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Medical Leadership & Civil Non-Conformity : Questions, Engagement, and Pushing Back the Curtain on Medical Secrets

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. Ronald Schumann (1946-2013). Biases. Disclosures Blogger (ad-free) Writer: publications, sites Radio

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Medical Leadership & Civil Non-Conformity : Questions, Engagement, and Pushing Back the Curtain on Medical Secrets

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  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

  4. 2012 Election

  5. Securing PC for Exp MCD pops. Nejm 2.10.11

  6. Medical leadership

  7. Center for Care & Discovery

  8. Leadership: MY story • Called non-profits, for-profits, AMCs • Mission-driven purpose • Sharing spirit • All junked for $$ including teaching and clinical care—all to preserve research • No money no mission • The brass ring of idealism

  9. 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?

  10. Civil Discourse

  11. conformity • Hospitalized Peer Pressure • What do the (big) (best) (other academic) (top rated) (non-profit) (clinical leader) places do?

  12. Man in Gray (1956)

  13. Docs in White Coats

  14. interviewees

  15. conformity • Man in the gray flannel suit • Doctors in white coats • my pediatrics evaluation • Interviewees in their dark suits • Unions? For a higher purpose

  16. Less conforming

  17. Howard McMahan, MD ocilla, GA

  18. Yeoman Farmer

  19. Cowboy archetype

  20. Non-comformity • The yeoman doctor, out on own • The farmer • The cowboy, the individualist • Last of a dying breed • Non-union

  21. hospitalists

  22. Fasting growing in U.s. History

  23. Don’t call me a conformist

  24. Conformity, redux • Minions of hospitalists—unionize? • We are mostly employees now • There’s been a ‘widgetization’ of medicine • Bad: loss of autonomy, perhaps creativity • Good: systemization and quality control • Hell’s Angels (conformity of a different sort)

  25. Civil discourse 1:collective bargaining

  26. Civil discourse 2

  27. Civility 3 • labor unions • Trade groups (NPA) • Political organizations • New media (social) • Conformity (non) of a certain kind

  28. Fundamental Questions • Bloggery: • What pisses me off? • Waiting • Jargon • Shoddy communication • (Lack of) Empathy— • putting yourself in your patients’ shoes

  29. Engagement • Patients • Systems • Learners • Colleagues • Management • Collectivism— • Preaching to the choir—you are the leaders of the bunch 13k, 200 here you are the 1% of the 11.7% (111000 residents and fellows total in US)

  30. Pulling back the curtain • Telling stories: advocacy

  31. Medical secrets • Make a commitment to find out or tell- • Get Curious!

  32. 1. Why do patients wait so long?

  33. 2. How much is this going to cost?

  34. 2. How much is this going to cost? • Neel Shah is here • MCR data

  35. 2. how much is this going to cost?

  36. 3. Who do I work for? • The patient, right? • It’s not always clear—dual and triple loyalties when you work for others….. • Easy examples—utilization review • Hard examples-I’m in a department and my chairman tells me to refer to my own neurologist or surgeon when it’s less convenient for a patient

  37. 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?

  38. 5. How do I do the right thing?

  39. 6. What do I do with errors?

  40. 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/purpose—it’s really hard, and not my strong suit.

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