Fear and Change Update – layoffs and loss of control

By  |  February 20, 2011 | 

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.

Leave A Comment

About the Author:

Dr. Lovins loves learning about medicine and leadership, sings in a rocking band called the Inflatables and is married to a photographer named Andrew with whom she shares three excellent children and two small dogs.


Related Posts

By  | June 7, 2018 |  0
Everywhere I go these days, one of the top questions on the minds of hospital leaders and hospitalists alike is, “How can we improve hospitalist patient satisfaction scores?” It’s a dilemma. There are people who know way more about this subject than me, but I’m not aware of anyone who has really cracked the nut. […]
By  | June 4, 2018 |  0
The question of appropriate ward garb is a problem for the ages. Compared to photo stills and films from the 1960s, the doctors of today appear like vagabonds. No ties, no lab coats, and scrub tops have become the norm for a number (a majority ?) of hospital-based docs—and even more so on the surgical […]
By  | May 11, 2018 |  0
There have certainly been numerous articles, periodicals, missives, messages, courses and LinkedIn articles about the importance of strong leadership. I myself have blogged that most “challenges” in hospital medicine could likely be solved with strong leadership and adequate staffing. But recently I gave a talk with Sarah Apgar from UCSF on differences in supervision and […]