Optimal Goal Setting: Achieving Success Beyond New Year’s Resolutions

by Guest Author

One of my personal and professional resolutions has been to discover capabilities among young people and provide opportunities to cultivate it. I feel extremely proud to include the well-written insights of this 25yo Franklin, MA native (who requests anonymity) in my practice’s blog, and I look forward to more of his contributions promoting wisdom and well-being. –Dr M

As each year begins, millions worldwide embark on a journey of self-improvement through New Year’s resolutions. However, statistics show that many individuals have failed to keep up with their resolutions by this point in the year. So, why do so many people struggle to maintain their goals long-term? In this article, we will explore the reasons behind this common phenomenon and provide insights into optimal goal setting strategies that can help you achieve success throughout the year.

The “Fresh Start Effect”

Despite the lack of success associated with New Year’s resolutions, people continue to embrace them. Their decision may be due to the “fresh start effect” — seen in the phrase “New Year, New Me.” Humans naturally gravitate towards temporal landmarks, such as the beginning of a new year, as opportunities for a fresh start. While this can be beneficial in some cases, it can also push a shift in behavior onto a future self, overlooking the present moment. People are often overly optimistic in believing that a future version of themselves will take responsibility. Why not do it now? When does the future you start, and when does the current you begin? This isn’t to say that a fresh start is a bad idea; it is just something to consider when creating a goal.

Goal Setting Strategies

Many individuals strive for ambitious changes without considering the practicality and feasibility of their objectives. How do you plan on achieving the goal? What does the goal entail? A goal of “I want to get better at art” may be difficult to stick to unless there are surrounding goals, milestones, or habits to follow. Not having a clear direction or way to measure progress can contribute to a lack of focus and commitment. If you don’t feel like you’re achieving the goal, you may lose motivation or become demotivated, derailing your progress.

The effectiveness of goal setting lies in the approach. Let’s explore the most popular New Year’s resolution — improving physical health and weight loss — as an example to guide us through the goal setting process.

Defining “Physical Health”

Defining what it means to be physically healthy is crucial if this is your goal. What aspects of your physical well-being do you wish to improve? Is it overall health or something specific? It can help to identify areas for improvement, such as cardiovascular health, alcohol consumption, sleep, or strength. Once you have identified the areas you want to improve, it’s time to establish specific goals and ways to measure your progress. For instance, if you want to gain a certain amount of weight by July, you can break it down into monthly goals and track your weight gain progress. To support a goal of cardiovascular health, you can create another goal of walking a few miles daily. If your overall goal is improvements in physical health, it is best to have other goals to support it.

Tracking Progress and Adjusting

Regularly monitoring your progress can be crucial to stay on track. For example, if weight loss is your goal, establishing daily or weekly tracking habits can help you identify patterns and adjust your exercise routine, diet, or calorie intake. Keep in mind that progress might not always align with your initial expectations. However, by including other measurable goals and consistently reassessing and adjusting your activities, you can prevent demotivation and maintain confidence in your progress.

Flexibility vs. Strict Adherence

When setting goals, it’s vital to balance flexibility and strict adherence. Some individuals thrive when their goals have clear boundaries, such as going to the gym every other day. For others, a more flexible approach is preferable, allowing them to choose from various exercise activities such as going to the gym, yoga, or walking their dog. You can enhance your motivation and enjoyment throughout the journey by tailoring your goals to your personal preferences and needs. It is also helpful to plan for alternative actions when encountering a barrier to success, such as a snowstorm.

Approach vs Avoidance

People can perceive the same situation differently depending on their mindset. An approach mentality seeks a positive outcome, while an avoidance mentality avoids a negative result. Imagine a penalty kick at the end of a game of soccer. If the player scores, she wins. If the player doesn’t, she loses. There is no correct mindset to have during these events, but typically, athletes perform better with an approach mentality — focusing on winning rather than not losing. This mindset can be applied to many goals, such as activity levels. Do you want to get more daily steps in, or do you want to spend less time on the couch? The expected outcome would be the same, but the mindset may affect your motivation.

