In Medicine Teamwork Is an Invention of Administrators and the Government

I recently had the opportunity to give a team-building group exercise to my staff of Medical and Administrative professionals. The focus was on how to build a better team of individuals to better handle our increased patient load. In the beginning of the Seminar, I had everybody fill out an assessment as to how they felt we operated as a team. There were five categories to judge: Trust, Conflict, Commitment, Accountability and Results. The majority of the scores were low, demonstrating that this room full of people, who work with each other day in and day out, some for years, did not feel that they were a team.

Over three hours I discussed trust, conflict, communication, respect, personality types, the ego, how to disagree and how to come together as a group. We did numerous exercises to delve into these areas and discussed them as a team. At the end, when we are supposed to move into being a team, two members stated emphatically that they will never trust an administrator or any superior as long as they carried a license. So after three hours these people were no closer to begin working as a team than before.

Now I do need to make an observation: the Administrative Staff were more willing to work together for the common good than were the medical personnel. They were steadfastly islands unto their own.

So now I have twenty some people who instead of working together for the betterment of the organization, they will work for the betterment of themselves.

And that about sums up medicine.

The government has been attempting to make medicine a team event instead of an individual event. We use the term Provider instead of Doctor. We want to pay for a medical appointment based on how we judge the quality of the work, not for the work that was done.

For example, as an Administrator of an ASC (Ambulatory Surgery Center), I need to gather information on my GI doctors' Colonoscopy Documentation to report back to the government. When it is brought up to the powers that be that, gee,  maybe they should ask the doctors for this information, we are told this is a great opportunity to build a connection with our physician’s office.

In surgeries, there is a Time Out, where someone other than the doctor calls for a pause to review the case, make sure they have the right person, make sure they know what body part they are operating on, if an arm or leg, which side, etc. The doctor has to wait for the Time Out to finish before s/he can begin.

Government and Administrators have tried to pigeon hole medical people into being a team, when in reality medical people are, for the most part, lone wolves. They have been trained to think this way, that if they make a mistake only they will be held responsible and they will go to jail. As such, all medical people have the mindset of “Trust but Verify.” They will not agree to anything they are told, until they see the rule, policy, guideline in black and white, and even then, if they don’t agree with what they are reading, it is disregarded.

So the battle will rage on between the Government that is trying to make medicine into their image and the medical personnel who will leave rather than comply, until medicine in America is fundamentally transformed.