Driving Effectiveness for the Next Generation of Anesthesia Leadership | Live from the Anesthesia Economics Summit

WEBVTT
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The first question is how do you within your groups go about identifying and measuring ESCO leaders?
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Is there a formal process you give it much law?
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Well, I get started with the recent examples.
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So I've been working in a very large department transition private group to deploy a model.
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And with when I sat down with the chief officer, one of his first questions he asked me was who do you choose as a leader?
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When do you hire a leader?
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How do you identify those leaders?
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It's really interesting that you get advertised and people are apply to work and they've got an experience or not.
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I said, but you know, when especially in this situation with a department transition, I would rather get people on the ground and kind of look at them and watch them work and see where people gravitate towards.
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Actually, you know, you see those characteristics in people as opposed to somebody just applying for the position.
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Um line explaining.
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I typically, when I'm looking for here, uh collapse can look at the first person apply because a lot of people have a little different titles, and maybe they have the experience, maybe they don't.
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Um I'm more interested in looking at the people that other people respect, and you can quickly identify who people are going to follow.
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And then when you kind of see that in the person, then you can kind of sit up and ask some questions if they're interested in it, do they realize it's leadership qualities?
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Because there's very specific things that leaders bring, and most people that leaders don't even realize they have it, they just do it.
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And so that's kind of the first thing that I look at.
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And of course, you're always going to find people that are just gonna kind of fall in your lap and apply for a job.
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And you know, it's like, wow, those people are perfect.
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But it's interesting when you're in this long enough, you can sit in a room, you can pick people out and have those leadership colleges, even if they don't know the language.
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Um Joe's right on this as far as identifying the people within your practice that people gravitate to.
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From our experience, um, we've actually started a formal process.
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We did not have a formal process, let's just call it five, six years ago.
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Now, as we onboard people, we actually are pairing every physician, every CRA within day one.
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So that creates an onboarding process, smooth it out.
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That first few weeks, if they have questions, they go straight to that person, they're assigned to, they build a relationship.
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And that helps with the onboarding from a physician standpoint.
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You know, we we have assignments, and we work with them, and we get to know them.
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So making sure that they're successful because so much goes in to recruiting nowadays.
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Like if you are lucky enough to hire people, bring them on, the last thing you want to do is for that person to not engage in the group and then desire me after six or a month or a year or something.
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So we we look at it as a long-term relationship.
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We're gonna hire somebody, we're gonna bring them in and make sure that they're successful.
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Meaning we give them all the tools they need.
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What did that?
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It's not immediately clinical.
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This is all useful.
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So how do they give it a main difficult case?
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Manage politics to the war, manage staffing to politics?
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Exactly.
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So those are the things that nobody in the teaching has just seen, or you know, nobody in the training is doing.
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So we we actually really have the formal process kind of which we did not use a lot of it.
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It's great.
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It's great to do that because uh the package you're formalizing, but we think you have a thought um uh how to do this.
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Because in many cases, we have really don't have necessarily that thought through.
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There's no there's no way to help build those skills skills, which are super important uh as much as also the financial acumen.
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The business acumen, those pieces of the possible act.
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The answer will need to be sitting down with the controller, with the not be able to build the spreadsheet, but be able to talk about the spreadsheet and be able to speak our language, and if you can build those relationships as the leader with the different groups of financial team, operation, quality, all of those relationships as you go forward.
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So sort of in a lot of organizations, there's a sort of a sense that anesthesia isn't working well.
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How do you identify a dysfunctional anesthesia leader?
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And and how do you uh address the dysfunction in such a way that it doesn't destroy the entire question?
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Yeah, uh I'll take a quick step in it.
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You know, obviously uh one of the things uh there's some possible leaders uh that are very focused on this at the very moment.
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It's it's you know it comes out to leadership.
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We've got three or four new division leaders within the department that I'm working with, and um you know trying to kind of uh develop them, get them skill sets and all that.
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But you know, one of the things I would teach as a leader, you know, you want uh obviously people to follow you.
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How do people follow you best?
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How can you treat other people?
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So I think you know the first dysfunction you're gonna see is how they're treating other people.
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You know, the complaints we can hear of, oh, you know, he's not being fair to me, or he's doing this or that.
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And so it's really that's kind of the first thing that jumps off the page how you know does that person treat other people and how do people respond to that person?
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That's maybe kind of the first thing like we've got a problem with this leader.
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And not only did they complain, but they actually vote with their feet, they're gone.
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The team is gone.
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The retention is a huge issue in those scenarios.
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Yeah, go on.
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I was gonna say from a Washington point, we we actually really work on retention.
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So when we do hire someone, the next step is fastback.
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So we we do a lot of things across our company to make sure we have retention.
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Um physician leadership is important, but it's more of our um workforce is made by including CRNAs.
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How do you not only identify a CRNA leader, but how do you integrate that CRNA leadership into the department leadership because the scheme of making things work on a daily basis?
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Well, we we actually, from our standpoint, we we take our CRA leadership, we have two of them, two teams.
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And we work with them on a daily basis to align them.
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We we value their opinion because that's when we're making these global decisions, we really, as far as staffing and our ATDs, we we really don't make decisions without informing them and giving their buy-in.
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Because they know exactly who's on the ground and what our staff is saying.
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So we we engage them, and then we also engage our all of our staff.
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Um, like even last weekend we had a uh a yearly round table with all of our staff.
