How sad when a PCP calls, saying, “My chief warned me that if I don’t dramatically improve my productivity, I’m going to be terminated.” Such doctors are often patient-centered listeners who cannot bear to shift from healer mode to assembly line mode.
Some of these docs learn how to better balance healing with task completion; others make a beeline for concierge or direct primary care practices; still others leave clinical medicine altogether.
But my primary focus today is not on the beleaguered front-line PCP; it is on the harried medical leader, whose job is to translate industrialized medicine’s quest for corporate profitability into performance metrics of efficiency, quality, and patient experience.
Medical leaders are often, in effect, middle managers. Many of us (yes, I myself was one for thirteen years) took on a managerial role with the following questionable assumptions:
- That our ability to effectively manage patients meant that we could be equally successful at managing physicians and other professionals.
- That because we were intelligent, we would be good on-the-job learners as neophyte managers.
- That our commitment to the profession and to caring for patients would translate into aptitude for balancing corporate and patient priorities with the human needs of our team members.
- That allocating 10 percent to 50 percentof our time to managing others would relieve our own stress as full-time clinicians.
A sad truth is this: Most everywhere, health care is a low-margin industry that lacks resources to invest in leadership development. Although our business’s central, sacred function is caring for our fellow human beings, many who move up in the health care hierarchy do so without possessing the so-called “soft skills” that facilitate one’s ability to lead groups and motivate others.
“Soft skills,” a military term that arose in the 1960s, refers to the interpersonal savvy that it takes for organizational stakeholders to succeed. Soft skills are about more than the weaponry and the machinery; they’re about the people. Whether it’s academic medicine, corporate medicine, or public sector medicine, we are simply not taking enough time to focus our leaders’ attention on the interpersonal dimension of their work. Excellent training and supervision enhance essential managerial skills, but most health care organizations choose not to invest in that which is “soft.”
Consequently, so-called performance problems of physicians, like the PCP I described above, sometimes end up being addressed with last-minute ultimatums and referrals at the eleventh hour. We are all saddened that our system’s manifold challenges persist, only to be aggravated by crises like the pandemic. It isn’t surprising that many members of the public are losing faith in the health care industry and the medical profession.
Steve Adelman is a psychiatrist and can be reached at his self-titled site, AdelMED.
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