Building a Great Hospitalist Team

By  |  January 20, 2015 | 

Ever since we are children, our parents and society teach us how to play together with others. What we don’t realize is that this lays the groundwork for developing important teamwork skills — the same skills that enable success and positive outcomes in the workplace. My own experiences in hospital medicine practice throughout the last decade continue to increase my appreciation for these seemingly simple yet invaluable techniques.

Like many young hospital medicine directors, I began my leadership role with only a basic understanding of teamwork concepts. Excited by the new role, I immediately decided that the first task that I would tackle would be to take my new group of disparate physicians and build them into a team that could produce positive results for my hospital and our patients. As you can probably imagine, achieving that goal is not an easy task. I would learn that it requires thought, patience, empathy, strategy and a willingness to be flexible.

An early lesson involved discovering that I would need to know and understand the motivations driving each of my team members. One colleague who had been an employee for a very long time was at first resistant to me in my leadership role. Her initial reaction to any new idea or goal was very bellicose. I wanted to dismiss her as simply disruptive or resistant to change, but I encouraged myself to persevere in learning more about her. I eventually uncovered through many small conversations that she was afraid that change would destabilize the program and her job security. She was, in fact, deeply invested in the program but didn’t know how to express it constructively because she felt threatened. I was then able to work together with her to both assuage her fears and develop her role in the team. This experience illustrated for me how important it is to be persistent in uncovering the motivations, hopes and fears of each of your team members. Knowing their mind helps you reassure them that the projects that you are leading are good for everyone on the team, involve them in the development process where their interests lie, and connect with them on a level that is more than just a boss/employee relationship.

Every group of hospitalists has physicians with different personalities, and therefore, each physician is driven to improve performance by different factors. As I interacted more closely with my hospitalists, I started to understand better their strengths and weaknesses. I scheduled regular team meetings where everyone could share their thoughts and concerns without fear of repercussion. I tried to make each meeting an open and welcoming environment. Over time, each doc has become more comfortable with my personality and style of leadership and I with their personalities. This type of familiarity builds trust, improving the shared work ethic and sense of team.

Physicians are independent and strong-willed by nature, and as such need time to accept and buy–in to change. To lead a team, I learned that being patient and empathetic gave our projects the best chance of moving positively toward our goals. Additionally, I found that being open about the operations, successes and failures is key to the team’s morale and productivity. I regularly share team performance data at our monthly team meetings. Individuals are given routine feedback on their performance through a dashboard that displays their quality and performance data compared to the team. I think this process both generates healthy competition and allows for self-evaluation and self-improvement, all of which ultimately result in better quality outcomes and productivity. This simple effort combined with other quality improvement initiatives enabled our team to show a significant reduction in length of stay with a concurrent increase in patient satisfaction scores in our first year together, much to the delight of our parent institution. Physician morale was also improved because everyone felt invested.

I truly believe in being a “hands-on” leader. I ensure that I work side-by-side with my docs and do the same shifts they do. Besides allowing me to address situations in real-time, it strengthens my relationship with the rest of the team because we all share in the workload and difficulties. I get to lead by example and reinforce the expected standard of performance for the team by showing that those standards are neither unreasonable nor impossible. On the flip side, this type of practice ensures that I create realistic visions for the team and set achievable goals — if I can’t accomplish the goal or maintain the standard, how can everyone else?

Leadership styles vary considerably, and there is no “right” way to lead a group. I do believe, however, that every leader can agree that each successful effort is the result of a strong team of individuals working in unison to achieve clearly defined goals. Patience, strategy, and a willingness to be flexible and empathetic are just a few tools that can help a leader foster the growth of their team and team members, and affect positive change within their institutions.

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