Tag: accountability

Taking Ownership

How many times have we all waited for someone to take care of something for us? How many times have we been stalled in a work project, waiting for someone to finish their part? The frustration and loss of time in doing this makes no sense. I say forget it! Let’s try a different strategy. It’s time to take ownership.

So, what does that mean? According to the Harvard Business Review, one of the most egregious momentum killers is waiting for someone else to act, take initiative, or take charge. Most of the time, no one is coming. So, why do we do it? If help isn’t coming, let’s liberate ourselves and take responsibility and move forward. Start believing in yourself as an individual and take stock of the fact that it is, in fact, your responsibility for the quality and timeliness of an outcome. This applies even when you are working with others. It doesn’t mean that you are always in charge of everything. It doesn’t mean that you shouldn’t collaborate with anyone. It just means that you take ownership of your part and the results.

The same article in the Harvard Business Review went on to discuss that there are a couple of basic things to understand about taking ownership. First, I think we need to be able to tell the difference between fault and responsibility. When we finger point at others or at ourselves when something is not getting done, the perception of fault gets in the way of taking ownership of a difficult problem. Then, the problem still doesn’t get solved. Get rid of the blame game and we will all be more successful. Second, taking ownership frees us up to move toward getting results or finishing a project. Last, we can actually help others not just ourselves by taking ownership. Sounds like a win win to me.

The bottom line is, taking ownership/accountability/responsibility for your part can only help yourself, others, and the project move forward. Blame and finger pointing does nothing but waste time and energy. Don’t waste the energy. Put your big girl panties on, take responsibility and forge ahead!

Grade Whore

Yes. I know you have seen this title before but something happened today that made me feel like this post was worth a second look….so here goes..

Hi my name is Dr. Laura Katz and I have been a doctor for 24 years. I signed up to care for people 24 hours a day, 7 days a week, regardless of how much I get paid. I signed up for a lifelong commitment to the health of others, sometimes at the sacrifice of my own health and my family life. I signed up to compassionately listen, problem solve, give 110% and guide people every day into better futures for themselves and their infants. I did not sign up to be a grade whore!

OK. That was a strong word, but it is fitting nonetheless. So, what the heck am I talking about? No worries. I am about to explain. We now live in a society in which patients do not seem to be thought of as patients anymore. They are thought of as clients or consumers, which changes the whole flavor and mentality of the doctor patient relationship. ( I personally am kind of stuck on the patients as patients idea. However, I am behind the times to say the least.) I think that this kind of thinking is potentially very harmful. The kind of thinking involved that classifies patients as consumers or clients lets loose a whole wave of entitlement behavior on the part of the patient. The old adage ” The customer/client is always right” has really run amuck here. Patients now think that they should be able to go to their doctor’s office and demand what they want for their medical care or demand what pills they should have prescribed , just like they can demand what hair cut they want or what good they want at a restaurant. If they don’t get what they want, they have complete free reign to go on Google, Health grades, Vitals and attempt to destroy that doctor’s reputation with little to no recourse available on the part of the physician. Sure, we can go to Google and attempt to reply or prove why the stated comments are skewed or not factual, but the chances of that review coming down are slim to none in my experience. What’s worse, said patient who is posting the bad review does not have to really be accountable for it or even prove that they have ever actually been to that doctor’s office! What?! How is that ok? How did this review process get so out of hand? I am all for having input in your medical care and having patients advocate for themselves and insist on quality, but these rampant reviews when things do not go their way? No. I think that is wrong. Reviewing the wrong doctor? This could actually ruin someone’s career. I have had some reviews in the past that were awful and caused anguish and concern, only to find out after extensive research that that person had never actually seen me! I am sure that they are still out there somewhere and they still haunt me. I never want anyone to be hurt or wronged by me, but I cannot help rectify a problem with someone that I have never met. Still, these reviews are treated as gospel by those patients who carefully comb through online resources when selecting a doctor. They may not stop to question whether they could actually be true or not. They will just keep looking. I have to admit, as a patient, I look for reviews as well when selecting a physician, but if I can speak to someone directly who has seen the physician, that holds a lot more weight in my decision-making process. I am much more a fan of fact, not potential fiction.

