Author: Matthew M. Tomaino, MD, MBA

Community

Do you have an action plan?

My last JHS Focus post introduced the Waterline model as a guide to providing clarity regarding the root causes of team conflict and/or underperformance. I suggested that, more often than not, a system or process issue may be the basis for the problem even though we, as emotionally driven team members, may attribute underperformance to an individual or to an…
Community

How can we move the needle on an under-performing team?

Over the past several years I have actively cultivated my appreciation of what interferes with optimal team performance, and spent a considerable amount of time investigating possible solutions. I had the privilege recently to lead a workshop on team development with the Wake Forest Orthopaedic residents, and it became very clear to me that encountering conflict on teams during the…
Community

Conflict on your Team: Dismissed, Deplored or Discussed?

I attended the annual meeting of Team STEPPS in Cleveland in June. STEPPS stands for Strategies and Tools to Enhance Performance and Patient Safety. The initiative has been developed by the Department of Defense, and superbly practiced within most, if not all, army health centers. For any one not familiar with its key principles, it’s worth checking out the Agency…
Clinical

Reframing failure

Failure in life - no matter how great or small - can provide a transformational opportunity for growth. In fact, most if not all innovation is the result of trial and error, a consequential response or iteration, and so forth. Indeed, in medicine, progress has relied on the scientific method forever. However, our bad surgical outcomes are often stigmatized as…
Patient Communication

“What’s in your tool chest?”

I have never considered myself a “carpenter” and am not particularly handy around the house. My enthusiasm for orthopaedic surgery was not a love of hammers and nails, but a desire to be able to be both a primary care musculoskeletal provider and surgical subspecialist. I initially wanted to become a cardiac surgeon, and my interest in complicated problems and…
Patient Communication

Forgive and Remember

Since I was informed of New York State’s investigation of my practice in 2010, when a drug-seeking patient complained that I did not prescribe postoperative narcotics, I have had ample time for introspection and self-evaluation. Indeed, I have asked myself how such a “good physician” and “good man” could be shamed so mercilessly, particularly since I, like Mark Chassin expressed…