Hey buddy, can you spare some change?

Medical academics live in a world of two calendars. One starts on July 1 and the other January 1. The good news is that artificial temporal bifurcation gives you the opportunity to make resolutions and restart and recharge twice a year, not just once.

During those times, and every day in between, most of us could do with some change. Here are 20 reasons why you won't:

1. Fear.?We have an innate fear of the unknown. “I’m afraid of what will happen.”
2. Myopia.?We can’t see that change is in our broader self-interest. “This won’t help us.”
3. Selfishness.?Unless change immediately pays off for us, we’ll resist it. “What’s in it for me?”
4. Homeostasis.?Equilibrium is more comfortable, change is uncomfortable. “I’ll feel better when things are normal.”
5. Ego.?Those with power have to admit they’ve been wrong. “I feel I’ve positioned us well for the future.”
6. Sleepwalking.?Too many people live unexamined lives. “I just don’t get it.”
7. Lack of confidence.?Change threatens our self-worth. “This will reveal the true me.”
8. Timing.?Certain preconditions have to be met for change to occur. “I’ll change when the time is right.”
9. Human nature.?We are naturally self-centered, and change requires some selflessness. “Others will benefit more than me.”
10. Inertia.?A body in motion takes considerable force to alter course. “We’re already down another path.”
11. Short-term thinking.?People have difficulty seeing and supporting long term visions. “I can’t see that happening.”
12. Perversity.?People perceive only the opposite or downside outcomes of the change goal. “That’ll make things worse.”
13. Complacency.?We like the path of least resistance, we’re not natural maximizers or optimizers. “I’m satisfied with the ways things are.”
14. No constituency.?The power base of the status quo is greater than that of those trying to bring about change. “There’s no critical mass behind us.”
15. Groupthink.?Social conformity limits our thinking. “What does the group want to do?”
16. Short selling.?Perceived lack of knowledge, skills, tools and experience. “We’ve never done this; we don’t know how to do this.”
17. Exceptionalism.?People can’t see the situation objectively. “That may work elsewhere, but we’re different.”
18. Futility.?Change is seen as superficial, not worth the effort. “Why go through so much pain for so little gain?”
19. Cynicism.?People distrust the intentions, motivations, or track record of change. “Here we go again.”
20. Future shock.?Grand scale change makes people hunker down, sensing they may not be able to adapt. “I smell disaster.”

Many things rot from the inside out, like people. trees. teeth and businesses and organizations that don't innovate. The problem is by the time you realize that things are amiss, it's too late. Ambidextrous organizations are rare.

Some psychologists believe and teach that changing how you behave depends on changing how you think. Others think it is the other way around, and, if you just "fake it till you make it", then your thoughts and attitudes will change. One way or another, how you feel has a lot to do with how you act.

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When an organizational change is first proposed, most people immediately want to know three things: what does this change mean to me, why is it happening, and what will it look like when the change has been made? People only begin to be open to accepting, embracing, and making this change when their mindset starts to shift from “this change is going to be difficult, costly, and weird” to “this change?could?be easy, rewarding, and normal.” This author offers four straightforward approaches for leaders to support their people through this necessary mindset shift, resulting in a critical mass of people who will understand, accept, and adopt the change reasonably quickly.

Here are 10 principles of leading change management:

If you find yourself stuck in a rut, constantly resisting change, try:

1. Practicing entrepreneurial habits
2. Viewing the world using an entrepreneurial mindset
3. Traveling
4. Volunteering
5. Doing something that scares you
6. Spending more time in nature
7. Learning something new
8. Examining your unconscious biases
9. Listen to your inner voice by experiencing the value of solitude
10. Get in touch with your innerpreneur

If you’ve got a major change on the horizon (or if you're currently leading one that's stuck in a ditch), you need to be aware of three common pitfalls — and how to avoid them.

1. Don't underestimate the scope of the work.?
2. Don’t overestimate your employees' capacity to execute your vision while continuing to carry out their existing day-to-day responsibilities.
3. Don’t hide why this transformation is important to you.?

Harvard Professor John Kotter outlined an 8 step way to lead change. It starts with creating a sense of urgency and understanding the why.

1. Leadership is about vision, direction and inspiration. When it is about vision, direction and motivation, it usually is not sustainable.
2. External vs. Internal: The first key difference is while motivation is typically accomplished through external factors, inspiration is an internal force. Wayne Dyer puts it this way: “If motivation is when you get hold of an idea and carry it through to its conclusion, inspiration is the reverse. An idea gets hold of you and carries you where you are intended to go.”
3. Duration and Effectiveness: Since inspiration is an internal force, it lasts longer and is more effective. Motivation, particularly when connected to a system of external rewards, is only effective as long as you are able to keep the system of rewards consistent. Inspiration has deeper roots; its influence sticks with you and propels you further than mere motivation can.
4. People’s Responses: People respond to inspirational leadership exponentially better than they do to compensation or coercion. People are always more eager to do something when it is an idea they feel connected to and invested in. While external forces can be a key motivator, people will react far better to a personal investment.

Then it takes finding the right champions and leverage small wins. Just be sure you don't confuse strategy with metrics and wind up like Wells Fargo.

Niccolò Machiavelli got it right with this quote on Change and Innovation in his 16th century political treatise,?The Prince.

“There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. For the innovator has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order, this lukewarmness arising partly from fear of their adversaries … and partly from the incredulity of mankind, who do not truly believe in anything new until they have had actual experience of it.”

Like the saying goes, the only thing that is constant is change. Except, that is, when it comes to people.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@SoPEOfficial and Co-editor of Digital Health Entrepreneurship