Leadership Archives - Page 12 of 15

Medicare: We Want a Quiet Life, But Need Disruptive Change

Leaders facing dysfunction must make tough decisions. Too often, they unconsciously choose consensus. They talk. They argue. But, they rarely hold convictions that require extended engagement. Usually, they think and speak the same as other leaders in similar roles.

We long for a quiet life. We seek harmony and peace over rigour and truth. We find conviction bothersome, disruptive.

These days, people tolerate opinions as long as they sound mainstream. We forget how to debate. Desire to engage and debate is thought unsociable, even uncouth.

Change requires vision, conviction. Conviction requires thought and opinion. Opinions need to be discussed and debated.

Status quo survives on compromised consensus.

We need leaders to debate healthcare: front-line care, middle management, and overall system governance. We need articulate convictions presented from all angles. For too long, Canadians have valued peace and quiet over progress and excellence. We stopped doing the hard work of engaging in change, of improving our system.

It’s like we designed a system to provide very high frequency television (VHF), with ‘rabbit ear’ antennas, and expect it to handle modern communication: online movies, video streaming, high definition TV, cable, PVR,…everything.

Medicare remains fundamentally unchanged for 40 years: just bigger, more expensive, and more wasteful. The basic structure of Medicare is the same providing first-dollar-coverage for all medical services. Our feeble response to change has been to add more management, more bureaucracy, and more unions.

We must re-learn how to debate, and we need men and women of conviction to tackle healthcare, with will and determination. Compromised consensus must go.

(photo credit: tvlift.com)

4 Features of an Outstanding Clinic

Helping in new clinical settings over the past year, I find these core features in great clinics and hospital departments.

Outstanding clinics:

1. Remember Their Core Motivation

Most of us run from task to task without asking why. At some point, we chose to do what we are doing right now. Even with years of training, people don’t have to keep providing patient care; they could look elsewhere.

People need help to remember why they do what they do, and why they work in a particular place.

Most people who work in healthcare applied from a desire to help people. They looked for specific jobs that allowed them to help and serve patients.

Outstanding clinical groups never forget that serving patients comes before anything else.

2. Support Their Core Business

Especially in large groups, staff might think the clinic or hospital pays them. In a sense, that’s true, but also very wrong. Every business gets paid for doing something.

Although revenue flows through the clinic before it gets to the staff, employees must know that the clinic stays open if physicians see patients. Anything that slows, or stops physicians seeing patients results in poor patient service and less revenue.

Great clinics keep physicians working at what physicians do best: seeing patients.

3. Think About Governance

Governance refers to how organizations are governed and controlled, how decisions get made, and how decision-making units fit together. A solo physician deals with everything, or delegates to an office manager.

Problems arise as clinics grow. At some point, groups need to think about a formal, simple governance structure. Communication, authority, and accountability must flow in a line through the structure. If structure gets ignored and leaders start talking like customers expecting to be heard like owners, chaos ensues. (Check out: The Imperfect Board Member)

High performing clinics have an explicit governance structure that everyone follows.

4. Manage Performance

Once everyone remembers why they are there, knows how the clinic earns income, and understands how decisions are made, staff needs support to perform well. With clear expectations, most staff members excel; some do not. Even in a small group, staff needs performance reviews, incentives to improve, rewards for excellence, and follow-up on underperformance.

Outstanding clinics measure performance using explicit criteria supported by everyone. When members do not perform well after attempts to help them change, great clinics help low performers find work elsewhere.

Final Thought

Oppressive workplaces leave you emotionally exhausted at the end of a day, fill you with dread at going to work, and require you to tiptoe around icy colleagues. Dennis Bakke wrote bestseller Joy at Work suggesting that we embrace human values as ends in themselves, not just means to business ends.

Outstanding clinics foster uplifting, healing work environments.

How to be Great Without Being Gifted: Knowledge Integration

Some say you achieve greatness, or excellence, by finding your unique talent and pouring life into it. Malcolm Gladwell’s writes about people who master their talent with 10,000 hours of practice in Outliers.

One talent, sport, pastime, or ability. Gifted people with tones of time.

For the rest of us, excellence is less obvious.

We can all have it, but unique greatness shows up invisibly to us. It grows out of a life of enthusiastic passion poured into a unique combination of interests particular to our individuality.

Consider your interests in quilting and guacamole, or petunias and meteorology: we combine interests unlike anyone else. If you think of more, say porcelain, hydrology, glass blowing and poetry, you should expect very few people in the whole world to be passionate about all of them at once.

If you take a unique mix of ideas and add decades of enthusiastic exploration, you end up a world expert. YOU become a world expert at the unique integration of knowledge that’s been your life’s passion.

You: a World Expert.

We all have the time. We all have interests. The only decision remains whether we will spend our time passionately pursuing all that captures our interest around us.

What’s your expertise? How can you share it?