Adherence to Goals

Motivation tends to fluctuate over time, often coming in waves. While you may feel incredibly motivated to achieve a goal at a particular moment, relying solely on the momentum of future motivation can be risky. Instead, developing habits and routines can prove instrumental in maintaining your goals, especially during periods of low motivation. Establishing consistent behavior patterns allows you to continue progressing even when your motivation wanes.

There are a few ways to adhere to goals. Change the environment around you to support your goals. Avoid putting yourself in an environment where it is difficult to maintain your goals. Eating healthy while going to a fast food restaurant can be mentally taxing. Enlist the support of friends, family, or support groups to hold you accountable and encourage you. The opposite of this can also be positive. Talking about your goals, behavior, or plans can be fulfilling. People can become so satisfied by talking about their goals that they lose the motivation to keep progressing.

Be adaptive; Don’t let going off course prevent you from getting back on. Consider your other goals, or think about the payoff you’ll get in the future.

Conclusion

New Year’s resolutions can be valuable tools for personal growth and transformation. However, it’s crucial to approach goal setting optimally to maximize their effectiveness. Setting realistic goals, maintaining consistent motivation, incorporating short-term objectives, and creating a clear direction can set you up for success. Embrace the power of habits and routines, and remember that goal setting is an ongoing process that requires periodic assessment and adjustment. With these strategies, you can elevate your goal-setting game and achieve long-term success beyond the fleeting nature of New Year’s resolutions.

June 19, 2023

Challenges of this Career

Special thanks to a kind and generous patient, Peter F, who shared this New York Times article from last week with me [see below], and regularly supports my practice with his trust and exploratory inquisitiveness.

It is with humility and regret that I will be raising rates once more for the services we provide here at Thrive Adult Primary Care. I have debated with myself fervently about how to ask patients to pay even more than they already do for their healthcare. The NYT article touches on those themes, which may manifest differently for doctors “in the system” compared with the handful of us who remain trying to keep our operations small and independent. But the end of this article actually reflects on that, too, which I greatly appreciate.

The bottom line is that United States Healthcare is deeply dysfunctional. I have been opining for years that it “is a behemoth structure of popsicle sticks held together by duct tape and Crazy Glue.” However, the pandemic necessitated and thereby introduced a severely wily network of sinews to uphold it, in the form of artificial intelligence engines, third-party-upon-third-party workflows, legislative edicts and revenue streams.

So it is not going anywhere anytime soon. “The System” as everyone calls it colloquially, is simultaneously indispensable and inefficient. And it is no longer only patients who suffer beneath its mutative, misshapen shadow. Rather, ALL stakeholders are being impacted by its weight and grasp, including and especially those who are in positions at the foundation of it all, obligated to prevent it from tipping and eventually crashing upon those it was supposedly designed to protect.

Anyhow, there I go again, unnecessarily waxing philosophical. Meanwhile, I suppose what I’m doing here is attempting to self-alleviate guilt over asking patients to help me keep my practice open. Costs have gone up — everyone sees it. This includes rent, gas (whereas I do plenty of home visits including at distances as far from the office as Wellesley, MA), utilities, various forms of insurance, and professional services that are essentially mandatory for operating a medical practice such as having a CPA, a business lawyer, payroll, hospital affiliation… and on and on.

As a reminder: yes, we “take Medicare.” But please be aware that this contributes progressively less and less to the revenue stream of the practice. Medicare is a shared resource among ALL citizens of the United States. The greater the population, the greater the needs, the greater the output without a synchronous increase of input… the less there is to go around. Each service we provide, for which billable claims are submitted to Medicare, has been DECLINING in dollar value through the years. Meanwhile, there is more work to do for each service rendered — more documentation, more forms to complete, more ancillary services to interact with… Imagine trying to run a contracting, plumbing, restaurant or other business in today’s economy where your resources consume more time, energy and cost while your own prices keep going down because you don’t control them. We have no say over what Medicare pays. Whatever they pay is all we get.

I will not be laying off employees to cut costs. We have MORE work to do (as just described), so they are each essential in their roles. I HAVE suspended my own salary so the practice can stay operational without debt. But with my own personal living expenses to pay, of course that can only go on for but so long.

