When we think about being successful at work, we all know that it takes a lot of hard work. But even with that work, success is elusive. That’s because we don’t have a good sense of what it means to be truly great at a job, even for seemingly obvious jobs, like being a doctor. I provide a simple framework on how you can be the best at any job.
“What would you do if I punched you in the face right now?”
That’s the question that Mark Craney, former Operating Partner at Andreessen Horowitz, says is the best sales interview question he’s ever received.
“What!?” you might say, as Ben Horowitz did when retelling the story in his book What You Do Is Who You Are. Horowitz continued by asking Cranney, “He wanted to know what you would do if he punched you in the face? That’s crazy. What did you say??”
“I asked him, ‘Are you testing my intelligence or my courage?’ And the interviewer said, ‘Both.’ So I said, ‘Well, you’d better knock me out.’ He said, ‘You’re hired.’ Right then I knew that I’d found a home.?
I would never ask a salesperson this question. I ask questions like, “How would you convince our customer to buy this product?” or “What are the key customer needs that you’d hit on to engage our customers.” But I’m not a salesperson, I’m a product person. When I read this exchange, I realized that salespeople (at least some salespeople) are looking for different things—different qualities than I consider. This question highlighted Craney’s competitiveness as well as his ability to understand why a question was asked, even under immense stress.
Even though I have some favorite interview questions, they’re not necessarily “the best” interview questions. Salespeople and product people have different definitions of what it means to be the best and everything needs to be thought of in that context.
For every job, there are two things that are key: core competence and value add:
- Core Competence: These are the key things you need to be good at your job. As a doctor, it’s about knowing how to treat disease. As a security guard, it’s about keeping people safe. It’s a limited set of tasks that needs to be done at a strong level of competency. While doing them poorly makes someone bad at the job, doing them well doesn’t make someone great.(1)Atul Gawande writes about the importance of the basics in The Checklist Manifesto.
- Value Add: This is how someone becomes great at their job. Once people achieve core competence, they need to focus on how they can provide the most value to their customers. Often these tasks fall outside the traditional job description. For example, the best security guard isn’t the strongest and most powerful person in the world, it’s a powerful person who is also friendly and respectful and makes people feel safe.
In high school, I was good at math. Actually, in the words of Mike from Dollar Shave Club, I wasn’t good at high school math, I was f***ing great. I was on the math team. I scored 7th in the Nassau County math championships in middle school—in a county bigger than the state of Rhode Island.
Then there was my friend Richard. Richard was good at math but not as good as I was. He wasn’t on the math team. But he would consistently outscore me in AP Calculus class. I’d get something like a 95. I knew the material but I’d make stupid mistakes. He would beat me with a score of 99 or 100. Getting 100% on a calculus test isn’t about who can solve the hardest problems, it’s about who can solve the problems on the test with the fewest errors.
Richard graduated college and became a doctor. He’s a very good doctor. He is rock solid on the basics. While you’d think this would be true of all doctors, it’s not. To become a licensed physician in the US, all doctors must pass the United States Medical Licensing Examination. Doctors should know this stuff cold, so I thought they’d need a 90% or so to pass. Surprisingly, a passing grade is about 70%. That’s for people right out of med school, having spent years learning this stuff and studying their butts off.
Knowing this core material well is key to being a good doctor. A few years ago I had a palsy on the side of my face. Richard showed me the latest material from the American Academy of Neurology (AAN), which says that steroids are a good treatment but there is no evidence that anti-virals help. The Academy recommends that anti-virals NOT be prescribed. But Richard isn’t in my state and not a specialist. So I go to a local neurologist who said, “You should take steroids and anti-virals.” Then he continued to bloviate, “In my experience, I’ve found that anti-virals are very helpful in treating the disease.” There is no way that this is true! He is just spouting old and outdated research and hasn’t been keeping up with his reading. He was the epitome of the arrogant misinformed doctor.
So what makes a great doctor? Is it just about knowing the best treatments? For a surgeon, it should be even simpler—just cut the thing out better than anyone else in the world. But while that will make a very good surgeon, being a great surgeon is harder.
Being a great surgeon is about more than being great with a knife. In his book Being Mortal, Atul Gawande told the story of a patient he calls Joseph Lazaroff. Lazeroff is in his sixties and suffering from incurable prostate cancer. His lower body was filling with fluid and he’d recently woken up with a paralyzed leg. There were only two options: surgery and comfort care. Even with the surgery, Lazaroff only had a few months to live. The surgery wouldn’t cure him of the disease or even reverse the paralysis. The purpose was just to keep the paralysis from getting worse. It was a was very risky operation with serious complications including death. But Lazaroff pleaded to Gawande, “Don’t you give up on me. You give me every chance I’ve got.”
