Some of the biggest mistakes I have made as a physician leader occurred when I heard one side of a story and took action.
An incident report arrives. A nurse stops me in the hall. A physician calls me or an administrator emails me. My suspicions about the individual in question have been confirmed.
And I pounce.
Finally I have something documented and now I can take action.
I meet with the individual in question. I point out the facts, I point out the history, and I point the finger.
But I am wrong.
It becomes obvious that I have missed some critical aspects of the situation. The story that I pieced together about the incident fits together so nicely. However, it is fiction.
The incident report, the nurse, the physician, and the administrator left out a broad perspective. And now from my stifled and embellished viewpoint, my integrity and my ability to manage the individual (and everyone else) is in question. In 5 minutes, I’ve lost my credibility.
5 Steps To Get To A Better Conclusion
You don’t need to lose credibility. There is a better way to investigate incidents with integrity. Follow these 5 steps in order to get to a better conclusion:
Ask questions and listen.
- “What happened?” Listen to the allegations of the incident.
- “What else was happening?” Probe for deeper information and truths.
- “What do you think was their perspective?” Ask for possible alternative viewpoints.
2. Thank Neutrally.
You don’t need to agree. You don’t need to validate. Just accept the information as information and thank the individual for bringing it to your attention.
- appreciate “The information that they have provided.”
- will “Take what they have told you into consideration.”
- say “Thank you.”
3. Think Neutrally.
You are a detective. You’re an objective third party just finding the facts. It is important for you to remain neutral. Reserve judgment. Don’t create fiction.
- Neutral words.
- Neutral expression.
- Neutral energy.
Be Sherlock Holmes. (Or Deputy Chief Brenda Leigh Johnson from The Closer.)
Seek out others who may have been involved in the incident. Listen to them. Repeat these first four steps until you can look at the incident from a broad perspective.
After you have investigated the incident fully, decide if any action is needed. Only then can you take informed action.
Investigating incidents with integrity will make you a more effective physician manager. You will be fair. You will be considerate. You will be credible.
Things You Can Do Now:
Read about how I missed a large tumor while seeing a patient; it’s the same kind of error. It’s a result of anchoring bias and it occurs both clinically and administratively.
Read about the three major cognitive errors that physicians make at KevinMD by Drs. Groopman and Hartzband.
Practice validating complaints without agreeing with them. You can say that you understand what someone experiences without agreeing with specific perceptions of that experience. This will allow you to investigate without being anchored to any specific response.
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