The world has changed and I am praying my patients can understand. Please believe I have analyzed each case and calculated rate changes for active, loyal members in an effort to remain your doctor while upholding the margin that it takes to keep us operational, both this year and moving toward the uncertain future. And I am more than willing to have discussions on an individual basis for anyone who feels truly unable to financially keep up with the adjustments.

To cap it all off though, with an ear to the ground, we are shifting our goals and identity to remain relevant and sustainable in this ever-changing global atmosphere. We hope to be a federal 501c3 nonprofit by the end of the year, and creatively generating Healing, over “healthcare.”

It is a slow but steady and worthwhile climb. Stay tuned, and thank you for tuning in thus far.

nyt-2023-06-15-the-moral-crisis-of-americas-doctors Download

September 30, 2019

Double Down on Protection

When it comes to defense, does it get better than this?

Only if you have properly vaccinated against Influenza!!
(Come on, this is a medical website — bad jokes are inevitable)

Visit our Open House 10/17/19 and get protected!

We are excited to partner with MBs Pharma Care
in hosting our First Annual Flu Clinic
at the Thrive Adult Primary Care office
on Thursday 10/17/2019 from 9am – 5pm

This event is OPEN TO THE PUBLIC, and ALL INSURANCES are accepted
for coverage of your annual flu vaccine!

Yes, in the medical field we recommend annual flu shots for everyone. We do this for a phenomenon called herd immunity, meaning that we aim to reduce the exposure of individuals who are susceptible to severe disease by immunizing everyone. Influenza is not your typical cold virus. It has been known to cause fatal outcomes in certain populations, generally the very young, the very old, and the chronically ill — that is, people whose immune systems tend to be weaker than average. Healthy individuals with strong immune systems can contract influenza and have it manifest as nothing more than a really bad cold. However these people are still contagious and therefore may potentially spread the virus to others who are at risk for a worse outcome. I am typically pushier about advising someone to get the vaccine if they have regular contact with these susceptible individuals, all the more for someone who is one of them.

I have heard the argument that, “every time I get the flu shot, I get the flu.” Let’s make it clear that it is impossible for this to happen with the injected flu vaccine. In this formulation of the immunization, it is as if the virus particle has been broken in half before being introduced to the patient. A broken virus cannot replicate and therefore cannot generate infection. However the whole purpose of the vaccine is to activate your immune system to generate antibodies so that if the real flu comes along, your body will be prepared. The activation of your immune system feels a lot like how it would feel when your immune system is trying to fight off the flu in the case of an actual infection. So some people will potentially develop low-grade fevers, body aches, weakness and fatigue. This should last no more than a couple of days, and be assured that it is not an actual infection with influenza. The nasal flu vaccine (“Flumist”) does in fact contain a live virus, enough to trigger an immune response but rarely enough to cause infection. For several years in a row, Flumist showed no protective benefit against contraction of the flu virus, and was not recommended for the 2017-2018 season, but for the 2019-2019 season, protection against H1N1 virus has been added to the nasal flu vaccine and is felt to be beneficial for appropriate individuals.

I do advise patients who are actively ill to avoid the flu shot. Again, this is not because the vaccine can cause an infection with the actual flu virus, because it cannot. However, when a person is sick, their immune system is already busy trying to heal them from their current illness. Giving a flu shot under these circumstances only adds strain to the immune system when it has a job to do; as a result, it may both prolong the active illness and reduce the likelihood of developing an effective immune response against Influenza.

Rare adverse effects are possible with the flu vaccine. Probably the scariest of these is known as Guillain-Barre Syndrome which is a type of short-term paralysis that starts in the feet and legs and may ascend to the upper body. This is exceedingly rare, but of course anyone who has had this type of reaction to the flu vaccine in the past should avoid it in the future. Also, the majority of available flu shots are prepared using eggs, so folks with an egg allergy should ask whether an egg-free preparation is available where they are planning to receive the flu shot. In general, anyone who has been able to tolerate the flu shot in the past should have no problem with the shot this year, either.

