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…
Work/Life Balance

“New Year’s” Resolutions

Unlike residency and fellowship, which are typically divided into discrete rotations or blocks; the passage of time in practice seems to flow in a relatively unobstructed fashion. Certainly the long winter drags on and business inevitably picks up as summer arrives,  indicating the change of season.  But, without distinct check points throughout the year, it is easy to forget to…
Clinical

The Science Behind Crazy O.R. Rituals

Everybody has them.  If you think you’re an exception, ask your PA, scrub or circulator and get ready to be surprised.  I’m talking about bizarre little rituals in the operating room.  They’re usually innocuous, arbitrary habits, but if neglected, make the entire case feel “off”.  Maybe you always have to be the one to clip the tourniquet towel; maybe it’s…
Career Path

What is the purpose of retirement?

Many doctors are increasingly frustrated about the bureaucratic and regulatory environment of physician practice. For those who are nearing retirement age, it is tempting to “hang it up” early to escape the stress of a job that has lost its fun. Since younger physicians are frequently much more adept at the use of EHR’s and other forms of technology, they…
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…