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Medics as Managers?

Some years ago I had the privilege of working with a wonderful, very well respected surgeon with whom I shared many of my research findings.

In the course of my day jobs, it often fell to me to have to interrupt his Sunday morning, pre-lunch sherry with a phone call to determine which of his patients (that were due for admission later that day for surgery on Monday) I could cancel, due to a lack of beds in the facility.

This to me was a soul destroying task at any time made doubly horrible by having to disturb this great man’s relaxation time.

But as time went on, our Sunday morning phone calls became more of a mutual teaching session as we discussed the operational ills of the hospital and our individual findings.

Over the months, my admiration for this man grew and our discussions expanded from phone ‘chats’ to hurried, condensed discussions when we met in corridors and on wards. Then one Sunday morning, after eliminating the week’s unlucky patients, we started to tackle the issue of medics as managers.

I knew that he had, during his career, held many posts in the higher management strata of the hospital but was curious to know why he now shunned the chance to influence the running of the hospital and chose instead to concentrate on his clinical work.

“Don’t tell me you are too old to play management games – I don’t believe that for a minute,” I told him.

“You’re right in one respect but not in another.”

“What way?”

“The guilt. I’m too old to carry any more guilt.”

I hesitated before asking but realized that this would probably be my only chance to get to the core of this man’s reluctance to participate in the running of the hospital so I asked …

“Guilt about what?”

The line went quiet until he said, “I’ll tell you next week IF I can muster the courage.”

I felt that the moment had passed and I knew that I could not bring the subject up again. The following week’s phone call came and went with no mention of his guilty past so I just forgot about it until approximately a month later when I was on duty again.

“I’ve been thinking about what I told you, and as you didn’t push me on it, I’m prepared to tell you what I feel guilty about……..”

It took some time for him to explain it to me, but the bottom line was that a few years before, he undertook the task of reviewing the levels of nursing staff. He did the maths and recommended that the hospital cut back nurses by some 10%. There was too much wasted time and not enough efficiency, according to the figures.

The result of this decision still haunted him as mistakes were made by overstretched staff, and patients suffered unnecessarily.

His lack of understanding of the nurse’s practices using the troughs of their workload to buffer the peak times was his undoing. Despite warnings from senior nurses, his recommendation was adopted by the board and it was a decision that haunted him from then on.

He told me “being an expert in one field does not qualify one as an expert in another, no matter how much we think of ourselves…”

I told him that my goal was to help make managers as respected by the medics – as professionals and equals – as he was by his peers. He wished me luck, and died a few months later of an unexpected massive coronary. I just hope that he was able to assuage his guilt before he died.

Copyright ©2008 TOCH, Inc. Used with permission.

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