My favorite part of a recent podcast with James Clear, author of Atomic Habits (Avery, 2018), was the last five minutes, when he talked about a potential downside of good habits. When we decide to improve and create a new practice with the right cues and rewards, we form a new habit. But habits can put us on autopilot, and if we’re not careful, we can stop improving or even regress.

This is why surgeons’ effectiveness can peak four or five years after they start practicing—unless they actively try to improve their craft, and why “number of surgeries” may not be a metric that correlates to quality of outcome. James Clear suggests that deliberate reflection is critical to loop back to learning to create further improvement, which can then lead to mastery.

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