Change is inevitable, change is necessary, change is often for the good; but change is hard. Even getting married to our life-partner is considered one of the top ten most stressful life events. http://www.garlandscience.com/textbooks/0815341571/pdf/supplements/StressfulLifeEvents.pdf
I have hesitated posting in this blog for some time because of all of the changes going on in my hospital – I was waiting for things to settle down. But, since the settling may take a while, I’ve decided to write about those these changes.
We have been in a transitional stage for over a year, and will be in one, probably, for another year. Our CEO retired at the end of 2010, not a stellar financial year. Everyone in the hospital knew change needed to happen. For months before our CEO left there was anxiety about who would be standing once we had our new chief. Unanticipated circumstances led us to have a temporary CEO who will be with us for 3-6 months before we get our new permanent chief, so we know we will go through this transition twice.
Fear of change and loss are widespread. The changes that are needed, and they are needed, may require all of us to think in a way that we never have. Alliances that have been in place for decades are broken or may need to be broken. Things held as sacred, consciously or unconsciously, may no longer be sacred. Like in “Survivor” (never seen it, but I’ve heard) when resources are scarce its impossible to know how others, or even we ourselves, will behave. The distribution of authority changes and it’s hard to know exactly how the new chain of command works. Personally, I struggle with needing to protect my group while also needing to protect myself at a time when I feel vulnerable. When I feel vulnerable it can be hard to make my best decisions. If I take a step back and look from the outside, I can appreciate that I’m in a deeply uncomfortable yet fascinating social experiment which has played itself out endless times in every business scenario. But business and medicine make strange bedfellows.
To be a manager by definition means that you are beholden to the institution above you and the employees under you. Physicians, especially hospitlalists, spend so much time in the hospital that their colleagues become their second family. Feelings of protectiveness, jealousy, fear of abandonment, rivalry, love and belonging all exist in the workplace although we may not recognize them as such.
My job now is to anticipate what change is required and to stay on top of it, to be proactive instead of reactive. Being reactive, as we all do at times, can lead to misguided and emotional decisions. I need to be judicious with information yet be as transparent as possible so that my group can keep a sense of control over itself. We need to maintain our primary goal of safe and excellent medical care while trying to maintain the cohesive and caring community we have built over many years. This is the most difficult challenge I have faced in my career. I will, however, as the British Government said in WWII, “keep calm and carry on”.