Life in Emergistan: The Leap Physician Satisfaction System

Leap, Edwin MD

doi: 10.1097/01.EEM.0000473168.47109.8f
Life in Emergistan

Dr. Leap is a member of Blue Ridge Emergency Physicians, an emergency physician at Oconee Memorial Hospital in Seneca, SC, a member of the board of directors for the South Carolina College of Emergency Physicians, and an op-ed columnist for the Greenville News. He is also the author of four books, Life in Emergistan, available at www.nursingcenter.com, and Working Knights, Cats Don't Hike, and The Practice Test, all available at www.booklocker.com, and of a blog, www.edwinleap.com/blog. Follow him @edwinleap, and read his past columns at http://bit.ly/LeapCollection.

Article Outline

I have never been the director of any professional group. I have, however, been directed, and I have a few tips for those who are directors and administrators. I give you the tenets of my physician satisfaction system, in no particular order.

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Every physician breakroom or lounge should have a wall for photos of girlfriends, boyfriends, children, spouses, parents, dogs, cats, horses, boats, new shotguns, or whatever makes those doctors happy. Emphasis on children and spouses, boyfriends and girlfriends, moms and dads. See below.

Post this where physicians work: If you have a husband or wife, please avoid having a girlfriend or boyfriend. It is unfair to your spouse and children. And it is very, very expensive, as hobbies go. You're better off with a boat.

Every physician break room should have the following:

* A recliner

* A refrigerator with snacks and drinks

* A television with cable

* A computer with Internet and without the silly hospital firewall. Pay for it yourself if you must.

Know your doctors. The best way to do this is to talk to them. It's tough to really talk on a shift, so do it away from work. A quarterly group dinner is a nice touch. Or simply, “Hey, let's go to lunch one day to catch up.” You have to mean it, though.

Remember that a married doctor is a unit. When there are important decisions to be made (into which you and your partners are allowed input), invite your doctors' husbands and wives to give their opinions. You'll be grateful for the wisdom a loving spouse brings to the table. And remember, nobody is more motivated to make the group money than a spouse with a mortgage to pay and babies to raise.

Want to score points? Send a card or note to the group spouses now and then. Thank them for their service, their encouragement, their patience. Ask them how their family is doing. Remember that being married to a physician ain't exactly a pony ride. Everybody needs a kind word.

Attend weddings, celebrate births, have anniversary parties. Visit the sick in your group. Send condolences. Mourn at funerals. Laugh and cry. If you take the time to know them, it won't be hard. They'll be family.

Lead from the front. If your docs tell you nights are really hard, work a string of nights. If they tell you that someone on staff is really hard to consult, talk to that person yourself a few times. (Tell those difficult doctors to back off and play nice.) If everyone hates the EMR, do everything you can to make it work for them. Never ask your troops to do something you won't. Never, ever.

Be fiercely partisan toward your staff.

Help your doctors develop long-term plans, including an exit strategy. We can't all go into urgent care or academics, but we can plan for a slow, steady withdrawal as the years go by. Encourage wise decision-making, especially in the young Jedi.

Develop a sabbatical. Encourage your doctors on sabbatical to travel, take a class, enjoy sleeping in their own beds. It may be the longest time they have slept all night with their husbands or wives consistently in years. It may be the first full reset of their circadian rhythm since medical school.

Watch your doctors closely. It's easy to become overwhelmed, depressed, or anxious. Help them through mistakes. Let them decompress. Let them be sad. Don't chastise, teach. Find a local counselor in case they need to talk about that death, that tragedy, their personal demons. Doctors kill themselves sometimes. Try to keep it from happening.

Identify the strengths in your doctors. Some are born leaders; let them move in that direction. Some are brilliant clinicians, so use that. Some are great with people. Let them mentor. Some have hobbies or interests that make them better physicians. Celebrate the unique individual gifts that every partner brings to the table. Now and then, use these to remind the hospital what a unique and valuable team you have.

Take pride in your group. A logo and T-shirt would be a nice point of pride. Brag about your doctors. Tell the local newspaper about them. Help them be invested in the community, treasured by the community.

Praise your partners, to their faces and to others. Write down the good things they do for future letters of reference.

Give your team permission. Permission to succeed, permission to fail. Permission to try new things and sometimes permission to leave it all behind.

Call in pizza from home on really busy nights, and on terrible nights, come in and use your authority to make things happen more smoothly.

A lot of schedules have holes. If you don't want your entire group to realize this, subsequently leave, and then come back making more as locums than they did before, be their advocate.

We have a difficult job. But with the right leader, it can be wonderful even when it is tough. It's up to you, directors, to set the tone. Good luck and Godspeed.

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