Trying to Decide if You Want to be a Physician Assistant?
Imagine a "hypothetical" student, Steve, who has decided to go to physician assistant school. What makes him think that’s a good option?
Well, he spent months toying with other possibilities —medical school and even law school— and he eventually decided PA school was the best fit.
He’s always enjoyed chemistry, after all, and he likes the idea of working in health care. He feels like the lifestyle of a physician assistant, with its semi reasonable hours and good pay, would suit him well.
This is pretty thin evidence for such an important decision!
Steve (maybe like yourself) is contemplating a minimum time commitment of two years for graduate school, not to mention tens of thousands of dollars in tuition and forgone income.
He’s placing a huge bet on paltry information!
Big, Costly, Expensive, Life Altering Decisions
In 2006 , John Hanks, a vice president at National Instruments (NI), a company that makes scientific equipment, was deciding whether to make a big bet on wireless sensors.
The technology had a lot of promise: A wireless sensor might be installed in a coal mine, in lieu of a canary, to monitor methane levels. Or sensors could send information back from a rotating piece of equipment, like an oil drill head, where a wired solution would be impractical.
Some of NI’s customers were skeptical. Could you secure the data? How reliable would the sensors be in tough environments?
Hanks didn't feel like he had enough information to make a wise decision.
What he needed to do, he realized, was OOCH!
To "ooch" is to construct small experiments to test one’s hypothesis. (The word “ooch” does not come from National Instruments, but apparently it’s common in parts of the South. Maybe it’s a blend of “inch” and “scoot”?)
Hanks said, “Part of the culture here is to ask ourselves, ‘How do we ooch into this?’ We always ooch before we leap.”
Hanks went looking for a good pilot customer to test his assumptions — someone he could learn from, someone who had complicated technical needs.
When he met Bill Kaiser, he knew he had the right guy. Kaiser, an electrical-engineering professor at UCLA, was working with some biologists to develop wireless sensors to be installed in the jungles of Costa Rica.
The mission of their project was to understand the flux of carbon dioxide (CO 2) in a jungle. To make those measurements the NI team faced a demanding set of challenges:
- The sensors would have to be installed throughout the jungle.
- They’d need to be battery powered (since outlets are rare in jungles).
- They’d need to be resistant to the elements.
- They’d need to take accurate measurements and send them reliably.
In trying to meet the biologists’ needs, Hanks’s team didn't bother building an elegant, expensive product.
Instead, they cobbled together a prototype using what they had on hand.
The UCLA biologists wanted to measure CO2 levels at different heights in the jungle, so the NI team helped them rig up zip lines between trees. The buckets slid along these cables, powered robotically, taking measurements as they moved. “It was like the ESPN football sports cam for the Costa Rican jungle,” said Hanks.
The project gave Hanks a crash course in what it would take to serve a cutting-edge customer with sophisticated needs. If the sensors could work for the demanding UCLA project in the jungles of Costa Rica, then they could probably work anywhere.
The ooch boosted Hanks’s faith in the technology, and after a few more experiments, he was ready to stop ooching and start leaping.
He gained approval to begin developing wireless sensors, a multiyear project that he estimated would require an investment of $ 2– 3 million.
The experiments had allowed him to confirm his intuition about wireless sensors, and now he could proceed with greater confidence.
Rather than jump headfirst into the wireless market, Hanks and his colleagues decided to dip a toe in.
Rather than choose “all” or “nothing,” they chose “a little something.” That strategy— finding a way to ooch before we leap— is a wonderful way we can reality-test our assumptions.
When we ooch, we bring real-world experience into our decision!
So What About Steve our Prospective PA?
This is a situation that cries out for an ooch!
An obvious one would be to work in a hospital, clinic, nursing home or anywhere else he can find real life, "in the trenches" healthcare experience.
He’d be smart to work in proximity of a Physician Assistant, Physical Therapist, MD, Nurse, Nurse Practitioner, CNA, Paramedic, EMT, Radiology Technician, Phlebotomist etc. etc.
He would be smart to work for free, if need be, to get the job. (Certainly if he can afford several years of school without an income, he can afford to take a month long unpaid internship.)
Surely this concept— testing a profession before entering it— sounds obvious. Yet every year hordes of students enroll in graduate schools without ever having run an experiment like that:
- Law students who've never spent a day in a law office.
- Med students who've never spent time in a hospital or clinic.
Imagine going to school for three or four years so you can start a career that never suited you!