Gawande, a surgical resident at the time, abided by the patient’s wishes as he signed the consent form. In an intricate operation, the surgeon removed the tumor around his spine that would lead to further paralysis. The operation was a success. However, Lazaroff died within two weeks from complications. Gawande now realizes that surgery was the wrong decision.
The purpose of medicine isn’t a fight against death, it’s a way of providing the best life for people. Paul Kalanithi writes about this in his book When Breath Becomes Air. Kalanithi was a promising young neurosurgeon when he was diagnosed with pancreatic cancer in his mid 30s. He wrote of the difficult process of determining how to wring the best moments out of a fading life. He asks questions about what makes life worth living:
Would you trade your ability—or your mother’s—to talk for a few extra months of mute life? The expansion of your visual blind spot in exchange for eliminating the small possibility of a fatal brain hemorrhage? Your right hand’s function to stop seizures?Kalanithi, Paul. When Breath Becomes Air (p. 71).
These are the conversations that great doctors have with their patients. At these critical junctures, it’s important for doctors and patients to define what it means to truly live rather than just stay alive. When patients are signing their consent to a procedure, it should be more than a pro forma listing of side effects like you’d see at the end of a pharmaceutical commercial.(2)Kalanithi discusses the importance of these conversations in When Breath Becomes Air and it’s also a key part of Kalanithi’s Op-Ed How Long Have I Got Left?
What If It’s Not Life and Death
Let’s go back to Richard. How does he help people live their best lives? He goes beyond just treating his patients’ symptoms to help them lead better lives. Here’s the best advice he gave me. If a doctor says, “I’m not sure what’s wrong with you but I’m going to send you for a number of tests, you should buy life insurance right away. Once you go for all these tests they might find something really bad. After that, it may be very expensive or impossible to buy life insurance and that’s exactly the time you’d need it most.”
In every job, in order to do it exceptionally well, you’ll to focus on the greater goals of your customers. Let’s look at a less intense job than a doctor: New York City doorman. There’s a hierarchy of doormen based on seniority. In order to be a daytime doorman, you need to be at the building for years, with the new guy getting the overnight shift. When a new doorman starts on the night shift, he thinks, “This job is crazy. I need to avoid falling asleep in the middle of the night and keep the building safe.” While he’s right, he also needs to greet people when they enter the building.(3)The head of security for a private police force told me that the most important thing he looked for was the ability to recognize members of the community and make them feel at home. So the hardest thing about the job is putting a smile on your face to greet people after you’ve stayed up the whole night.(4)Smiles are important in many service jobs. I was once sitting at a McDonald’s when people were getting feedback from management. The manager said, “You do a great job but you need to smile more,” which seemed silly at the time but showed how important the added value was to the company.
In any job, you need to be able to define the core competencies of the job. You need to focus on that small set of tasks and do them well. But being better at the core competencies doesn’t make you excellent at your job. In order to be excellent, you need to think about the bigger picture about what value the job adds to the customer. Then focus on those tasks that will make the biggest difference.
In my book, I end each chapter with questions on how to apply these lessons in your everyday life. Here are some things that you can do to “Be Best” at your job:
- What are the core competencies you need for the job? This is likely a small set of things that you need to do well. Focus on doing these things really well, even when tempted to do things more interesting for you.
- Beyond the core competencies, what is the goal of the job? Remember that you don’t get to define the goal. Just because you think that something is interesting or that you’re good at it, doesn’t mean that it’s important.
- What is the small set of value-added activities that will really make a difference to your customers? Often these are soft skills that aren’t part of the job description.
|↑1||Atul Gawande writes about the importance of the basics in The Checklist Manifesto.|
|↑2||Kalanithi discusses the importance of these conversations in When Breath Becomes Air and it’s also a key part of Kalanithi’s Op-Ed How Long Have I Got Left?|
|↑3||The head of security for a private police force told me that the most important thing he looked for was the ability to recognize members of the community and make them feel at home.|
|↑4||Smiles are important in many service jobs. I was once sitting at a McDonald’s when people were getting feedback from management. The manager said, “You do a great job but you need to smile more,” which seemed silly at the time but showed how important the added value was to the company.|