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I get asked how I became a physician-scientist, entrepreneur, Ironman triathlete, podcaster, and ranch/inn owner. Short answer: I didn’t plan most of it. Looking back, five lessons kept showing up—sometimes by design, sometimes by accident. Use them as a framework, then try the short exercises to make each lesson your own.

1) Ask for Advice—Then Trust Yourself

In college I was torn between medicine and business. I asked my father—an excellent physician—and he told me to choose one-he felt that it was one vs the other. I chose medicine…and then ultimately spent decades at the intersection of clinical evidence and health economics, co-founding companies designed for the win-win-win: patient, clinician, payer. He wasn’t “wrong”; he was advising from his vantage point. Your gut includes data others don’t have—your curiosity, risk tolerance, energy, and values. Seek counsel widely, and then own the final call.

Do this:

• Write the decision you’re wrestling with at the top of a page.
• List the best arguments you’ve heard for and against each option (no more than three per side).
• Now, in one sentence, capture what your gut is telling you and why. Circle it. That’s your provisional decision. Put a date next to it and commit to the next tiny action that tests it this week.

2) Know Your Superpower—and Your Kryptonite

Medical training clarified that I love caring for individuals, but I’m most alive solving systems problems—how to deliver evidence-based care at scale. During my PhD I pushed to meet the dissertation requirement through peer-reviewed publications instead of a door-stop tome—faster impact, same rigor. My superpowers: cutting a clean path from A to B and translating complexity so non-experts can act. My kryptonite: day-to-day people management. Not my strong suit. Life accelerated when I built teams that complemented me. Same at the ranch: I handle function and systems; Gail, our “Chief Beauty Officer,” makes it beautiful!

Do this:

• Make two honest columns: What I reliably do well and What drains me / I’m not good at.
• For each “not good at,” write the name of a person or resource that could cover it (a colleague, contractor, tool, or process).
• Choose one task to delegate, outsource, or stop this month. Use the saved time for something squarely in your superpower.

3) Start with the Big Picture, Then Work Backwards in Small Steps

In my twenties I noticed two traits that made men look older than they were: big bellies and small arms. Crude observation, but it sparked action. I began daily core and arm work to avoid a future I didn’t want. That snowballed to running, then cycling, then swimming—ultimately four full Ironmans and 15 70.3s. Today, at 69, the target shifted: durability over speed, strength for ranch life, and arriving at every start line healthy. The formula hasn’t changed—see the big picture, then reverse-engineer tiny, repeatable behaviors.

Do this:

• Define the 10-year picture in one sentence (health, work, relationships, or lifestyle).
• Ask, “What would be obviously true of someone living that picture?” List three behaviors.
• Shrink one behavior into a 10-minute daily version (e.g., core routine, walk, outreach note). Track it for seven days. Adjust, then repeat.

4) When You Don’t Have a Vision, Take the Next Best Step

Not everything needs a master plan. We bought Texas land for a weekend escape. Then the world shut down, we moved out full-time, built a lodge, cut trails, added exotic animals, and eventually opened a bed and breakfast-Madrone Springs Ranch. There was no ten-year roadmap—just a string of sensible next steps guided by curiosity. Sometimes a telescope is useful; other times, a flashlight is enough.

Do this:

• Identify one “someday” curiosity you keep parking because you can’t see the end (learn a skill, start a project, explore a place).
• Define the smallest irreversible step that would move it from idea to motion (one class signup, one email, one hour of tinkering, one site visit).
• Schedule that step in the next seven days. After you do it, ask: “What’s the next best step?” Repeat.

5) Build Around What You’re Actually Good At

My podcast, Live Long and Well, is where both modes converge. Each week I see wellness claims outrun the evidence. My lane is translating rigorous research into clear, agenda-free guidance. I’m not the best researcher, fastest triathlete, or most charismatic host—but I am relentless about synthesis, clarity, and usefulness. That same mix powered the healthcare companies I helped build: align science and incentives so people can make better choices. You’ll go farther by doubling down on strengths and partnering for the rest.

Do this:

• Audit your week. For each recurring task, mark + if it uses your superpower, – if it doesn’t.
• Choose one – task to eliminate, automate, or delegate in the next two weeks.
• Choose one + activity to expand by 60–90 minutes weekly (protect it on your calendar). Revisit the audit monthly.

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Bringing it together

The five lessons aren’t contradictory; they’re complementary. When you have a clear vision, work backward into small, consistent steps. When you don’t, take the next sensible step and let the path reveal itself. All along, know your strengths, own your gaps, and trust the data your gut is giving you. You don’t need a 30-year blueprint—you need one honest incremental step and one doable action. Progress beats perfection, every time.