What do operating rooms and small businesses have in common? Not much from my current perspective having spent the last few days and nights at a major NYC hospital. However, operating rooms, more specifically the surgeons in the operating rooms, can learn plenty from small business best practices.
For starters, successful small business owners know it is wise to capitalize on both their own and their employees' strengths and to minimize weaknesses. World-renown surgeons are experts at their craft – that craft being surgery. However, many of them lack the skills necessary to deal effectively with both the patient and the family. Some have absolutely no compassion and no ability or desire to communicate.
Hugh Laurie portrays Dr. Gregory House, a brilliant diagnostician who is sarcastic, callused, and downright nasty and can be entertaining to watch on television. However, when your father's surgeon is a real-life Gregory House, it is not funny. Luckily both Dr. House and this Dr. House wannabe, have a dedicated, caring staff with both the ability and desire to communicate. If the operating room were run like a small business, this world-renowned surgeon would focus his energies and time on what he does best – surgery. His staff would continue to assist and observe the surgeries, but the staff would be the ONLY part of the surgical team to speak with patients and their families. The surgeon would not have any access to the patients and his/her message would be carried by those who have compassion and good communication skills.
The concept of congruency in marketing messages and brand perceptions refers to clearly-defined and consistent messaging and delivering on one's branding promise. There is a large collage of messaging on the wall directly opposite the nurse's station all about "relationship-based care" and how the staff at the hospital work together to create the most caring and nurturing medical experience for the patients. Yet, right in front of the same collage, as well as in other areas of the hospital, arguments and harsh words can be heard between staff members. The nurses in this hospital work like dogs yet are treated with disrespect by many of the physicians. If the hospital was a small business run by a wise business owner, hard-work and dedicated employees would be rewarded rather than treated with disrespect by those who have more education.
If a hospital was run like a small business, there would be a project manager for each patient charged with the responsibility of managing the medical care. They would set up processes to assure that doctors documented their instructions for each patient in the patient chart rather than telling the patient what the next step is and then walking away. This lack of communication runs rampant in hospital settings leaving the brunt of the work on the shoulders of the nurses who are bombarded all day long by patients and their families about carrying through on the doctor’s orders. Nurses are not permitted to administer anything without the written directive or approval of the attending physician, so when they are questioned by a patient or family member, they have to leave a message and track down the attending physician to follow-up and get the necessary approvals. This is not an effective use of their time and could be avoided if physicians would simply document their orders. In a small business, team work, effective communication, and collaboration would be encouraged and all egos would be left at the door.
In order for small business owners to truly understand the needs and wants of their target market, they need to put themselves in the shoes of the potential client or customer. It is difficult for anyone to really understand what someone else is going through unless they have been through it themselves or if they try to look at a situation from the perspective of another. So when we met with the surgeon and discussed the two options available for surgery, I posed the following question to the surgeon: "What would you do if this was your father – which option would you choose?” His response was "My father is dead". That response was obviously not very helpful, totally irrelevant and extremely rude. But, alas this surgeon was recommended to us by two top physicians and his reviews on the web all raved about his top-notch surgeon skills, even though the same reviews also shared that he lacks any bedside manner. The customer reviews were right on target, the surgeon proved his surgical prowess and also his lousy communication skills and total lack of compassion. Clearly this surgeon (and many others) not only don’t know how to put themselves in their potential market’s shoes, they don’t want to (and they don't have to).
Several people have posed the question: "If you had a choice, would you rather have a surgeon who is top in his/her field or a surgeon who has a good bedside manner?" My response is "why can't we have both?" Unfortunately, we don't live in a perfect world and both are often not an option. So we opted for the world-renowned surgeon with Dr. Gregory House Syndrome and the surgery was a success.
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Julie,
Wonderful article! The comparison you used between business and health care is a perfect lens through which to see how vital "soft skills" like communication are.
I have had some horrifying experiences with family illness that brought me into up close and personal contact with what is broken in health care. The most astonishing revelation was that many health care professionals do not think of their patients and their families as customers.
I am so sorry to learn that your Father had a serious enough health issue that it required surgery. You have mentioned how dear he is to you. My prayers are with you and your family.
Susan
Hi Susan,
Thank you for appreciating the article. I actually started it the first day we were at the hospital as a way of releasing frustration and not punching the surgeon out. My dad is being released this morning and I can't promise that if I see said surgeon, I won't swing at him!
MOST healthcare professionals DON'T see their patients as customers and even worse – when one is as accomplished as this surgeon – they don't have to. His surgical prowess is sought out because of his professional reputation so he can continue to be nasty and still get "customers". I remember before his surgery, my dad was doing some online research about this doc and told me that he doesn't like to deal with the patient's families. My response? "Too bad – he is going to have to"
. I don't think the surgeon likes me and of course, I don't really care! I did go head to head with him and was not intimidated by his attitude. All I care(d) about is my father's health and understanding the situation.
Yes my dad is very dear to me and thankfully the surgery was a success and he is going to be fine – thank you for your thoughts and prayers and of course, your comment!
