From physician leader to corporate physician - Essay - Column

Physician Executive, Nov-Dec, 2003 by Eddie Erlandson

IN THIS ARTICLE ...

A former vascular surgeon shares his experiences moving from the clinical world to the business world where he is now health care consultant and team motivator.

Five years ago I assessed and enhanced my patients' vascular health.

Today, I assess and improve the corporate health of departments, divisions and whole organizations.

My "patient exams" now take the form of in-depth leadership competency interviews called 360s, that involve an executive's peers, managers and teams.

"Patient consultations" look like one-on-one feedback and coaching that often involve prescriptions for telling the truth, learning on the run and becoming accountable.

I used to write articles on clearing arteries.

Now they're about clearing the sludge that brings our organizations to a halt.

Instead of conferences with families, I hold offsite teambuilding sessions that help boards and executives support one another and act in concert to achieve their financial goals and deliver value to their customers.

And sometimes I even talk about healthy lifestyles, but mostly my speeches involve the entire array of radical changes we must each make to achieve the results organizations need now. Some of these radical changes include instantly becoming curious any time we hear criticism and dropping any behaviors that resemble victims, rescuers or persecutors.

Changing careers

The path from there to here started eight years ago, when I noticed how hard it was to create change at my own medical center. There was no question that the system needed to change, in terms of economic outcomes as well as disease management, prevention and health.

When I co-designed and taught Life Lessons, a 16-week wellness program, I received significant pushback from some physicians because it included mind/body practices like meditation and yoga. One physician even remarked that next we'd be teaching Communism!

After two years, the 300 people who completed this program showed statistically significant improvements in quality of life, overall health and endurance, plus reduced cholesterol, blood pressure and weight.

One day, an executive who participated in Life Lessons commented that he knew his health and well-being had improved and that he would live longer. He got my full attention with his final comment: "I'm also applying this at work and our bottom line is up 25 percent this quarter."

Our institutions and our patients all suffer from the same disease: resisting change. I became increasingly aware of the phenomenon of sludge: a mixture of protectiveness, pleasing, paternalism and independence that gums up the works and stops any real progress in its tracks.

Sludge emerges in all typical health care scenarios, like competing for resources, turf battles, customer responsiveness, innovative information systems and practitioner engagement.

And it's endemic to corporate America as well. Wellness requires exercise and muscle building, and the antidote to organizational sludge is a different set of muscle-building exercises that burn through to higher, creative solutions.

Preventing the build-up of sludge in our health care systems and corporate world is exactly parallel to clearing it in our vascular systems. As I taught patients how to identify and manage stress by understanding its physiology and impact, I realized that communication and conflict resolution were the most common issues.

I began to develop my own skills in these areas, taking workshops from the Intuition and Medical Leadership Group through the Kaiser Institute (www.kaiser.net) and also from the Hendricks Institute (www.Hendricks.com). The radical changes in my perspective and approach yielded several results:

* I broke a lifelong pattern of conflict between my obligations to patients and to my physician executive role by making the conscious decision that I was putting in enough time for both and could be effective at both. Amazingly, the criticism stopped from both sides and I became happier and more effective all around

* After listening to administrators complain about the clinicians and the clinicians complaining about the administrators, I stopped and asked myself how I was helping to create this. I realized I had the tendency to want to keep everyone happy. Each side thought I agreed with them and I had no idea of my real opinion. I changed my strategy and began speaking candidly to both. Both sides stopped carping and complaining and I had a lot more energy at the end of the clay. We also got to some solutions we hadn't reached before.

* I also altered the framework of medical executive committee meetings. For each issue, we went around the table three times: First, to give our views, second, to acknowledge how we were each keeping the issue going, and third, to identify the step each person was willing to take to resolve the situation. We moved through numerous agenda items more quickly and had time for more discussion at the end. We, all felt more engaged.

In 1999, I heard Kate Ludeman PhD, author of The Corporate Mystic, speak about her work with the executive teams of Dell and other top corporations. She was bringing candor, accountability and authenticity into the business world, just as I was doing in the health care profession. Here was a kindred spirit!