Archive for the ‘workplace’ category

Modern Healthcare’s “Don’t Ask, Don’t tell”

August 1st, 2010

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The July 19th edition of Modern Healthcare had a very revealing article by Melanie Evans entitled “Don’t ask, don’t tell.” The cut line under that title was “A third of physicians in a  study don’t feel obligated to report impaired [fellow] docs.”  Ms. Evans went on to describe the fact that the word impaired refers to drugs, alcohol or mental illness.  The study was from the Journal of the American Medical Association and it queried nearly 1,900 physicians.  Having been involved with the management of hospitals for over two decades, the results of this study shocked me.  Not because I didn’t believe it was possible; not because I didn’t believe there could be a problem but because it was clearly not my experience.  Yes, there were impaired physicians, administrators and staff members, but the programs available to them were comprehensive, thorough and unending.

If the question was posed, “Is there a problem with drugs, alcohol, and mental illness among physicians?,” my answer would have been  yes.  The same, however, is true of administrators, staff and employees.  None of those exposed to an environment that intersects with life and death issues on a daily basis and that requires the incredibly long hours necessary to keep the  proverbial “wheels on the bus” is without risk of these problems.  Add to that the relative ease of going  from one “friend” to another to get the prescription that is needed, and we have created a potential formula for disaster.

The seriousness of the outcomes derived from this series of questions is not something that any of us “in the business” is in any way ignoring.  It is real.  It definitely could result in injury andor death through medical errors.  So, the question becomes one of management, monitoring and self-policing.  The airline industry pays very close attention to the impairment of their pilots. Why?  Their crashes are typically not between one pilot and one passenger.  They are large, emotional events that impact literally thousands of lives.

When will the medical community begin to embrace the same standards as the airline industry?  It seems to me that we are currently “on  the move toward that objective now,” and as the public and government put more and more pressure on the healthcare industry to be transparent, it will become harder and harder to hide those shadow surgeries that went wrong  or those mis-diagnosed cases that could be traced back to impaired professionals.

Image credit: Edie Falco as Nurse Jackie - (c) Showtime Networks

The Modern Healthcare article ended with the statement that doctors “need more education on programs that evaluate and manage treatment and monitoring for impaired doctors.”  I agree . . . in this case, more is better, but how many “Nurse Jackies” (i.e., the hypothetical impaired employees) do we have flying low throughout our facilities as well?  The healthcare industry needs to pay attention to all of its impaired at all levels.

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Dr. London Said it on Sept 6, 2001…Reihan Salam Said it Today

June 28th, 2009

All week my search for pertinent topics for this blog were side-tracked by the deaths of numerous luminaries: Michael Jackson, Farah Fawcett, Ed McMahon, and even Billy Mays.  We’ll miss you all.

Then, during lunch today, the Pittsburgh Post Gazette reached out and grabbed me with this headline:  The End of Male Rule.The reason that this headline was so moving to me stems back to the Saturday of the week-end before 911 when Dr. Wayne London, an old metaphysical theorist friend of mine told me that:  1.) The American financial system as we know it would collapse.  2.) The center of the U.S. Military would come under attack, as would 3.) the patriarchally-controlled Catholic Church.  He then said, “All of this will happen as Mary Energy begins to lead toward the change, and women will take control of the world again.”  He went on to explain that this woman control is not a new phenomena, just one that has not been around for quite some time.

Pentagon 9/11 memorial service, September 11, 2008 - Photo credit: UPI
Pentagon 9/11 memorial service, September 11, 2008 – Photo credit: UPI

Well, after the Twin Towers were hit, our own American citizens did much more damage than anyone could have ever imagined possible to our financial system by setting up the elaborate mortgage and derivative schemes that nearly caused the entire U.S. financial system to collapse.

Of course we all remember the horrible hit that the Pentagon endured on 911, and now we face the huge financial burdens of continuing two wars and trying to rebuild a completely exhausted military that has been over-stretched and nearly wiped out emotionally by the last several years of redeploying both our all-volunteer army and their equipment over and over again.  When you begin to see more suicides than casualties of war, something is obviously very wrong with the System.

The Church went through what has come to be recognized minimally as a very difficult time with millions and millions of dollars in lawsuits and structural challenges over sexual abuse issues that had been closeted by numerous U.S. Bishops for years and years.  The celibacy thing seemed to have been much more destructive for the men of the Church than the women.

So, what was Reihan’s interpretation of this metamorphosis, this change in traditional male dominance?

PTA President Charles J. "Chuck" SaylorsPTA President Charles J. “Chuck” Saylors

Before we go there, on NPR this evening, I heard about Chuck Saylors, the first male president of the National Parent Teacher’s Association since its inception in the late 1800′s, and it all started to make even more sense, a guy in a predominantly female organization deserving to become president because so many men have assumed more house dad roles.

Reihan’s article started with the line:  “The era of male dominance is coming to an end.  Seriously.”   He went on to describe the fact that the Great Recession has turned what was a quiet evolution into a revolution…a mortal blow to the macho men’s club.  He quotes the fact that 80% of job losses or over 7 million jobs have been lost by men in this recent massacre, and the predicted number of male jobs lost by the end of 2009 is estimated to be around 28 million worldwide.  He adds to the fact that soon there will be three women for every two male college graduates in the U.S.

One of his most interesting revelations was that Iceland threw out the entire men’s club in their last election, as did Lithuania.  Could this be the beginning of a trend?

Of course the article went into much more depth, had numerous other examples to support these claims, and was compelling in its support of Dr. London’s theme.  The bottom line, however, is not easily denied.  We macho, risk-taking, aggressive guys have done a lot of damage over the years, and it will be fun watching this predicted shift in the next decades.

