I’m making this a bigger deal than it really is.” Or you know, “I’ve got this issue that’s not…” What is your vision again? What do you really, really want? “You know, I want more time with my family.”
Okay, great. That’s your vision. What has to happen to get more time with your family? So then that might mean, well, I need to restructure my schedule. I need to delegate to so-and-so. Well great, now you’ve figured it out. You’ve actually got the game. There is, though, another level. And what I’m sharing with you, in order to see change, you have to elevate your vision and your next steps. They have to be greater than R, which is resistance. So resistance comes in the form of three areas. There’s barriers, there are hurdles, and there are gaps. So a barrier is something that is immovable. So like a regulation, a law, you have to work around them. You can’t change them, unless you get a big group and lobby it. You can’t change them. So you have to work around it.
So, take your dissatisfaction, and if you look at your vision, and if you look at the resistance, is there resistance? If you list all of your resistance, how many of them are barriers versus hurdles? Hurdles are things that, “Oh yeah, I’m going to have to deal with so-and-so. My boss is a hurdle.” Well, the boss might be. You have to jump over them and it takes energy and effort, but it’s not a barrier. And then the last one is a gap. A gap would be a hole. And we have to fill that hole before we can. So a gap might be, maybe you have a gap that you need an office administrator.
Maybe you’re implementing a new software system, some gap in there. But what you’re looking at as resistance is either who, could be a person, or what, a thing. But once you realize what your resistance really is and what has to happen to get to your vision, then you really realize, “Oh, it’s so much more doable than I thought.” But oftentimes if you don’t break it out and list it, then change doesn’t happen because it all gets lumped in and it feels like it’s insurmountable.
James Maskell: Yeah. Yeah. I really like that. And yeah, so the change equation, I could definitely see sort of being universally applicable to people. I think it would be fun, right now, just to tie in, now you’ve come through that. I mean I could see for myself how working with staff or understanding yourself and your own strengths and weaknesses really plays into it. If you know that about yourself, this whole equation is going to be a hell of a lot easier to implement. Right?
Jeremie Kubicek: Yeah. And if you really list on your resistance, you may go, “I want to implement a new system but I have a nurse that’s been here a long time, and they’re not very open to change” and you go, okay, well if you understand their voice, which is what we’ve done before, if you understand, “Oh she’s a Guardian, she’s a Guardian. Okay.” So what does she want? She’s black and white. She wants details, logic. So I have to build the bridge so she may be a hurdle, not a barrier. So that hurdle then goes, “Okay then I’m going to have to communicate with her. I typically communicate like this, because I’m a future-oriented voice. She’s a present-oriented voice. So I’m going to have to answer dot, to dot, to dot. Three questions. Those three questions, I want her to be a part of the solution. We’re going to meet out of the office.”
See what I mean? People haven’t taken the time to go, “What’s the resistance?” A lot of people will just be so dissatisfied. There’s too much resistance so they don’t do anything. And then next year rolls around and they have the same thing, but the resistance got bigger and the dissatisfaction got bigger and eventually they have a midlife crisis. Buy a Harley and go ride into Mexico. Right? And they’ll just check out completely, thinking that’ll solve it.
James Maskell: No, I can absolutely. Yeah, I mean I think that’s a great example and I’m glad you brought that up because yeah, I mean ultimately, when I was a sales rep, before I even started the Functional Forum for years before, and I would go in and sit with doctors, you know, obviously as a sales rep, you’re trying to sell them on doing something new. You’re trying to help them solve a problem that they know they have. So you would identify what that problem is and then a lot of times you would see that these problems would be seen as a barrier, but actually a hurdle, real problem, not enough self-awareness to be able to get someone else on that team to really even understand the difference between a future thinker and a present thinker, and these barriers on these hurdles. And these whatever would lead to, in a couple of years, “I’ve got to leave practice cause it’s too stressful.” And it’s like a stitch in time would have saved nine, five years ago.
Jeremie Kubicek: Absolutely. So that’s where being intentional, breaking things out. I was just in Africa, I just got back. I saw lots of elephants, and giraffes, and hippos. I wasn’t planning to eat an elephant, but you know that that phrase, what’s the quickest way to eat an elephant? One bite at a time. And what has to happen a lot of times is a lot of frustration is pent up inside people. And so they sweep it under the rug and never deal with it. So this is a formula that actually helps them to break this down.
You can do the same thing with your personal life. If you want to look at 2020 and your family, you do the same thing. What are you dissatisfied with? What’s the vision? What has to happen next? What’s the resistance? Is it a person or is it a task? Start breaking those down to realize, “You know what? Actually we can do this.” If you’re listening, you may want to walk it through with someone having an advisor that’s in your life or a coach that’s in your life, or you know, you’ve got someone that you can reach out to, to maybe process it with. I just did this exercise with my parents in their seventies and it was a game changer to them, on their next season of life.
James Maskell: Yeah, that’s really great. So, let’s say you’re doing this and then there’s a big list, right? And 2020 you want to do a lot of things differently and you feel yourself moving into a new stage of life. How do you prioritize or what is a structure to be able to prioritize those processes, so that you don’t overwhelm yourself on January 1st and give up on January 2nd?