We are all obsessed with reviews even at a hospital-wide level. We have things like HCAHPS and Press Ganey reviews that survey patients in a whole hospital environment. Hospitals then turn around and use these reviews to grade themselves and physicians and somehow use them as a judgement of worth. Now I will admit that these reviews at least require some documentation that a patient actually received care at that institution, but there are still too many factors not under the physician’s control that they are being lumped together and used to judge them. Patient’s will return a poorly rated survey if they didn’t like their hospital food or if they did not like their nurse for example. These are things that the doctor does not have any control over. There are some patients that you can bend over backwards and sideways for and they still will not be satisfied. Are you supposed to go against your medical judgement to do something that a patient wants in the hope of a better survey score? This is not supposed to be some sort of contest in which the 5 out of 5 score is the only objective. Did you know that places like John’s Hopkins have done studies regarding this kind of patient/consumer driven care and that outcomes tended to be worse when patients dictated their own care and doctors complied for fear of a bad review? Think about that.

This kind of culture sends us doctors scurrying and begging for positive reviews from our patients in the office as well on a daily basis because now we are worried what could be out there on all the public sites and how many of them could potentially apply to us. I have to admit, I have stopped looking at those reviews because they really mess with my head at times and actually get in the way of me providing quality care to my patients. I understand the concept of healthy feedback and its potential utilization in betterment of myself and my practice, but that does not seem to be the intent of the review process as we know it today. It feels like I am begging for a good grade or asking patient’s to sign some invisible report card when it really does not matter. I will give them 110% whether they leave me a review or not. Now having said that, we do conduct in-house reviews every day. Every single patient is given an option to review our practice and myself every single day. Every single patient decides whether or not they want their review to be shared. Now these reviews I look at carefully, each and every one. I take these to heart because I know that these are the patients that I am actively taking care of. We have been very lucky in that this review process has been very informative and that patients have been very thoughtful in their reviews. This has allowed our practice to take all appropriate action when necessary. I do believe in the review process, but it has to be done the right way to be constructive and true to it’s original intent.

I think that our culture of the patient as the consumer has also led to a huge breakdown in the respect that patient’s show to their physicians. No, I am not yearning for patriarchal 1950s medicine when gruff physicians dictated to their patients and patients followed without question. But, there is a part of me that thinks it is worse to have patients running amuck and dictating their own care. The customer/patient is not always right in these situations. Sometimes patients want things that are actually dangerous for them and would put both of us in danger. I actually have the medical degree and the training. Please let me use it and guide you. I like patients to be on their own team. I like to make decisions together. I like them to advocate for themselves, but not yell at me when I don’t do what they want even if it would be bad for them. I think we need to compromise somewhere in the middle. Have a fantastic day everyone!

Dr. Katz

It’s Just a Job

I saw someone post on Facebook the other day…People at work are not your friends. It’s just a job. Do your job. Go home. I also hear people say ” It’s just a job.” far too often. While I get that we are always told not to bring our work home with us and to make sure that we have healthy work and life balance, I am not sure that that is what that statement really means. For the majority of folks, if you were to ask them about their current employment, they might respond with a somewhat dismissive, “It’s just a job.” I think that this response it somewhat a metaphor for the troubles with work ethic and even life ethic that seem to plague us. As an employer( and an employee), when someone says it’s just a job, here is what I hear. ” It’s just a job. I don’t actually care that much. At least I am only somewhat responsible during my shift, which I hate showing up to and then I am free as a bird after that. I can always dump what I didn’t finish on the next person. It is a means to make some money, but that is it..and even knowing that, I don’t really appreciate the fact that it is helping me pay my bills and be able to live. I don’t really care that I am lucky to have a job and lots of other people don’t. I have no sense of true commitment or loyalty to my boss and I have no ties to my work colleagues. And finally, I literally never even think about my job or what I am responsible for when I am away from it and if I forget something, oh well.”

