I have beeen off of the blogosphere due to too much drama in the industry. (Incidentally, if you are wondering "what drama?", you are in the wrong area of the member community and should check out the Washington Connection section.)
I was asked last week what kept me up at night as it relates to my position and management. Hmmmm. I thought about this...because the current and perhaps obvious answer would be the looming 20% cuts to Medicare reimbursement. Ok, yes this bothers me (I'm not totally in la-la land), but what I am concerned with is the reduction of resources ($$) and how it relates to obtaining and retaining these resources. I believe that one of the more pressing issues will be the downward pressure of finding and retaining talent; be it providers, mid-levels, billing staff or clinic staff. As we experience this downward pressure, medical management executives will have to become even more aware of how we are leading and managing our organizations. We need to figure out how to pull a rabbit out of our hat to keep our talent on board with inevitable cuts and an almost inevitable increase in patient flow.
Hogan and Kaiser explains, among many notable things, the strong correlation of employee satisfaction to satisfaction with supervisors. The definition of "satisfaction" in this study was satisfaction with supervisors. In fact, of many surveys reviewed, the authors found that "75% of the employees in any given organization report that the worst aspect of their job is their immediate boss". Read that sentence again...because nowhere in there is mention about pay, working conditions, medical specialty (I like this one) or not enough paid vacation. This is great news everyone! Because we (you and me) have the opportunity to make a difference on this part. After we have written our Senators, let some steam off on Bill's political member community, the ability to have rock star organizations comes down to how we manage and lead our practices.
Back to the question I was asked...when I started to think about shrinking dollars, I was more concerned about losing physicians or staff to the competition who run their organizations better, with the same reimbursement-not the inevitable budget reduction. Are you with me?
I have to start with myself, then if I am to manage under these future inevitabilities. For the purposes of keeping this blog to a length that anyone with a short attention span would finish, let's just focus on some things we need to consider about ourselves first and save the rest for the next blog. And to be clear here, I subscribe to the academic tradition of leadership versus the troubadour tradition (i.e. the latter being self-serving and account-settling memoirs of former CEOs and politicians). Solid research linking personality traits to effective leadership reveals that organizations that excel and achieve the height of organizational effectiveness, even though organizational effectiveness is somewhat difficult to measure. Despite this challenge, Jim Collins identifies two elements that were common among all leaders: modesty and humbleness (not self-dramatizing and self-promoting)and the ability to be phenomenally persistent.
These characteristics do not exactly conjure up the super-charismatic CEO-type we think is necessary to lead, does it? All the more reason I need to look at my day-to-day executive personae and adjust as necessary without losing my personality for the sake of organizational effectiveness. Persistence is such an underrated characteristic in medical management and one of the more simplistic. Think of how many times you have explained financial statements, or the connection of charge capture to the claim form.
This week, I am going to focus on those two characteristics and how they effect every facet of my projects and conversations throughout the week. There is a realistic connection of leadership style to the prediction of employee attitudes (something I have control over); and attitudes and team functioning can predict organizational performance. You see then, a lot of this is within our control if we only respect and not abuse the privilege of authority. Perhaps you will agree with this perspective, in that "like Ceasar's wife, people in leadership positions must avoid even the appearance of impropriety".