"Would like to do" vs "Have to do"


'Tis the season [originally published right after Christmas]...and what I mean is that it's time to cue the barrage of articles telling you how to set yearly goals and how to go about achieving them.

How many of them do you actually read? Maybe you peruse them just to play a little mental "bingo" for what they likely contain, like the notion of making "SMART" goals or telling others about your goal so that you'll be held accountable. Yawn.

In my experience, there's really only one criterion that determines whether or not I accomplish a task or goal: is it something I would like to do or something I have to do?

I would like to read more, exercise more, and take more (any) vacations, But I have to get the furnace serviced, fix the roof, and take the care in to get that rattling sound checked out. Which ones do you think are more likely to actually happen?

Here’s the thing: although the items on the “have to” list are urgent, they are all focused on the short-term and aimed at avoiding further damage and cost, while the items on my “like to” list are all about my long-term health and growth (I will submit that taking a vacation is about both). Accomplishing tasks on my “like to” list will have a bigger impact on my well-being down the road than the “have to” tasks, but the lack of immediate urgency somehow reduces their priority. This idea of time-inconsistent preferences is well-known and well-studied. And, all those goal-setting articles and exercises that are appearing in your feed are really just trying to help you shift priorities and assign more of the "have to" vibe to the tasks that will elevate your long-term health and growth. The fact that there are so many methods and approaches to re-prioritizing these tasks is evidence of just how hard it is to accomplish. And, as difficult as it is to do in our own lives, it's often even harder to do at work...

In the healthcare arena, the “have to” items we face every day are in regards to regulations, administrative duties, and contract deliverables, while the “like to” items look like this (depending on what you are):

For QI Orgs: “We would like to be the type of organization that has the specialized knowledge to be able to go after [specific types of] contracts.”

For individual physicians: “I’d like to become known for research in [a specific clinical area] to help build my career and increase my chances of funding in the years to come.”

For larger health systems: “We’d like to promote our institution so that it is recognized as a leader in [a specific method or topic].”

Just like in my personal example, in these examples the “like to” items are about the bigger picture and longer-term vision of what these individuals and groups would like to become. They would improve the long-term health and growth of the organization or individual and often reflect core beliefs and values of those who aspire to them. It’s rare to be able to aspire to what we’d like to become just by doing what we have to.

Ironically, it’s often the case that it’s only a matter of time before those “like to” items become “have to” items or - even worse - “wish we had” items. And, once that happens it’s often too late to do anything about it: after the RFP is released it’s too late for the QI organization to develop a necessary skill (tell me if this sounds familiar: “Oh, shoot…who are we going to find to write that part of the proposal that demonstrates knowledge and experience in that specialized area?”); once the physician is already writing the grant application it’s too late to publish the paper he or she would love to cite as a reference.

You’ll notice that those “like to” items don’t include the specifics of how they’ll happen. They don’t need to - if you know where you’d like to go, chances are there is someone out there who can help figure out how to get you there. That’s the great thing about “like to” items: they typically don’t have all of the requirements and restrictions around them that “have to” items do, so you can get creative about how they get done, and by whom.

As your organization is making your list of goals for the new year, what are the things you can add as “like to” items, and how will investing in them this year will pay dividends down the road?