Speed Limits vs. Seat Belts

Tiller-Hewitt HealthCare Strategies’ Partners – Guest Blog Series
Cameron M. McGregor MSN, RN, Clinical Operations – Innovate Team, Premier Health Partners and former Physician Liaison for Community Mercy Health Partners

Picture this: You are driving down the open highway, it is a glorious day outside and traffic is relatively light. The posted speed limit is 65mph.

Given that scenario, answer the following:

1. How fast are you driving?
2. What would make you slow down?
3. Are you wearing a seatbelt?
4. What would make you take it off?

For me (and, let’s face it, most people), the answers are something like the following:

1. 80 “ish”
2. State Patrol (or anything that resembles one)
3. Yes
4. Arriving at my destination

Rule Followers vs. Rule Breakers

So, what makes it OK for someone (me) to break some rules and not others? Another way to ask the same question is: What drives people to follow some rules and not others? The answer lies in leadership. For me, seatbelt wearing was a parental mandate (still is, even well into my adulthood) – there was no alternative, no opening, and no discussion. They did it, I did it and now my children do it. Similarly, breaking speed limits was also a learned behavior – acceptable as long as you didn’t get caught and completely tempered by extrinsic factors.

Physician –Hospital relations remains one of the hottest topics in healthcare. But what makes some hospitals so much better at it than others? It is really very simple: Do you view your physicians as speed limits or seat belts?

Those that treat them as speed limits, find themselves constantly entangled in a state of what has been termed “playing relationship chicken”: pushing each other’s limits with punitive repercussions to see who will alter behavior first. The behavior changes only when an outside authority, such as a consultant, a corporate mandate, or a governmental policy change forces what will inevitably be only a temporary modification in conduct. This cat and mouse-esque game takes up valuable and increasingly limited resources that detract from what should really be our industry’s hottest topic…patient care.

Alternatively, if they are treated as seat belts, with a firmly ingrained understanding of the symbiotic needs of both and that a solid business relationship often begins with a personal one, the health system will organically create a collaborative culture that holds them light years ahead of the competition.

These are the systems that lead with a pure intention, making strategic decisions not because the competition is or isn’t doing it, not because it is the popular trend or the latest fad, but because it is the right thing for the health of the patients and of the system. The reasoning behind every decision originates from their mission. They are the genuinely “mission-driven organizations”.

The Relationship Builders

Great. So, how do we get there? This is not a small thing especially given that building strong relationships is not a teachable skill. It takes people in the organization with an innate passion for what they do – an instinctive desire to have actual, meaningful relationships with their stakeholders that extend beyond the walls of the hospital. This doesn’t mean you need to put your children in playgroup together. What it does mean, is that trust is built over time and usually has a personal component. First though, you need to evaluate where you stand today which can hidden be in the minutiae.

During my time as a physician liaison, I developed a number of practical senses (the most useful of which was a fine-tuned BS detector but that’s a blog for another day). I can tell the status of the relationship between physicians and the hospital just by the verbiage they use when speaking of each other…and it has become one of my biggest pet-peeves.

Think about it: How many times have you or a colleague used the term “have to” (complete with eye roll and impressive sigh) when talking about meeting with a doctor? How about how you “handle physicians” (insinuating it would be different from how you relate to “regular people”)? Or my personal favorite, “we own them” when referring to employed clinicians? Although it seems harmless, the way we speak about each other is a very clear indicator of our level of respect for each other. Hospitals often make the mistake of considering doctors as “possessions” to be acquired or “barriers” to be removed rather than as a relationship that needs to be cultivated.

Where to find “relationship builders”

They are likely right in front of you, hiding in plain sight. In our haste to move at what has been aptly coined “the speed of healthcare”, we often laser focus on one quality instead of the entire picture. These people are not always the most obvious candidate on the list. Look for the dark horse who always seems to come up in conversation when people are looking for a “problem solver”, who seems to command sincere respect just by how they enter a room, who is always being sought after for an opinion, someone who treats the housekeepers the same as the CEO and who, no matter how fast they moving, always has their seat belt fastened…not because someone told them to but because it’s the right thing to do.