Issue link: https://beckershealthcare.uberflip.com/i/568709
80 THOUGHT LEADERSHIP Physicians Administrators Stop bad behavior A medical license is not a license to abuse colleagues or subordinates. Administra- tors, nursing leaders and others spend too much time on poor physician behavior, which runs the gamut of yelling at people, bullying house staff, not following up and not responding to colleagues up to outright verbal and physical abuse. Such behavior is never OK and we have to stop it. Be inclusive I visited a surgical leadership team that was bemoaning the lack of physician support for their decisions. They described how they prepare for the meeting so as not to "waste the doctors' time." They also held the meetings in the mid-morning. The process was flawed. Mid-morning meetings are bad for surgeons who start operating at the crack of dawn. And "prepare for the meeting" was code for how the real discussions were taking place without the physicians present. That is not inclu- siveness. If you want physician support for key decisions, include them in the real decision-making. Do not just ask them to validate decisions that have already been made. Practice humility Physicians are not always right. We believe we know a little bit about everything, but this does not make us an expert in every- thing. Our nonclinical colleagues working in finance, marketing and other operational areas are intelligent and highly accom- plished professionals. They are necessary for our businesses to run successfully and they deserve the same respect we seek for ourselves. We have to accept that we are not always the smartest person in the room, and we must also understand our own emotional intelligence. Recognize the need for symbi- osis I like the phrase, "We are partners." In medicine, working together for patient care is essential. A colleague once told me that physicians are the engines of medicine. I agreed, but added that planes can't fly without wings. It takes a lot of professionals to deliver patient care. Recognizing the need for the tandem roles of physicians and administrators is necessary to balance the mission of providing quality patient care and maintaining the health of the business. Lead by example Not having a title doesn't mean physicians are not held in high esteem by other healthcare workers. They are! People look up to physicians for guidance and advice, and closely follow their actions. Knowing that our nonclinical colleagues may hesi- tate to challenge us because of the respect they hold for physicians means we have to be that much more self-aware to avoid taking advantage of the power differential to get what we want. Fix op- erational issues Administrators have the power to fix opera- tional problems — many of which adversely impact the physician work environment. Listen to what physicians say and try to offer solutions. Improving the operational environment will improve physician pro- ductivity and satisfaction. Beware of trigger issues Poor communication and a lot of change in an organization can have dramatic emo- tional consequences on physicians. In such an environment, even small changes can have a big effect. At Cleveland Clinic, when leadership decided to make a change to the physician health plan to create parity with the employee health plan — the major difference was a $35 copay for specialty care paid by employees by not physicians — physicians were furious. In reality, the physicians were not really angry about the copay. The health plan change was the trigger issue for discontent stemming from poor communication that had built up for a long time. Before executing some- thing new, understand the mood of your physicians and the effect the change will have relative to other recent changes, and ensure that appropriate consultation and communication takes place. vidual strengths and expertise. In so doing, the matrix can help us better man- age together and ultimately deliver better healthcare to our patients. Building the matrix, block by block Having been a hospital trustee, C-suite leader, private practi- tioner, employed physician and patient, my career has afforded me a tremendous 360-degree view of health care operations to inform a bal- anced matrix that delineates the responsibilities of physicians and administrators. e items in this matrix are meant to be a starting point to identify some of the difficult issues we oen don't talk about. e list is not comprehensive or definitive, and there are certainly overlapping areas of responsibil- ity. However, working through it and adding items that make sense for individual organization can help hospital leaders, administra- tors and physicians nurture em- pathy for each other and develop a clearer understanding of each other's roles, all with an eye for achieving better team work and, ultimately, better patient care. By calling out some of the proverbial "elephants in the room," such as our reluctance to address physi- cian bad behavior, a respon- sibility matrix is a good way to create candid, transparent dialogue that allows physi- cians and administrators to work on problems together, without acrimony. If we better understand each oth- er's roles and perspectives — in a sense, if we develop empathy for each other — our ability to function as high-performing teams to serve our patients will be greatly enhanced. n