Ok I get it, that is adding a lot of weight to one sentence, but I really think that it is applicable. I think some of us have lost our sense of value and ethics when it comes to work. On top of that, inflation aside, we expect to get more pay for doing less because we are somehow owed. I get that not all jobs have the same level of objectively measured importance, but they are still important for different reasons. Each and every job has an associated goal that requires completion for the rest of the steps to continue. Even a ditch digger has to complete the required depth and width to be able to accommodate whatever object is to be buried and if they don’t the rest of the project cannot continue. True, it is possible that no one’s life in particular will be significantly affected by it, but it is still important nonetheless. I cannot think of any job that is not interconnected to another one in some way or that wouldn’t be improved by some real investment on the part of it’s employees. In my office, this is particularly true. I am a physician and I also practice aesthetics. My job is essentially runs 24 hours a day, 7 days a week. There is never a time when I am not responsible for the lives of my patients. I get that. I embrace it AND.. I knew what I was signing up for so I tend not to complain. To me, it is a sacred honor and privilege to be able to care for people and I reremind myself of this every day, even on the worst days. I am that weirdo in the operating room that takes an additional pause after the surgical pause to reflect on how lucky we are to be able to be here for this patient, for this procedure. I worked hard to get here and I am not leaving any time soon. I know that I am never really “off the hook” when it comes to patients. I don’t ever really leave the office even when I leave it physically. But, it’s ok. I love what I do. I am grateful for what I do. I will always be grateful for what I do. I take care of my employees and patients like family. I would do anything for them. I keep working whether I get paid or not so that I can take care of my employees. Do I expect my employees to be on call 24 hours a day, 7 days a week like I do? No. Do I expect them to be there as late as I am all the time? No. Do I expect them to have the same crazy level of work ethic that I do? No. Their level of responsibility is not the same, but they are responsible nonetheless. I do expect them to complete their jobs to the fullest. I do expect them to go through some checks and balances each day BEFORE they leave to make sure that all tasks are completed, all referrals are in, all labs are called, all scripts were sent, etc. I expect them to not directly refuse tasks or passive-aggressively avoid them and think I won’t notice. I expect them to have a team mentality and realize that we are all incredibly important in providing the best care for our patients. Even though the only cog in the wheel that really can’t be replaced is myself, they need to understand that I will value each and every one of them and treat them with respect. Having said that, I also hope that they realize that respect is a mutually earned commodity and it has to be given and returned in kind.

I hear stories from employees from an older generation about incredible abuse they suffered in the workplace that went on for years and years and how they kept coming back for more because ” that’s what you did in those days.” I hear about how they were insulted, made fun of, worked with no breaks, had to cover for their boss’ alcoholism and had to make excuses for them if they failed to show up for procedures, etc. Compare that to nowadays when employees quit over proverbial hangnails and there is no comparison. I have to admit, when I first hear those stories, I find myself thinking oh I wish I could even get a fraction of that loyalty. Then, I catch myself because I realize that those situations were not about loyalty. They were just about frank abuse and I don’t want any part of that. I am not converting myself into an asshole to get people to do what I want. It’s just not me. I feel like we should be able to meet somewhere in the middle. I have no idea why employees of yore put up with such terrible things to keep their jobs. I suspect that it is at least partially a reflection of our former extremely patriarchal society. I am not sorry that some of that has gone the way of the dodo, but I feel like we have gone too far in dropping our level of work ethic. Now employees feel like they can quit with no notice, no show no call for work, talk back and refuse to complete tasks. How did we get so far off track? I don’t really have the answer but I have some theories. I think that our culture has slowly transformed into one of ever-decreasing actualization of responsibility in everything that we do. If something doesn’t work out? Oh well. If a child is acting out..it must be his or her parent’s fault. If someone does something wrong, incomplete, or incorrect, we cannot even attempt to guide them without being misinterpreted as belittling or chastising and get written up. We are dealing with an overall decreased actualization of responsibility without the tools to deal with it because the potential repercussions of trying to deal with it are sometimes worse than whatever went wrong in the first place! How exhausting is that crap?

For myself, I keep plugging away hoping that my work ethic somehow becomes infectious and spreads to those around me. I offer uncapped incentives for hard work, on top of salaries. I am truly a believer in the phrase,” you get out what you put in” and I want to make that true for my employees. The ones that work harder will get rewarded with raises and incentives, but I do not want to, nor can I afford to, give it away. I desperately want them to be invested in their work and this is the most clever way I can think of to try to make that happen, by having something in it for them besides just work pride. I cannot really chastise people for wanting more money. I mean, who doesn’t want more money? That is a pretty normal human want. I am just hopeful that they see that they have all the tools to be successful financially and at the work place, as long as they put in the effort it takes to be so. It is a potential win win for everybody…the patients, themselves and for the longevity of our practice. Well, those are my thoughts. Have a fantastic day everyone!

Dr. Katz