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An ounce of prevention is worth a pound of cure

Medical Staff Leader Connection, July 14, 2004

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It is the job of a great medical staff leader to ensure the effective operation of the medical staff, which may occasionally require him or her to step in to put out a fire. Unfortunately, leaders who constantly battle fires can't devote time to important issues, such as future targets, strategic planning, and critical operational issues.  Therefore, it is often best for medical staff leaders to step in at the earliest signs of smoldering brush instead of waiting for a raging fire. For example, the chief of surgery hears through the grapevine that a general surgeon is steaming mad about being bumped from the surgical schedule that day. The chief also knows that other surgeons have been bumped from the schedule in the past. He or she has at least three options:

1. Ignore the rumor and hope the problem disappears  

 2. Dread the next surgery department meeting at which the upset surgeon will undoubtedly chastise anesthesia services 

3. Find the surgeon and the chief of anesthesia, and work with them to create a very simple action plan to reduce the likelihood that the incident will recur. 

The last option is the best choice since ignoring the issue is perilous--surgeons don't forget quickly--and allowing the subject to come up at the department meeting will undoubtedly result in 30 minutes of unproductive discussion, criticism, and insults. 

The chief of staff should work with the chief of anesthesia to minimize the chances that a surgeon will be bumped off the schedule in the future. He or she should also apologize to the surgeon directly. In addition, taking such action would allow the chief of staff to announce at the next general surgical meeting that the issue has been discussed and "a resolution is in the works." 

The advice is simple. When confronted with a potentially explosive situation, step in early and quietly. Attempt to prevent the issue from rearing its head at an open meeting. 

That's all for this week.

All the best,

Hugh Greeley

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