Medical Affairs in Transition

You can read the original article on the Five Fields website here

The quote “Everything changes and nothing stands still” is attributed to the Greek philosopher Heraclitus who lived around 2500 years ago.??There are many versions of the quote, however, regardless of what was actually said we all recognise that change is an inevitable part of life.??If medical affairs is going to change,?as I have written about previously,?a mindful approach can be helpful.??In this article, I’m going to cover some of the concepts of change, how this can affect individuals, and what can be done to optimise the change process.

Reactions to change

Probably the most referenced source in this area comes from research carried out by Elizabeth Kubler-Ross on terminally ill patients at the end of life.??From this Kubler-Ross identified 5 phases; denial, anger, bargaining, depression and finally acceptance which she outlined in her 1969 book?“On Death and Dying”.??Despite being adopted as a model for organisational change management, there is little empirical data to support it and people don’t move through the stages in a linear manner.

William Bridges has focused the latter part of his career on change and in his book “Transitions” provides an approach to managing change, a process he calls transitioning.??The following sections summarise and draw upon Bridges’ work.

Recognising the end

Individuals may often feel confused when undergoing change, but it isn’t the new phase that causes the confusion, it is the “end of the old”.??Therefore, the first stage of the transition process is acknowledging that the “old” is ending.??According to Bridges this natural ending process has 5 aspects: disengagement, dismantling, disidentification, disenchantment and disorientation.??

• Disengagement is the need for physical separation.??The acute disengagement and separation can be unsettling, and the benefit often only seen with hindsight.
• Dismantling describes self-inquiry and reflection.??It is the natural grieving process where old habits and behaviours are analysed and dismantled piece by piece
• Disidentification refers to the state of confusion that occurs from the loss of the way we define ourselves.??People no longer feel sure about who they are, and this can be especially troubling in workplace transitions.
• Disenchantment describes abandoning old assumptions and beliefs and forming a new reality in our head
• Disorientation refers to the challenge of navigation and how we move forwards.??We recognize this as the sudden realization that we are stuck.

These aspects don’t come in any particular order and are individual for everyone.??Four of the aspects refer to our own perceptions of reality and reflect our own internal world, only disengagement relates to the external world.??These internal aspects hold us on to the past if we don’t address them.??Simply addressing the external factor, walking away from a bad job for instance, without addressing internal factors will likely lead us to repeat the past.?

The neutral zone

This is a phase entered after the acknowledgement of an ending; it is an opportunity for a new sense of self to generate.??Often there is a sense of lostness and aloneness associated with the neutral zone and because of this it can feel like time has been wasted. However, we can gain a higher state of self-awareness by discovering what we truly want, what’s important to us, rediscovering our core values, or how these may have changed.??It’s an opportunity to rescript your life with some time out, however, it’s not necessarily a comfortable experience.?

This discomfort may be eased by simply surrendering and accepting that this phase needs to be navigated, along with recognizing the perils of trying to push through too quickly.??Taking regular time to be alone may be more practical than extended periods of solitude and may help ensure the transformative process isn’t missed, or the changes reversed.??

New beginnings

And it is with the end that new things begin.??When we are ready to take a new start, opportunities will arise.?The change is subtle and may simply be an inner idea or an external opportunity that presents itself.??One aspect to be aware of is the pitfall of not being aware of the opportunity that a new start presents.??If unaware, we can repeat past behaviours in a new way or format and neither transition effectively nor embrace the new start.??Seeking advice from those that know us well can help discern whether past behaviours are being repeated.??

Finally, in a new beginning it is important to not focus on results, but rather the process.??Focusing on results without a baseline against which we can judge will likely lead to disappointment.

Effective ways of navigating change?

There are various ways to address our internal perspective, and these include:

• Mindfulness to recover from a distraction and be present in the moment rather than the past or future
• Self-enquiry to address how habits have formed due of external stimuli and how we have ended up in a particular situation
• Reflection to think through your own behaviours towards a particular situation and how you may contribute towards it
• Contemplation as a cognitive process to reach clarity when faced with multiple choices and the pros and cons are weighed up
• Concentration to focus oneself on a task or activity when it no longer excites and energises

In his book Atomic Habits, James Clear describes that when changing our habits and incorporating a new habit, technical ability is less important.??Successful incorporation into our daily routine comes down to discipline rather than any special trait or characteristic.??As Churchill is quoted “when going through hell, keep going”, perseverance is key.?

The benefits of change

We go through change constantly and effective “transitioning” is a growth opportunity.?By recognising the end we let go of the ego and uncover more of our true self.?Passage through the neutral zone and time in the wilderness offers an opportunity to develop enhanced self-awareness, embrace our purpose and discover who we truly are and embrace the new beginning.?Ultimately this results in wisdom, a lifelong pursuit.

?

The next article will cover coaching and how it can be used to innovate medical affairs operations.?Also have a look at the?resources section of the Five Fields website?to download materials to accompany this article or click here and scroll down to?sign up to the Five Fields newsletter