In no other field is unity and collaboration between administrators and frontline staff more important than in health care. Unfortunately my own experience is that the disconnect and mistrust, especially from doctors and nurses, towards hospital administration is growing larger all the time.
Let me start off by saying that I have intimate experience of both sides of the divide. Obviously as a physician first and foremost, my loyalty is usually with “my own people” (as it should be). It took years to become a doctor, I consider it an honor to be one, and I enjoy my job. I’ve been fortunate enough to work with some very good administrators, but along the way I’ve also met some who leave a lot to be desired.
I’m going to try to take an objective view here. The biggest shortcoming of the worst ones — and by “worst” I mean the ones who fail to grasp what frontline medicine is all about — is that they seem to view health care as all about numbers and statistics. These administrators obsess over the figures, go over patients’ health statistics and metrics as if they were browsing over a shopping list, and fail to properly understand the reasons why barriers exist to achieving what they want. Most importantly, their focus on numbers comes way ahead of any concern or perception about the realities of the coalface. This applies almost exclusively of course to the “non-clinical” administrators. At this point, one could make the argument that the job of any administrator is to make sure the organization is intact and numbers balance. True to an extent.
But if you look around at the best and most successful companies out there — whether it be Apple or Wegmans — companies with stellar reputations and generally high customer satisfaction, you will notice that the leaders of these companies are just as focused on the end-user experience as they are on any numbers. Yes, their companies make a lot of money, but they also consider the customer experience to be the crucial part of the service they provide.
Furthermore, these organizations are known for treating their workers well and making sure conditions are first rate. In other words, they understand what the real deal is. My advice for all health care administrators is to do the same, and then some. When you see a number or statistic in health care, remember that this is a real person on the line. Their visit to the hospital was quite possibly the lowest point in their life for both them and their family. It may have changed them profoundly and they will vividly remember everything that happened. When you are looking at their length of stay, discharge time or hospital bill — always keep this in mind.
The best health care administrators I’ve seen have been the ones who have regularly “walked the factory floors,” gaining an understanding of what their frontlines are all about — talking to patients, doctors and nurses. This in addition to solid organizational skills and business acumen. There’s a common misconception that it has to be a choice between these two: connecting versus being a numbers person. It’s perfectly possible to balance.
As a reader of many autobiographies of famous people, this is a trait of many great leaders. I once worked with a hospital CEO in Florida, albeit in a smaller hospital, who could frequently be seen roaming around the medical units, heartily greeting people and chatting to them. He even put his personal cell phone number in every room on a sign that read something like “I hope your stay is good. Please call me directly with any concerns.” How refreshing. While this is obviously not replicable everywhere, he was a popular leader who was also achieving good results (and in case you are wondering, his phone wasn’t rung nearly as much as you may think). Similarly I remember the CEO of the hospital where I did my residency in Baltimore taking impromptu walks around the hospital, shaking hands and getting to know the staff and their everyday jobs.
Health care administrators, remember that your “workers” are among the most dedicated, caring and hard-working professionals that you could ever meet. They deserve to be treated well. You are not only doing your own work a great disservice, but also yourself, if you miss this opportunity to grasp the heroic work that goes on all around you. Making painful and unpopular decisions is part of leading any organization or entity, but that isn’t to be worn as a badge of honor or mean that you have to spend most of your day in the office.
As for the doctors and nurses, I would say that it’s sometimes all too easy to harbor negative feelings towards administration and see it as an “us versus them” fight or the “white coats versus the suits,” We can also take the initiative to bridge the divide and reach out with our concerns. Knowing and being friends with many administrators, they do have a very important job to do too and are just as human as the rest of us. That doesn’t mean that we will always get our own way (nobody ever does) but collaboration is the only way forward for health care. Let’s all work together. It starts with having the best and most sincere leaders in place.
Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being. He blogs at his self-titled site, Suneel Dhand.
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