Great analogy of a hospital and a small business. I don't know if we'll ever see the day where we have surgeons with great people skills. I'm sure they're out there but they're scarce for sure. Hate to say it but I think it comes down to the "Bryer Miggs" personality types. Although it's said that most of us have indicators in more than one type, I think it's easiest for us to fall back into the personality that's more comfortable for us. In the case of surgeons, it's usually get down to business and deal with the facts. Thank goodness you had a good surgeon for your dad.
Sherryl,
You would appreciate this story. My dad's surgeon had a few interns working under him – young, caring, compassionate, understanding, kind men. My mother asked one of them if he thought his personality would change when he became a surgeon. He looked at her and said "I hope not". She then went on to add that she didn't know if becoming a surgeon made a person nasty and callous or if they started out that way like their version of Dr. House.
You know I try to find real life examples and relate them to business. In this case it was cathartic and stopped me from punching his lights out. However, I did speak up quite a bit – I am sure I am not his favorite person LOL. He did soften once when I was at my wits end. My dad had some complications that thankfully ended up ok and then my mom, I guess from the stress, wasn't feeling well either. So here I was trying to be there for both of them and he opened his nasty mouth. I looked at him and said "don't start with me. Between my dad and now my mother isn't feeling well either, I don't want to have to put up with your attitude". He looked at me and said "i am sorry. Take care of your mom, your dad is in good hands". So see, underneath the pompous attitude, does lie a heart.
Thanks for your valued comment
I have worked in the medical profession closely with doctors. They are often so booked they don’t take the time to communicate. Surgeons often go into surgery because they have trouble with direct patient care. Just like someone may choose a computer career instead of a sales job. It doesn’t give them permission to be nasty.
I have also been on the family side. My husband has been hospitalized at least 2-3 times a year for the past 26 years. He has 5 specialists he sees regularly. I remember early in the illness we had a doctor that kept looking at his pager the whole time we talked. I finally asked him if he could quite at his pager until he got out of the room because I felt rushed. He said he was listening and didn’t realize how it looked to us. Another time one of his specialists wanted to admit him for a week. I asked if he could put it off for a few days because I wanted to get some additional help with the children. I told him it was hard on them when he was in the hospital. He said that he didn’t know how having him in the hospital would make any difference to the kids. I told him he needed to spend more time at home so they would miss him when he was gone. He said he often forgets that most people don’t spend all of their time at the hospital.
A hospital has a whole different atmosphere as the rest of the world. The rules are different, lives are being lost, and there are too many patients to see. The medical professionals loose perspective. They forget they are human because they have to be on guard to protect their emotions. They should all have to be on the other side but until you are in the waiting room waiting on a loved one you will never understand. I have seen a shift in customer service over the past 26 years. I think the nurses and other professionals are more respectful than they use to be. The doctors are still about the same.
You have got me started now. LOL
Hi Julia – sorry to “get you started”
You certainly are speaking from experience as you have had to spend so much time in hospitals with your husband. It must be so difficult for you. You are absolutely right about a hospital setting being a totally different animal. When it comes to life and death issues, in the end, nothing else matters right? AND with all that I wrote about my dad’s surgeon, I am still tremendously grateful that the surgery was a success. If given the choice between warm and fuzzy or capable, capable wins hands down.
The best example of trying to remind the docs that they ARE human is when I asked the surgeon what he would do if it was his father – which surgery option would he choose. His response was “My father is dead”! Besides not answering my question, that was an obnoxious response. I am truly sorry his father is dead but what does that have to do with my father? Nice huh? I told this to one of his interns who looked like he wanted to crawl into the floor LOL. This surgeon apparently is nicer to the patients than their families which is really helpful especially when//if the patient is unconscious!
The nursing staff and other physicians for the most part (there was one or two exceptions) were respectful and compassionate which would be indicative of the shift in customer service you mention. I don’t think the doctors will ever change – mostly because they don’t have to.
Thanks so much for sharing your experience and insights.
I think since most people will pick capable surgeons rather than those with good bedside manner, there is no incentive for some of them to change. Maybe if we are lucky a new generation will realize that patients are customers. But in reality, patients are not even the customers. Insurance companies or the government tell people where they go and what doctors to see. So there really is no incentive from a business perspective, either since there is no way that the patients can really go elsewhere.
Hi Kidgas. You are right – they have no incentive to change and we will always pick the surgeon with the best qualifications. Interesting timing for your comment in that I literally just returned from taking my dad to his surgical follow-up appointment. The surgeon was charming as usual – not! Apparently he treats us all the same – patients,nurses, his staff. The look on his nurse's face when I asked her if he treated her nicely was almost comical. I am just grateful that the surgery was a success and that I don't have to live with this surgeon LOL. But actually this reminds me of one of my daughter's elementary school teachers who was a real bully. I had heard that he was the exact opposite at home – almost like he was overcompensating for his lack of "you-know-whats" at home by being a bully in the classroom – so maybe this surgeon is the same?
Thanks for dropping by and leaving your comments
If a hospital was run like a small business, there would be a project manager for each patient charged with the responsibility of managing the medical care. They would set up processes to assure that doctors documented their instructions for each patient in the patient chart rather than telling the patient what the next step is and then walking away That is what is SUPPOSED to happen. It used to be like that. GREAT ARTICLE, SISTER!!!!
When was it ever like that? Certainly not in my experience. Thank you sister