New and energetic CEO + hospital over budget = FTE cuts.
The first round of cuts is done. We came in on a Tuesday to find several non-MD staff members gone. There was an interesting response amongst those remaining; very little conversation and a somber but almost giddy mood, (a little “hey! we’re glad we’re still here!” mixed with a sprinking of “I can’t talk about this because I don’t trust anyone anymore”).
Meanwhile process changes are occurring at lightening speed. We’ve geographically localized the patients and changed everyone’s admitting pattern putting more control in the hands of Bed Control and less in the hands of the MD’s. The housestaff, the hospitalists and the private docs are all being asked to give up some control over whom they admit. Suddenly doctors who didn’t even use the housestaff are complaining that they will lose control over this option.
There are some great things about these changes, some of which I fought for and some of which I didn’t. But I’ve noticed that even a good idea, if it didn’t get implemented the way I wanted it to, can sound like a bad one. I’m watching my docs experience this even more intensely since they have less control than I do. It’s very hard, maybe impossible, to shelve one’s ego and protective feelings over one’s turf, and why shouldn’t it be? It’s important to protect one’s turf. I’ve noticed this with my dog, Sylvie, who snaps at people and animals she loves in order to protect my rolled up dirty socks (she loves me the most, and that’s the way I like it). No one likes to lose control over something they once controlled,
- the dog who likes socks
ask any parent of a teenager. But doctors may have a particularly hard time of it given how comfortable we are giving orders and how important our autonomy is. We are trained to be this way. We are independent practitioners employed by an institution, frequently with a non-physician leader, which can be a real challenge. It’s also a good reason for us to get our MBA’s.