Reader feedback - Letter to the Editor

Physician Executive, Nov-Dec, 1998

Dear Editor:

Compliments go to Tom Marr and Dan Zismer for creating their article, "When is a Physician Network a Group?" (The Physician Executive, March/April, volume 24, issue # 2). It is particularly timely given the collective collapse of the PPMs following the widely reported failure of most PHOs. Culture is fundamental in creating and managing any organization, but particularly those in the public service sector. David Ottensmeyer, CEO of Lovelace, pointed this out in his 1976 article, When is a Group a Group?" It was published by the Medical Group Management Association, but unfortunately it is out of print.

Sincerely,

Steve McDermott

Executive Director

Hill Physicians Medical Group, Inc.

San Ramon, California

100 percent correct

I greatly enjoyed Earl R. Washburn's article in the recent edition of The Physician Executive (July/August, volume 24, issue # 4). As an almost retired physician executive who has worked in several various roles as a physician leader, I think Dr. Washburn is 100 percent correct. I hope that lots of physician executives read his article and take up the challenge to be the logotherapists of our profession, which is in need! To Dr. Washburn, keep writing!

L. Richard Schumacher MD

Managing Partner

KARE HealthCare Consulting,

LLC Managed Care Consortium

Peachtree City, Georgia

Physician: Heal thyself

I would like to compliment The Physician Executive on its excellent selection of articles in the July/August 1998 issue (volume 24, issue # 4). I found every one to be stimulating and cutting-edge. I would like to take the opportunity to comment on four articles in particular: "The Pinata Syndrome," "Physician Resiliency." "The Zen of Physician Initiatives," and "The Physician as Logotherapist"--all sharing the common thread of physician malaise, and all suggesting possible solutions.

All of the authors do an excellent job of delineating the dissatisfaction and professional malaise experienced by many physicians today, and which most attribute to outside factors "attacking" the profession. Washburn and Lyons came closest to the real issue, which is that physicians need to understand that their own thinking about the "factors out there" is the cause of the gap between their professional values of service to patients and the sacred nature of the patient-physician relationship, and their seeming lack of resiliency and joy in work. It is not the "factors out there," or any perceived obstacles which are causing the distress; it is the thinking which physicians are themselves entertaining about obstacles and expectations that is at the root of the problem.

It is not that medicine is on a collision course with its environment, but rather that physicians as individuals are faced with a daily choice regarding living with integrity to their deepest values versus continuing to imprison themselves with their thinking that outside factors are determining their happiness and job satisfaction.

As Washburn says, the role of a physician leader must be to lead us out of the wilderness; the wilderness we have created with our own thinking, via a lack of understanding of the role of thought in the creation of experienced reality. Lyons points to listening, which includes deep listening to ourselves and others, without the distraction of our own personal thinking--this is key to resiliency and responsiveness. The passage from Victor Frankl that was quoted says that actively questioning life and its meaning leads to depression and feelings of victimization, while simply taking daily personal responsibility to respond to life's requests of us and fulfill the tasks it constantly sets for us is the key to success. That refers us again back to daily choices each individual physician makes to be true to the values of the profession versus entertaining expectations and feelings of victimization that take us out of the moment and away from the task at hand, that of caring for patients or leadership in health car e.

Physicians do, in fact, have the freedom to act in our patients' best interests, and we will find that acting in that way will lead us back to the reasons we entered medicine in the first place and healing for both patient and physician. Medical leadership can take the lead role in reestablishing the moral and spiritual dimension of health care; the knowledge that inner moral fortitude and will exists in all of us but for our distracted thinking gives hope for recapturing the joy of practice and love of patient care that physicians are longing for in their hearts. Thanks for sharing such insightful articles with your readers, and encouraging thoughtful reflection on the most significant issues facing medicine today--that of reclaiming the joy and true healing nature of the profession we entered with such hope and optimism.

Sincerely,

Marsha Milburn Madigan, MD, MPH

Senior Vice President and Chief Learning Officer

Ingham Regional Medical Center

Lansing, Michigan

Experience, wisdom, and insight

Every time I read one of Joe Flower's columns in The Physician Executive, I want to let you know how inspiring and valuable they are to me. I believe I have been a very successful physician executive and my effectiveness has always been related to the "stuff" he communicates in Next! It is so refreshing to hear someone talk about it and elucidate it as effectively as Joe does. Living in the world of "being" and not just "doing" has its rewards, but also has its challenges... people sometimes wonder what in the heck you're talking about. Again, thanks to Joe for all the great experience, wisdom, and insight that he shares.