Finally, on rare occasion a savvy patient will bring up the presence of a mercury compound in the flu vaccine. This is thiomersal, or thimerosal, which is a widely used antiseptic preservative that suppresses the growth and reproduction of common bacteria. It does metabolize the the human body to a form of mercury that can be toxic in significant amounts. However the quantity of thimerosal in a dose of flu vaccine is less than 2.5% of what is considered safe daily intake. Meanwhile a flu shot is needed only once a year. If you want to reduce your body’s exposure to toxic chemicals you would be better off monitoring your daily intake of sugar, salt, or artificial sweeteners. But that is a blog entry for another day. 😉

All of that said, recommendations are merely that. In medicine, we base our advice on the science of statistics. What we recommend IN GENERAL will offer protection against bad outcomes in the population. But each person needs to make a well-informed decision for his- or herself about what advice they will follow or decline. It is my goal to ensure that the decision you make rests on a foundation of solid information. In all cases, my wish for you as a reader is that you STAY WELL this cold-and-flu season!

Oh, and feel free to check out the latest post from the CDC on flu as well:

https://www.cdc.gov/flu/season/faq-flu-season-2019-2020.htm

August 29, 2019September 13, 2019

The Secret to Longevity is Pliability – and change is on the horizon

Despite having grown up in New York, I am a proud and mildly obnoxious fan of the New England Patriots and the intensely competitive while ever-classy Tom Brady. I mean, what can we say: they’re awesome, no matter what you throw at them. Kinda makes you want to emulate their habits.

My favorite lesson from my favorite Quarterback is one I’m not sure I’ve heard him say in so many words, but it is the title of this post. Any fans who are paying attention will be aware that TB12’s new key word is “pliability.” In other words: flexibility, the capacity to adjust and adapt. As he keeps demonstrating through victories that defy age, the Fountain of Youth for athletes is not a rock-hard exterior, ironclad power, or even talents like speed or agility. No, indeed: remaining competitive with young guns is all about rolling with the tide even when it comes after you like a tsunami.

I have come to two conclusions of my own based on this concept:

There is always and only one standard worth achieving: BETTER.
No matter how much or how little improvement has been accomplished, there is never a ceiling to how much further improvement can be achieved, and there is also no reason to dwell on shortfalls compared to an idealized goal. As long as the average trajectory on any path moves upward –even if it moves down a little before moving up a little more– I believe it is safe to call it “the right track.”
Pain is only relevant to the extent that it points to danger. Once danger is eliminated from the equation, pain that is endured rather than eliminated leads to strength.
Discomfort of any sort tends to lead to a hard stop for many, if not most, people who were otherwise on a journey towards personal betterment. I’m going to call it a fortunate circumstance for myself to have grown accustomed to pain, depression and anxiety through various circumstances in life… fortunate, because despite some hard hits, I’m still here. That simple fact opened up an opportunity to understand that even some unthinkable horrors thus far have not stopped me, until I came to a point of realizing I can CHOOSE to not be stopped, regardless of painful circumstances.

I’ve learned this mostly from my new experiences with athletic performance doing CrossFit. As long as the pain doesn’t point to some hidden threat, or as long as any potential threats are mitigated expeditiously (e.g., ice is applied immediately to a muscle or tendon strain), I keep on coming out stronger and stronger… more flexible… more capable… in spite of subjecting myself to the transient pain of the workouts. Upon reaching this epiphany, I began to push myself harder, then developed acumen at understanding the limits beyond which I should not push lest I risk danger of injury, then rapidly identified the limits so as to practice nudging just a little more with each workout…

Then my new epiphany was that I can do this in other areas of my life. Mental and emotional discomfort became the new frontiers of limit-testing. Until they have become the new frontiers of emboldening strength and endurance.

The ability to change when faced with challenges is the Secret to Longevity… The Fountain of Youth, if you will.

Well, change is on the horizon at Thrive Adult Primary Care.

First: a new website is under construction. Please click here to check out our new Home Page.

Second: starting on October 1, 2019, we will be accepting Medicare! This will continue to be the only health plan through whom we will process third-party payment for the foreseeable future. This will mean lots of different things to different patients who carry Medicare plans, but for our active member patients whose insurance does not involve Medicare at all, NO CHANGES will be made to the current Direct Primary Care (DPC) memberships. More info will be shared in the weeks to come.

Third: our DPC pricing plans will also change significantly starting October 1, 2019. Once the rate schedule is finalized, information will be posted. But our current published rates will only be valid through September 30, 2019. So if you’d like to take advantage, contact us soon!