Anesthesia Services: We don't fire enough people
Anesthesia groups, anesthesia management companies ("AMCs"), physician practice management companies ("PPMCs"), and anesthesia consultants and experts ("ACEs") often forget one of the "immutable rules of business."(1)
"…..soft culture matters as much as hard numbers. And if your company's culture is to mean anything, you have to hang -- publicly -- those in your midst who would destroy it. It's a grim image, we know. But the fact is, creating a healthy, high-integrity organizational culture is not puppies and rainbows. And yet, for some reason, too many leaders think a company's values can be relegated to a five-minute conversation between HR and a new employee" (1)
Just like any other organization, critical anesthesia group functions are to set expectations, monitor performance, and establish consequences. This applies to both clinical and behavioral performance. One is not more important than the other. In this context there are four types of performance for anesthesia professionals:
- Good clinical and behavioral performance (recruit and/or retain)
- Good clinical and sub-optimal behavioral performance (see below)
- Sub-optimal clinical and good behavioral performance (coaching/mentoring)
- Sub-optimal clinical and behavioral performance (do not recruit or retain)
There is one particularly difficult challenge. The anesthesia professional with good, or even excellent, clinical performance and sub-optimal behavioral vales will do irreparable to your anesthesia service. If you give this person a pass, the message you give the other members of your group and your facility is that your values are a joke.
A high-powered residency or prestigious fellowship is no guarantee of being a functional member of an anesthesia group. When you retain an anesthesia professional that can't work in a team, you endanger your group. Years of hard work and dedicated service can be undone by giving tenure to a poorly performing group member. As noted in a previous blog post, according to Quint Studer, “We don’t fire enough people in health care.” And yes, anesthesia services don't fire enough people.
Take Home Points:
- An individual with good, or even excellent, clinical performance and sub-optimal behavioral vales can do irreparable to your anesthesia group
- If you give this person a pass, the message you give the other members of your group and your facility is that your values are a joke
- Anesthesia services don't fire enough people