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We met at a restaurant, we picked for everything, everybody had a good time, but the point of it was to engage with our with our all of our staff, get their opinions, let them know we care.
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You know, we listen to them, what changes can we all make to do better for them, and then we're we're all aligned.
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I mean we we have to take our our staff's opinions very seriously because we're all competing for staff and we're all have to be aligned on the same page.
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Yeah, sort of as a follow-up question, you don't make an annual one, but do you have a monthly?
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What goes on regularly and keep that dialogue?
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Me specifically, okay.
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I mean for me specifically, I'm I'm actually 100% clinical also.
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So not only is my title the president of the group, but I'm also the full clinical in the operating room every single day.
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So I actually think it gives us an advantage because we identify stuff right away.
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And we don't ask our staff to do anything that I'm not willing to do myself.
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Meaning, oh, somebody needs to go staff this location, somebody needs to do this.
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Well, I'm doing it myself.
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Understanding where the coming from that.
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Yeah, I don't think we should ignore that, at least in organizations that I've looked at, and particularly in academic organizations, the MC department that functions to the best is where the department chairperson is in the OR at least one day a week and takes a call.
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Because you can't leave from an office and you can't leave in a dogly.
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And just like you said, you learn more by practicing clinically of what needs to change than you could ever find out from a spreadsheet.
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Yeah, it comes down to stream credibility.
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You know, it's really difficult to manage people without putting your self in their place, just like Mark said.
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You know, the best way to manage people, the best way to get you for other partners functions, is being amongst the team and actually do the work.
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And it's still different, I do a lot of transitional work.
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And so I'm temporary in these situations.
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I don't get to develop as many relationships, but try to instill that on my division issues because you know they're responsible for their area.
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But like, you know, don't on your dates off when you're doing your art time, your admin time, you know, still make yourself known.
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You know, don't just disappear so that people know you're around, you're always available to them.
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So you have to be present, you know, physically physical presence uh around your team is important.
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I just think a lot of the models that we've seen have a heavy clinical component.
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Maybe not 100% a lot.
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Um protect time for leadership administration, research, all those things can be part of that possible.
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I'm gonna ask a question and then we'll sort of open it up to the audience to try to be more responsive to your needs.
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But how do you think the training of EMC providers needs to change or being modified so that we're developing EMC leaders and exposing them to leadership theories and examples as part of the training?
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What needs to change?
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That's tough.
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Um obviously it would be great to have a rotation or whatever it is during residency, where kind of learning the business side, about building, um, developing some of those uh other skill sets, clinically all going to come out and be great, hopefully.
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And so that's what we do.
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And that is one of the biggest missing pieces that we see when people come out.
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And you know, when I was young, freshman practice used to sit in our office or office manager just to take my mail and just ask questions in probably what we're talking about, but just try to understand how we got paid, how the contracts work, you know, things like that.
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It's very imperative, you know, that we get people involved.
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And you know, this new generation of people coming out, they're great clinicians, but they don't really have the desire in drive until leaders you know that now that we know we've got fewer big practice practices in the studio that don't come in, uh, learning our own practice, they don't really are involved in that business.
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They just want to come in and do a great job punching and punching up explaining.
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So, you know, how do we entice those?
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And I think if people are natural leaders, we just don't have that many.
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But again, there are people that have the skill set that doesn't know.
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Um I think that as far as in residency, it is it's tough to say that there needs to be dedicated time to learn that stuff.
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I mean, you only have so much time in residency where you're training a lot of world.
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Um you just have to you have to have a desire to want to learn.
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So when we get people in RAM, you have to spend time with teaching them how to navigate.
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I mean, it's it's more probably some of the most predictive successes of a career might hinge more on that than it is if you just go to Google knowledge.
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I mean, that that might be just as heavy as far as being successful as a clinical.
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Yeah, one of the things that we have done in the transition working on is we've built up a waterfall structure of um getting more people involved in leadership.
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So different committees, we developed an ADP structure for different sites that report out to our ATP director.
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And so we really tried to spread out the department purposefully to get more people interested in leadership, um kind of more boots on the ground, kind of paying attention to what's going on.
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So you're building that structure that people will decide.
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I like this, then you've got a natural built-in flow of future leaders.
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And it's not always easy to do when more private practices being developed more as an academic practice, um, but it's something to do very similar to like what Mark talks about with uh partnering up with a mentor and kind of getting these uh providers interested in the things that those of us do.
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I love that that you guys write that leadership and it kind of allows you to find leaders uh large organizations like my uh developed leadership academy.
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Um physician leadership has all kinds of ways uh physician programs as well to grow their knowledge on the large group in the Midwest, there's a particular one of the more secure leaders feels that it's his mission to nurture um the future leaders.
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And he he makes everybody that comes into the group aware that if you're interested in leadership or you're just interested in getting further exposure to the business of the anesthesia I'm here to help you.
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And what he starts with is asking them to read the book on your room, crucial conversation.
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And then he sits down with the anesthesia leaders in training once a week and talks about it and then relates it to problems they've experienced, and it's usually an outburst between uh an anesthesiologist and a surgeon or not treating um the nurses with the level of respect that it's so it's not just giving them the didactic training, but then finding examples where um people could have handled situations a little bit better and doing it so before we end, does anybody have any questions in the audience for the panel that we may not have covered?
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Okay, well, thank you.
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We've certainly enjoyed the opportunity to share some of our thoughts.