by Ted Eytan, on 26 Aug 2007 06:37 am
The Journey
Not in Trouble
I saw the aforementioned VP at a leadership meeting last week. He lived up to Lee’s description in his comments during the day – and he did read Lee’s blog post, so we’ll leave it at that.
One thing he said to me that related to the work I was doing was something to the effect of, “Before I spent time doing Gemba tours, if I walked into an area where staff was working, they would stop working. Now, they continue working because it’s normal for me to be among them.”
It made me think again about the culture and training of physicians. A few weeks ago, I arrived with a colleague to shadow a physician who I had talked to previously about seeing them practice. When we arrived on the appointed day, there was a concern, stated explicitly by this talented doctor, that they must be in trouble for something, otherwise they would not receive this attention. I explained that this was exactly the opposite – that this physician had a great reputation and had asked me previously for tips on using our systems and that I would be happy to oblige.
Last week, I was speaking with another very talented specialist about the way another department was using our systems. She asked, “Ted, do you know what their workflow is around this issue?” I know backwards and forwards how the system is wired, but admittedly, I don’t know how this work unit actually interacts with it at the level of the patient. So I said,”I don’t. Do you want to walk over there with me right now and ask?” She said yes and we did. And it was a great conversation. The physical presence of the layout said so much about their workflow and what was best for their patients. However, at the same time, it felt like there was an implicit assumption that there was a problem with a person or persons, otherwise we wouldn’t have come in the middle of the day to observe.
In each one the implicit “I’m in trouble” was wiped away quickly – the clinicians involved readily understood why this valuable and dug in – kudos to both physicians for not hesitating one moment to do something different to look at a problem. It was great. We all have the aforementioned VP in all of us. We just need the chance to be him/them. For physicians, who as I often state, spend 84 cents of every health dollar, their role in being the great VP cannot be understated.
I would imagine the employees in the model line will, through their experience with their VP, alter their management approach over time and come to expect this behavior from each other when they become VP’s. I hope the same for our medical group, and one day, for all physicians.
I think this is a good place to start talking about the role of medical education. Anyone out there interested in creating a 4th year medical student elective on LEAN? I’ve got the curriculum in my head…..