I’ve always felt that a world run by women might have a little better chance of having less warfare. Let’s hope that the female leaders of our future will have the attributes that will make them better than the men that they are replacing, and the world will be a better place.

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More on Leadership…

December 12th, 2008

Nick Jacobs, FACHE author of Taking the Hell Out of Healthcare

One imperative for any leader is a positive mental attitude. We must work tirelessly on believing in ourselves, and then we must work constantly to reinforce that belief with positive self-talk. If we embrace that concept that we can, there’s a very good chance that we indeed can. If, on the other hand, we believe that we won’t, we probably won’t. This single belief can initiate all forward movement. Winners in life constantly encourage themselves to think that I can, I will, and I am, and they don’t focus on the past —the should have, would have, or can’t do’s are gone forever. We can never make a better past for ourselves.

Last year, one of our employees attended a non-traditional educational seminar whose primary focus was directed toward the analysis of different personality types. When the employee returned, I asked, “What did you learn?” Their response was, “I learned that the primary function of people with my personality type is to pee on your cornflakes, to rain on your parade, and to frustrate your every creative idea, because that’s just what we do.”

Hence the opening paragraph of this piece. We are in difficult economic times, and the general counsel from our advisors is more often going to be to take no risks. If they are doing their jobs, we will be inundated with reasons why we should be against almost everything. In fact, words like growth, expansion, and opportunity all seem to be put away as this storm cellar mentality prevails. They will argue that they are saving their organizations by “shrinking to greatness” while opportunity after opportunity slips away.

One of my favorite visuals of this mind set comes from the 1990 movie Ghost where the people were helped to find their place in eternity by little demons that came out of the sewer grates to drag their souls into Hell. As leaders, we are surrounded every day by people who see their job as one of hard, cold, black and white facts. There are the extremists who spend their days spreading pessimism, fear, gloom, and negative energy; looking at the down side as they constantly undermine not only growth, but the attitudes that foster growth. The blacker the sky, the deeper the reinforcement of their concerns, and the more intense the corporate paralysis becomes throughout the organization.

Positive Mental Attitude Psychologist, Denis Waitley helped to change my life when he lectured on this topic nearly 30 years ago. He had been the U.S. Olympic athletes’ psychologist. Dr. Waitley taught us to learn from the past, set vivid, detailed goals for the future, and live in the only moment of time over which you have any control: now. He always spoke about the reality that life is inherently risky and that there is only one big risk you should avoid at all costs, and that is the risk of doing nothing.

Don’t get me wrong, conservative thinkers are important in the balancing act of leadership, but they must never be given the power to control all aspects of an organization. It is a recipe for disaster. The result will be stagnancy and eventually, business failure. There must be a means to carefully look at what they have to say, to evaluate the risks outlined, and then to make a decision based upon the prudent person process, but, having said that, remember that leadership is not a gutless proposition.

If you are not interested in some sleepless nights, tension filled meetings, or numerous failures, don’t get into the game. As Waitley says, the winner’s edge is not in a gifted birth, a high IQ, or in talent. The winner’s edge is all in the attitude, not aptitude. Attitude is the criterion for success. There are two primary choices in life: to accept conditions as they exist, or accept the responsibility for changing them.

A leader’s world is not always black and white.

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Think Global and Act Local

October 1st, 2008

Over the years people who’ve liked me have referred to me as a real visionary, but, in all fairness, the people who thought that I was an incompetent also called me a visionary. One group called me that as a compliment. The other group used the description as a put down. Considering that my physician discontinued my prescription of Atromid S medication back in the late 70′s because he said the it caused early cataracts, I’m not all that sure about my actual vision.

As a kid it was fair to say that my approach to any problem that came my way was, well, it was just different. In fact, I’d spend hours trying to come up with unique solutions to problems that otherwise might have only taken a few minutes to solve the normal way. It was my thing.

In fact, my problem solving skills could only be described as journeys down the “Road Less Traveled.” Kind of the McGyver approach. What can I do to meet this challenge by using a Zippo, some thread, a chewing gum wrapper, and piano wire? Of course there were sometimes periodic episodes of near tragedy from this approach, you know, like the time I watched the front right wheel on my wagon roll past me as my journey took me down the 80% grade that my parents called the backyard. Thank God the axle dug in just enough to stop me before the approaching cliff. (The bobby pin didn’t hold.) Between Evelyn Wood’s Speed Reading course and Cliff Notes, I read Moby Dick in about 13 minutes.

By the time college rolled around, it was clear that my addiction had spread from alternative methodologies of problem solving to a pure and simple love affair with anything that was new, cutting edge, leading (or even bleeding) edge or avant garde. “Contemporary” was the catch word all those years ago. From art films to modern music, there was no end to my attraction to new and novel things.

Well, Inside Healthcare ran an article by Clay Sherman that was entitled Think Global and Act Local that contained some great tips for survival in healthcare. Mr. Sherman talked about the Joint Commission the way that most hosptial CEO’s would like to, but do not have the guts to do so. He described the Joint’s role as one of minimalism, and that was where his description stopped. His suggestion was to drop the Joint and to engage some larger, more aggressive organizations like NCOA or Leapfrog. His words of wisdom here were, “Either embrace a rigorous standards process, or watch your successor do it.”

Mr. Sherman went on to suggest the need for us to embrace best practices methodologies, new standardization techniques, online communities for patients with similar diseases, and he closed by saying “Stay centered focused in building human assets — its their brains that are going to get you there.” Hmmm? Sounds a little like last week’s blog.

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