This is a truly terrible decision process, in the same league as an impromptu drunken marriage in Vegas . (Though maybe that’s unfair to Vegas, since a hungover annulment might be preferable to a hundred grand in student debt.)
Stop the Insanity!
To correct this insanity, the leaders of many graduate schools of physical therapy have begun forcing students to ooch. The same is true for most PA schools.
Hunter College at the City University of New York, for instance, does not admit students unless they have spent at least a hundred hours observing physical therapists at work.
That way, all incoming students are guaranteed a basic understanding of the profession they’re preparing to enter.
Ooching is a diagnostic, then, a way to reality-test your perceptions. If you think the wireless-sensor market is promising, try it first.
If you think you want to be a Physician Assistant, try it first - In any capacity that is humanly possible.
Ooching for Anxiety? A Special Situation
The strategy is useful even for more subtle situations. Some therapists, for instance, have begun using a cousin of ooching to help people reduce anxieties about decisions in their personal and work lives.
The therapists Matthew McKay, Martha Davis, and Patrick Fanning wrote about the case of Peggy, “a perfectionist legal secretary” who was terrified of making mistakes on the senior partner’s documents. She would spend hours hunting for and correcting mistakes. Then she’d worry that her corrections might have inadvertently created other mistakes, so she’d start the review over again. After a long day at work, she’d take the documents home, spending hours trying to make them flawless.
It was inconceivable to Peggy that she could proof a document only once and be satisfied with her work. The stakes seemed too high. So, in conjunction with her therapists, she created a list of ooches— small, incremental steps that would allow her to reality-test her fears— to see whether the sky would really fall if she eased up on her proofing regimen. If she survived one ooch, she’d move on to the next. Here was the sequence she mapped out:
- Take brief home and do three extra passes through it.
- Take brief home and do two extra passes.
- Take brief home and do one extra pass.
- Stay up to one hour late and leave brief at work. No extra pass.
- Leave brief at work and go home on time. No extra pass.
At each stage, she experienced intense anxiety, worrying about the dire consequences of her decision for the firm and her own job tenure. But after she completed each stage, she was surprised to discover that things worked out fine, which gave her just enough confidence to attempt the next one. Once she had completed stage five, she really pushed her comfort level:
- Deliberately leave one punctuation error in brief.
- Deliberately leave one grammatical error.
- Deliberately leave one spelling error.
According to her therapists, Peggy “found that making small mistakes didn’t cause the firm to lose cases, and also didn’t get her fired. Nobody even noticed the errors.”
She eventually eased her way into an editing routine that was strict but not obsessive. She’d ooched her way into making bolder decisions.
OVER THE PAST SEVERAL years, the notion of exploring options with small experiments has popped up in many different places .
Designers talk about “prototyping”; rather than spending six months planning the perfect product, they’ll just hack together a quick mock-up and get it in the hands of potential customers.
That real-world interaction sparks insights that lead to the next prototype and the design improves in an iterative fashion.
Meanwhile, health-care leaders advise using “small tests of change”: piloting new processes or innovations on a small scale to see if they yield measurable results.
For business executives, Jim Collins and Morten Hansen advocate a strategy they call “firing bullets then cannonballs,” that is, running small experiments and then doubling down on the ones that work best. (This mirrors National Instruments’ “ooch then leap.”) Finally, for a book-length treatment of the ooching philosophy, see Peter Sims’s book Little Bets.
The “ooching” terminology is my favorite, but we wanted to be clear that these groups are all basically saying the same thing:
Dip a Toe in Before you Plunge in Headfirst
Given the popularity of this concept, and given the clear payoff involved— little bets that can improve large decisions— you might wonder why ooching isn't more instinctive.
The answer is that we tend to be awfully confident about our ability to predict the future.
Steve, the budding PA student, doesn't perceive himself to be in a state of confusion.
Why would he waste his time getting a free internship when he knows Physician Assistant is for him? (If he drops out after a year, he’ll say, “It just wasn't for me,” as if that were something he could never have anticipated.)
In the design world, the diva product designer just knows, in his gut, that the product is right.
The idea of a “quick and dirty prototype” just makes him roll his eyes.
You don’t prototype elegance?
LET THY GUT BE THY GUIDE?
That diva- ish, “I just know in my gut” attitude is inside all of us. We won’t want to bother with ooching, because we think we know how things will unfold.
And to be fair, if we truly are good at predicting the future, then ooching is indeed a waste of time.
So the key question is: How good are you at prediction?
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Wait, I cannot fathom it being so stiraghtfoawrrd.
Wait, it never is 🙂