We are what we repeatedly do. Excellence, then, is not an act, but a habit.   - Aristotle 

We often think of habits as the things we need to help our patients change – stop smoking, exercise more, eat right, take your medications.  A big part of our work is to help our patients replace bad habits with good ones.  Inherent in the nature of a habit is the automaticity with which one does it, such as mindlessly lighting up a cigarette, mindlessly sitting in front of the TV for hours or even (on the positive side) mindlessly brushing our teeth.  Habits, mindlessly followed, can become mundane, uninspired routines.  


There is much routine in the work we do as physicians, and this routine risks sometimes leading to boredom and dissatisfaction.  However, mindful attention to our habits can also elevate the quality of our work in a continuous manner, for example the habit of participating in M&M can improve our work.  I think this is on my mind now because our practice is looking to set quality goals for the next fiscal year, and to achieve them, we’ll need to change some habits.


I recently read “The Power of Habit” by Charles Duhigg in which he argues that we can tap into the phenomenon of what makes a habit stick.  He describes the cycle of a cue that prompts a routine followed by a reward.  This cycle results in a craving for the reward, not unlike the bad habit of smoking we all combat in our daily work.  However, if we structure this pattern around the positive behaviors we wish to continue we can create a positive feedback loop leading us to continual improvement.


Before we can establish new habits that help improve the quality of care we deliver, we must be aware of our current habits and current outcomes.  I encourage you to look at your practice’s quality metrics, look at what habits get you those results and decide what habits need changing or need to be started to achieve the excellence we all aspire to in our work.


Please send your questions or comments to president@nhms.org or post a comment below.