Tag Archives: leadership in medicine

The Bat-Phone and Leader Presence

Recently I had the opportunity to speak to the mother of an infant hospitalized with respiratory illness in a hospital in another state. She was the daughter of a friend of a relative but it was a joy to speak to her, talk through some of her concerns and reassure her that from what she was telling me, she was in good hands. (Her baby did well!)

In the course of the conversation, I remembered that I knew a senior physician at the hospital and I send him a quick text. By the time I caught up with him a little while later, he had already been to the patient’s room. He missed the baby’s mother but left his card with his cell-phone number in case she needed anything.

His generous gesture reminded me of the “Bat-Phone” we instituted when I was a hospital CEO (Commander) a decade or so ago. I am relatively sure that I stole the idea from Quint Studer or another of the quality and patient experience gurus to whom we owe so much of the great things we were able to do at that facility while we were shaping a “Culture of Excellence.” We shared the Bat-Phone cell phone number with all of our staff, our hospitalized and ambulatory patients – probably thousands of people. I carried the phone with me every day. It was a visible symbol of our efforts to be accessible to our staff and patients. In addition to the phone number, we also had a link on our public and internal websites where people could reach out to the CEO by email directly. Continue reading

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Filed under General Leadership, Personal Leadership, Uncategorized

“Of course!”

 

A PICU nurse said that to me recently. We had just finished doffing and were walking out of the hot zone transition area of the Convention Center COVID field hospital where we worked. We struck up a conversation and at the end of our exchange I thanked her for serving these patients with us. “Of course!” was her reply.

I think I have heard that response more often these days. Perhaps it is cultural or generational (millennial?). Or maybe it’s just a new colloquialism characteristic of the times. I can’t recall whether it was as common before COVID as it seems to be now. But maybe I should just blame that on “COVID time.” (It seems I can’t remember a lot of things from before COVID.)

In the case of this nurse the “Of course!” took on special meaning. We talked about our shared experience working in pediatric intensive care and the special calling it takes to be a nurse in that setting. She told me that she loved taking care of critically ill children, but when this contingency COVID hospital was established she wanted to be a part of it. The unit where she worked couldn’t allow her go to part-time, so she resigned. And she has been a part of caring for the more than 1,300 adults with COVID we have admitted in our past year or so of operation.

She left something she loved to be part of something she felt needed to be done.

In his mid-twentieth science fiction novel “Starship Troopers” (Putnam 1959), Robert Heinlein wrote “Duty is the social equivalent of self-interest.” It is “the basis of all morality.” It strikes me that duty was not something we heard as much about before the pandemic. Attention and devotion to duty seem to be common virtues now. Continue reading

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A source of medical leader ineffectiveness?

Some of the same skills that make physicians, nurses, medical administrators and allied health professionals excel in our clinical roles can potentially hinder our effectiveness as leaders. If the process of recognizing these risks were automatic we wouldn’t need to think about it. And there would be an even greater number of effective healthcare leaders.

Unfortunately, every group I speak with can quickly relate stories of a bad leader or two. While bad leadership may be common, I contend that intentionally bad leadership is rare. People don’t get up in the morning, and while shaving or brushing their hair, look in the mirror and say, “Today I will be a bad leader.  I will mismanage and mess with someone’s career…” That should be sobering for us, however well-intentioned we may be. In the spirit of continual reflection and renewal, it’s worth examining three strengths we develop in the study and practice of healthcare that can sometimes be leadership liabilities.

Talented tacticians.
Healthcare is inherently tactical.  We learn the craft of medicine one patient at a time: one exam room, one hospital bed, one operating room.  It is a pattern reinforced through decades of training during the crucial years of adult development. After training, daily practice is a series of independent encounters in the ambulatory or inpatient arenas.  The rules of patient privacy necessitate our forgetting the last patient as we move onto the next.  Sometimes we may not think about them again until the lab or consult comes back, or we see them in follow-up.  There is little time or expectation for the awareness necessary to string together patterns of patient problems or behaviors, or for us to think about the larger, strategic implications of our medical practice.  The way of thinking may spill over into our personal lives where our best intentions to be the people/partners/parents we know we should be become lost in the tyranny of day-to-day “tactical” execution (drive the kids, take out the trash, finish the lawn etc). Continue reading

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Filed under Organizational Leadership, Personal Leadership