Lack of Accountability
Ah, a new year. And we have finally arrived at the end of our “problems” series. We’ve bravely gone where few healthcare leaders venture, into the truth about our industry — that we have, to put it lightly, a LOT of issues.
And if lack of training, lack of engagement, lack of communication, and lack of retention, weren’t enough, the terrifying fact remains that most healthcare organizations still don’t have any formal evaluation process for physicians. Unbelievable but true.
We have on our hands a serious lack of accountability. There are frequently no formal evaluations for physicians on staff. No quarterly check-ins. No formal goals or targets to aim for or celebrate accomplishing. Even often no real metrics on physician performance with patients. How can we expect anyone to improve professionally without actual goals and targets?
And this isn’t just a “doctor problem”, it exists on the leadership side as well. Physician leaders are pressured to put new initiatives in place and check boxes that they’ve provided “programs” (there’s a vague word) for physician engagement. Rarely are they asked to collect and analyze data about how these programs perform or how they impact the team’s quality of life.
In our highly toxic national healthcare system, “the need for enforcement could hardly be greater. In the 17 years since the federal government’s National Practitioner Data Bank was created to track reports of doctor discipline, nearly 50 percent of U.S. hospitals have failed to submit a single report, according to a Public Citizen study. The deficient reporting stems mostly from hospitals failing to discipline doctors and hospitals evading reporting requirements” (CitizenVox, 2009).
And unfortunately, not much has changed since 2009. The lack of formal evaluations on both sides of the healthcare system leads to an alarming lack of accountability and ultimately, a lack of responsibility when things fail. Besides intrinsic personal motives (which we know are susceptible to fatigue and burnout when professional needs aren’t being met), most healthcare organizations and hospitals offer no real motivation for physicians or their leaders to succeed.
HOW IS THIS POSSIBLE?!
The writing is on the wall.
Things are dire, to say the least.
Without formal training, coaching or a workable roadmap, leading a hospital team is, truthfully, impossible to do well. If we continue down this path we continue to set our entire industry up for failure. It’s as painful as pulling teeth and as tragic as watching someone drown in slow motion. It does not matter who’s in charge, without the essentials, anyone can lose enthusiasm, give up, and likely fall back on whatever everyone was doing before just to make things “easier”. The problem is, a short term solution cannot produce long term benefits. In such a difficult situation, even the most benevolent person can come across as oblivious and indifferent. And an oblivious and indifferent leader (even one who doesn’t aspire to be those things) is a catalyst for an unhappy workforce with exasperated physicians, nurses, and administration in addition to those in leadership.
The list of problems we have spent this fall outlining are at best, daunting and at worst, completely paralyzing. It’s ok to admit that we’re in a tough spot right now. However, the research I’ve conducted, many training sessions I’ve facilitated, and clients I’ve coached over the past fifteen years have conclusively led me to believe that we are not as far gone as we might fear. We just need a little redirection and a few slight adjustments to our priorities. I assure you, if your hospital culture is toxic there is a way out. A way to rebuild. And it begins with leadership training designed to prioritize communication, relationship building, and - surprise surprise! - health, over profits or flashy new programming.
Before, we waded through an entangling web of problems, easily caught by the masterful spider of despair. Now we begin to build our own web that will reorganize our workplace, revitalize our team members, and strengthen everyone’s morale.