Why are we here?
March 23, 2011
As I mentioned in the last Open Mike, I’ve spent most of March in clinical immersion. I’ve been all over the state, getting together with our medical staff in small groups. These are really intimate settings, usually with about four to eight clinicians in any given meeting.
First, let me say that it’s been very personally and professionally energizing to get out into your workplaces and see you in person.
Lots of folks are curious about these talks, and what I’m learning. I’ve met with nearly a hundred of you so far, and I’ll be talking with another hundred or more of you through early April. Now that I’m roughly at the halfway point in these meetings, I want to share some early themes.
We spend about an hour together in each of the meetings, and I ask just three questions:
- Why did you come to Group Health, and why do you stay?
- What’s working and feels right to you?
- What’s not working, doesn’t feel right, or feels like it needs to change?
So far, I have notes on hundreds of your comments, and I’m starting to organize them. For a diverse group, you’ve actually got a lot in common. Where it comes through most obviously is when we’re talking about why each of us came to Group Health, and what keeps us here.
Why are we here?
Easily eight out of ten of you mention that our philosophy of medicine—the way we practice—drew you here. And paired with the people and relationships in your workplaces, it’s a major thing that keeps you here. You’re telling me that you’re feeling really integrated with the colleagues on your teams, and that you love working in an evidence-based environment. I am also hearing that you like working with other clinicians who want to do the right thing, and keep improving how we do it.
This impressed me so much that I mentioned it last week when I was presenting Group Health’s work at the Northern California Permanente Medical Group’s Board meeting. They invited me to talk to their 43-member board of directors and executive medical director Dr. Robert Pearl about you and your work. I mentioned specifically, and confidently, that the values you bring to work are so powerful that they’re clearly related to our many successes over recent years.
When we talk about what’s working and feels right, I’m hearing that you feel people here are really committed to their work. The doctors I have talked with say they notice that people around them are starting to listen more, to hear more. I’m hearing that Epic is, for the most part, great (though there are many areas where you feel it might improve). And in our multispecialty groups, you’re generally feeling supported in doing the right things.
What’s not working?
Because I’m going to so many locations, I'm hearing lots of specific things about your clinic environments. This ranges from use of space in Tacoma to concerns about off-site specialty appointing in Bellevue.
Operational issues come up, like the extra work it causes when a feature changes in Epic. And some of you aren’t satisfied with what you call “filler” that appears in charts, obscuring the patient’s real story in the midst of all the extra information. You also need more time and support for your virtual medicine workload.
Another common, big-picture theme is that it’s time to change from top-down management emphasis. You all want to see more front-line-initiated improvement.
What happens next?
I’m looking forward to my next meetings with you, because I know I’ll learn something unique each time I sit down and pose those three questions.
I intend to keep sorting the comments into themes. I’ll use them to influence our direction, especially in areas that are most broadly felt to need improvement, or especially critical local issues. I’ll be working with my operational colleagues to push toward improvement based on what you’re telling me. Obviously, we won’t be able to take on everything at once, but we’ll address the things you’re telling us are most important.
My takeaway from this experience, so far, is my deep appreciation for you as a medical group. Where you have problems and want to fix things it’s not coming from a place of anger or victimization. You voice your concerns and fears and complaints because you care.
And let me be the first to wish you a Happy Doctor’s Day. March 30 marks the date that ether anesthetic was first administered in surgery in 1842. People began celebrating this day in 1933, honoring doctors past and present for their work. We have the best medical group in the United States, and I am deeply appreciative of what you do every day. Thank you for doing what you do so well, and with such commitment.
- | 2011
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