Why it matters.

Abstract

Physicians everywhere are facing changes in the ways they are paid, and in their relationships with their patients. In the United States, an increasing number of physicians are being confronted with the choice to join their practice to a physician service organization (PSO) or some other capitated financial structure in which they collectively put themselves at financial risk for the health of their patients. In all these decisions, the biggest handicap is fear. Some physicians let fear keep them from changing. Others let fear drive them too quickly into change that turns out to be unwise. The fear of change-the fear of the unknown, of things that, deep down, under the professional veneer, we wonder whether we can handle-is quite real. It is immediate and nearly constant. How can you drive out the fear? There is no simple answer. The complex answer starts with daily practice, with taking the practice deeper, taking it wall-to-wall. Here are some ideas for dealing with the fear of change, from owning up to your true feelings, to acknowledging failure, to breaking the change down into its smallest components.