Page 8 : Richard Winters MD

9 Dangers of Leading Physicians By Email

We’re no longer a group of 8 sitting around a table hashing things out. We’re a partnership of 19. It’s hard getting the group together in one place to talk about department and partnership issues.

How do we keep everyone up to speed?
How do we make informed decisions?

We’re using a lot of email. It’s an excellent way to update and get things done. But it has its problems.

1. Writing in the past.

There’s always one person who’s three days behind in the discussion. They reply on a busy email thread and everyone thinks “Dude, that was 3 days ago! Keep up.”

They skipped previous emails and jumped to the present. It’s not that the points made by the late responders are superfluous. Their comments may be key. But the discussion starts over again. Again.

2. Tangents.

In the beginning it was an email discussion of consultant coverage. Then it it transitioned to personal anecdotes about specific consultants. Then a joke. Now, it’s a discussion about investing in real estate.

Tangents can be easy to redirect in a meeting. They are difficult to control in an asynchronous email conversation.

Me. The Doctor.

The patient comes to see me, the doctor.
Right?

The patient doesn’t come to see the assistant.
Or the nurse.
Or the CMO. CNO. CEO.

They come to see me, the doctor.

Wrong.

The patient seeks care.
To feel better. To get that part working again.
To know what is going to happen.

I, the doctor, can examine.
I, the doctor, can diagnose.
I, the doctor, can write an order.

But then what?

Nothing.

If I am alone.

Not alone.

The assistant welcomes and readies.
The nurse monitors vital information. Medicates.
Advocates and listens.

The CEO. CNO. CMO.
They see the system. They see the limits.
They grow the opportunity.

I am not alone.

Without others. My order. A silenced suggestion.
My exam. A momentary thought.
My diagnosis. Only that.

Look

I can see patient after patient.
Look down and look forward.
As if I am alone.
As if the hospital is built around me, the doctor.

Or I can look left. Look right. Diagonally.
And see what I am a part of.
I see an office, a hospital, a system built around the patient.

And I can make it better.

Me. The doctor.

We Speak In Code

We use the same words. We mean different things.
The same words mean different things.

For example, in the hospital we talk of whether we are “fully staffed”, “overstaffed” or “understaffed.”

Fully staffed.

What could they mean when they say “fully staffed”?

All of the scheduled shifts are assigned.
Nobody has called in sick.
We are on budget.
I like to hear the sound of my own voice.
We were never in over our heads.
There is no wait.
There was the correct number of patients to staff.
I don’t know how to get more staff.
There is a balance of patient sickness to staff ability.
Our staffing is comparable to similar hospitals.
I go home on time and have all of my breaks on time.
That is one well-equipped wizard.

“Fully staffed” may mean all, none, or some of the above. It depends on your point of view. The specific meanings of your words depend on your life experience.

Translate

We speak in code. Our words translate our point of view. Our words are shortcut interpretations of our life experiences. “Fully staffed” is code.

Decipher the code in conversations to get to productive outcomes. Clarify the words and their specific meanings.

In what way are we “fully staffed”?
How specifically are we not “fully staffed?”
When are we “fully staffed?”
What does it mean to you to be “fully staffed?”

Then have a more cogent discussion.