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MEDICAL LEADERSHIP & CIVIL NON-CONFORMITY : QUESTIONS, ENGAGEMENT, AND PUSHING BACK THE CURTAIN ON MEDICAL SECRETS JOHN HENNING SCHUMANN, MD MAY 19, 2013.

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Presentation on theme: "MEDICAL LEADERSHIP & CIVIL NON-CONFORMITY : QUESTIONS, ENGAGEMENT, AND PUSHING BACK THE CURTAIN ON MEDICAL SECRETS JOHN HENNING SCHUMANN, MD MAY 19, 2013."— Presentation transcript:

1 MEDICAL LEADERSHIP & CIVIL NON-CONFORMITY : QUESTIONS, ENGAGEMENT, AND PUSHING BACK THE CURTAIN ON MEDICAL SECRETS JOHN HENNING SCHUMANN, MD MAY 19, 2013 CIR/SEIU CONVENTION

2 RONALD SCHUMANN (1946-2013)

3 BIASES Disclosures Blogger (ad-free) Writer: publications, sites Radio Consultant, legal work Academia-Program Director Primary care, Longitudinal relationships Community health, underserved, mission- driven

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5 2012 ELECTION

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9 SECURING PC FOR EXP MCD POPS. NEJM 2.10.11

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11 MEDICAL LEADERSHIP

12 CENTER FOR CARE & DISCOVERY

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14 LEADERSHIP: MY STORY Called non-profits, for-profits, AMCs Mission-driven purpose Sharing spirit All junked for $$ including teaching and clinical careall to preserve research No money no mission The brass ring of idealism

15 LEADERSHIP Domain change: from operations to patient experience A response: start a blog How to blog? anonymously What are the goals? Who is the audience?

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17 CIVIL DISCOURSE

18 CONFORMITY Hospitalized Peer Pressure What do the (big) (best) (other academic) (top rated) (non-profit) (clinical leader) places do?

19 MAN IN GRAY (1956)

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21 DOCS IN WHITE COATS

22 INTERVIEWEES

23 CONFORMITY Man in the gray flannel suit Doctors in white coats my pediatrics evaluation Interviewees in their dark suits Unions? For a higher purpose

24 LESS CONFORMING

25 HOWARD MCMAHAN, MD OCILLA, GA

26 YEOMAN FARMER

27 COWBOY ARCHETYPE

28 NON-COMFORMITY The yeoman doctor, out on own The farmer The cowboy, the individualist Last of a dying breed Non-union

29 HOSPITALISTS

30 FASTING GROWING IN U.S. HISTORY

31 DONT CALL ME A CONFORMIST

32 CONFORMITY, REDUX Minions of hospitalistsunionize? We are mostly employees now Theres been a widgetization of medicine Bad: loss of autonomy, perhaps creativity Good: systemization and quality control Hells Angels (conformity of a different sort)

33 CIVIL DISCOURSE 1: COLLECTIVE BARGAINING

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35 CIVIL DISCOURSE 2

36 CIVILITY 3 labor unions Trade groups (NPA) Political organizations New media (social) Conformity (non) of a certain kind

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38 FUNDAMENTAL QUESTIONS Bloggery: What pisses me off? Waiting Jargon Shoddy communication (Lack of) Empathy putting yourself in your patients shoes

39 ENGAGEMENT Patients Systems Learners Colleagues Management Collectivism Preaching to the choiryou are the leaders of the bunch 13k, 200 here you are the 1% of the 11.7% (111000 residents and fellows total in US)

40 PULLING BACK THE CURTAIN Telling stories: advocacy

41 MEDICAL SECRETS Make a commitment to find out or tell- Get Curious!

42 1. WHY DO PATIENTS WAIT SO LONG?

43 2. HOW MUCH IS THIS GOING TO COST?

44 Neel Shah is here MCR data

45 2. HOW MUCH IS THIS GOING TO COST?

46 3. WHO DO I WORK FOR? The patient, right? Its not always cleardual and triple loyalties when you work for others….. Easy examplesutilization review Hard examples-Im in a department and my chairman tells me to refer to my own neurologist or surgeon when its less convenient for a patient

47 4. HOW WILL I MAKE AN IMPACT? Those of you in this room are not just going to be punching the clock. What is your passion? What will you do to make a difference?

48 5. HOW DO I DO THE RIGHT THING?

49 6. WHAT DO I DO WITH ERRORS?

50 7. WHAT AM I AFTER? Prestige/power, possessions ($), or purpose? I was asked to become CQO it aligned with my goal of leadership, but not my passion/purposeits really hard, and not my strong suit.

51 8. WILL I STAY TRUE TO MYSELF? Your identity has been subsumed into your profession. It becomes too easy to view people as constellations of disease, diagnoses, drugs…. Why did you go into medicine? What gives you meaning? How can you avoid the pitfall of cynicism when its in the air around us?

52 9. AM I OF THE SYSTEM OR OUTSIDE OF IT? We are all most definitely OF, but are we toe holding in the other world?

53 10. ARE YOU AN INDIVIDUAL OR A HOME?

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57 THANK YOU


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