Jeremie Kubicek: That’s right. No, it’s momentum. You build, you start strong. Like you win easy battles first. So you know, some people will not go, “I’m going to tackle the biggest issue.” Well, actually in this case, start getting little wins. So I’m disappointed, I’m frustrated with, for example, our file system. Okay, well that might be a big, big project, or there might be something that’s really simple. Start with a simple one first. Start building momentum. We use a system and giant, basically, we took it from the technology space. It’s called Agile. And the way that we break projects down is we do two-week projects. So they’re done in two weeks and we put a champion, a captain, over every project, and then there’s two or three other people on that team. And it’s amazing what happens and how fast it happens with two-week deadlines.
This isn’t stuff we’re going to do over the next six months. You know, for two weeks we’re going to focus on fixing this. Now, it doesn’t mean you fixed the entire thing. You might have a big project and you have four two-week projects inside that big project. So the first two weeks looks like this. Then you shift the team, add someone else who might be an expert and then take it down. Then you pass the baton. See what I mean? So by for two-week sprints, they’re called. In four two-week sprints, you might have been able to really change it.
But that’s just more advanced project management. And the reality, though, is it starts with: What do you really want? Dust off your vision. The old adage is in the old verse is without a vision people perish. The reason they perish is because hopelessness wins. So if you’re feeling hopeless in anything, it’s because you haven’t taken the time to really understand what your vision is. So the cares of the world and all this stuff that you have to do kind of comes on the leader, and kind of weighs them down. And it keeps them from becoming who they wanted to be.
James Maskell: That’s awesome. Yeah, and it’s good to do. How often do you go through this process? I mean, obviously, at the end of the year it’s good, you can set it up. But is there a sort of recommended timeframe that you recommend doing this? Like quarterly or monthly?
Jeremie Kubicek: Well, we did this for our business in April of 2018, and it changed our entire business structure. We were so frustrated with our business model and so we changed it and so we talk about it on a regular basis. So much so that from this, the natural next step for us was GiANT TV. We created GiANT TV because we went through the Change Equation. Because we were trying to figure out how to scale leader development and make it so inexpensive for people to make a Netflix of leadership. And that’s what we built. Now, it took us from April of ’18 to August of ’19 to build it and now people are using it all over the world. So, that’s an example of how people can do it. We use it. We talk about it constantly, but now we don’t talk about our dissatisfaction. We mainly talk about our vision.
James Maskell: Absolutely. Well, look, I’m really glad that this is coming up at this time. I’ll just give you an example of what’s hot in our world right now, is that I think a lot of practitioners, their dissatisfaction as being that they can only treat rich people, right? People who can pay outside of the system. And also they’re dissatisfied with the fact that only a certain number of that patients get better because only a certain number of them really jump into the behavior change and do it. And so, ultimately, if the vision is to really help everyone get better and to be able to help anyone, so then people realize, “Okay, what is the natural next step? Well you’ve got to do group visits. You’ve got to facilitate better behavior change. You’ve got to make it more affordable.”
And then the resistance to doing that is like, “Okay, you’ve never run a group. So what is it going to take in order to do that?” That’s why we’ve run this group as a challenge. You know, we’ve done a bunch of different things to make it easy to overcome the resistance and do something new. And so I’m really glad that we’re talking about this at this time of the year. Because, I think for a lot of practitioners, the shift that comes with really realizing that this isn’t going to be in the shadows any longer, that this is going to be the way that things are going to get done comes with a bigger vision. And hopefully that can root out some of that resistance for sure.
Jeremie Kubicek: Excellent. So good.
James Maskell: Awesome. So Jeremie, what are some parting words of wisdom or resources? I know for myself, December always seems like a time where I can actually get some more reading done. Because there’s all kinds of family stuff and I’m not working exactly the same hours, although with my book coming out in January, who knows? But what are some reading that you’d recommend for people who need something to inspire them to take action on the change equation?
Jeremie Kubicek: Well.
James Maskell: Feel free to plug your own book.
Jeremie Kubicek: Ordering your book. No, I mean, The 100X Leader is a field manual for people. If you’re wanting to figure out your subcultures, build a system and process for developing your own people and leading your own practice. And The 100X Leader is one of the best books out there on that. So I think the key though is actually taking the time to go through that process, listing your dissatisfaction. The best book might be your own journal, to those listening. Take a journal and write down dissatisfaction. On the next page, write down your vision. On the next page, think about what would have to happen to get to that vision. Then go to your resistance list if it’s a barrier, hurdle, or gap. That exercise alone could make December really, really profitable and productive. So I think this contemplation is a great asset that most people don’t take the time to do.
James Maskell: Awesome. Well, look, Jeremie, thanks so much for being part of it. If you’re listening to this and you haven’t checked out the other podcast we did with Jeremie, make sure to go back and check it out. The 5 Voices, super crucial. And we’ve started to get feedback from practitioners in our community, who are taking advantage of typing their patients, and typing the team members, and getting more cohesion in their organization. And ultimately, we think that it’s a best practice for the practices of the future. Jeremie, thanks so much for being a business guest here on the [podcast] and the Evolution of Medicine in 2019, and we’re excited to see what 2020 holds for our community, our movement, your work and our work together.
Jeremie Kubicek: Well, I love what you’re doing and I believe in it, and I think it’s so good. There’s so much change that needs to happen in medicine, and I think you guys are on the cutting edge, so I appreciate you all, have a good holiday. Thanks so much.
James Maskell: All right, this has been your host, James Maskell. This is the Evolution of Medicine Podcast. Thanks so much for listening and we’ll see you next time.
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