Tackling the Root Cause, not just the Symptoms: How ONE mental shift can lead to less frustration and anger at "The System".

As a physician, do you find yourself frustrated with situations at work where you feel decisions are being made by management without any input from the physicians?

Do you find that you are given metrics to achieve which may or may not be realistic, which may have worked in other places, but may not work where you are?

Do you feel powerless, struggling to meet these metrics?

And when you try to bring your complaints to management, you feel as if you are not heard? 

Do you want things to change? 

In this episode, I talk about ONE crucial change I made which led to me feeling less frustrated and more empowered.

If you would like to be part of the solution too and want to explore your specific situation with me, the link to talk is

https://calendly.com/ashapadmanabhan/exploratory-session-with-asha

Connect with Dr. Asha Padmanabhan:

🌐 Website: www.theleadershiprx.com
📝 Facebook: https://www.facebook.com/asha.padmanabhan.9
📸 Instagram: https://www.instagram.com/asha.md/
💼 LinkedIn: http://linkedin.com/in/ashapadmanabhan

Subscribe to my email newsletter for more actionable tips, click here
https://asha-padmanabhan.mykajabi.com/newsletter

✨ If this episode resonated with you, be sure to subscribe, rate ⭐️, and leave a review ✍🏼. Your support helps us bring these conversations to more women physicians.

Subscribe to my email newsletter for more actionable tips, click here
https://asha-padmanabhan.mykajabi.com/newsletter


To explore how Coaching can help you, DM me on LinkedIn or Facebook

Transcript

0:08

So many times I have coaching clients come to me who are so frustrated with situations at work. Decisions are being made by the management without any input from the physicians. Physicians are been given metrics to achieve, which they may or may not find realistic, which may have worked in other places, but may not work where they are currently in exactly the same way. And the physicians feel powerless. They are struggling to meet these metrics. They are frustrated and angry and when they try to bring their complaints to management, They feel as if they're not heard, which then again, leads to frustration, anger, disgruntlement and eventually disengagement on burnout. Does any of this resonate with you? This is the Leadership Prescription Podcast for Women Physicians. And I'm your host, Dr. Asha Padmanabhan I'm a board certified anesthesiologist, a clinician leader. And a Certified Physician Coach. I coach women physicians around the essential skills they need like communication and conflict management, how to speak up, how to advocate for change, how to manage up, how to negotiate for money and time that you are worth and how to intentionally shape your career without sacrificing your personal life while advancing in our professional career. So have any of you been in a situation where you feel frustrated, angry, and disenfranchised at work? Because of all the things that you're being asked to do by the bosses? Personally I know I have been in this situation so many times, both as an individual physician employee. And as a physician leader, I've been given projects to complete or metrics to meet. Both situations had different challenges. As a physician employee, I was frustrated many times, because it seemed like I was being told I needed to achieve all these metrics, especially in surgery for me, like the first case on time starts, turnover times, making sure they were not over whatever metric the hospital came up with, the surgery cancellation rates and so many more. And I felt like I was banging my head against a brick wall because of course all these metrics did not depend only on me. Right. And I'm sure you have all the situation as well. These metrics that I was asked to meet depended not just on me, but on the OR staff, the surgeons, the patients, housekeeping. So many other people were involved in these metrics and I was upset because I was being held to these standards. That I felt was unfair. So how could they hold me accountable for this? That was not just dependent on me being on time or at work at a reasonable time and doing my work fast. So then I became a physician leader and now there was one more added layer. So not only now was I responsible for my own metrics, my own first case on time starts and making sure my room was turned over. Now I was in charge of making sure the physicians and nurses in my group work together with the OR staff to make these metrics happen. And so now I have to make sure that everyone was on the same page, even if I had to drag them kicking and screaming. And now I was a recipient for all the complaints that my colleagues had, everything that I had previously been complaining about. So in the beginning, I spent a lot of time being frustrated and angry. How could they, that's the management, the administration not see that this was impossible. How could they not see that? Trying to get these metrics to work was not dependent on only a couple of people, but so many different parts of the whole chain. Could they not see how my colleagues and I were getting frustrated and angry and upset and disenfranchised. And eventually how we just wanted to put in the minimum effort because we were tired of it. And we knew that none of this would work. So I set up meetings with the administration and I detailed all the roadblocks and I told them all about why it wasn't working. And how it affected my morale and that of others around me and how it was driving me to burnout. And how all the physicians around me where we're being driven to burnout and the frustration got worse because the response was that you have to find a way to make this happen. This is what the hospital's administration wants and we have to make it happen. So that's a standard response I got and I'm sure many of you have gotten the response when you have brought up problems to your administration or to your director. So they didn't seem to be interested in hearing how and why it wasn't working. They just wanted to make sure we fixed it. So I would go back to my group and remold and we complained and together. we kept getting frustrated because it seemed that no one cared. And eventually we felt that people would leave and then it would get worse. And then something happened. As my leadership journey progressed, I started learning how and why my approach to the problem was so ineffective. There comes a point in time when we have to stop blaming others and start looking at how we can make a change. And how we can be part of the solution, not just part of the problem. And so I started looking at each problem from several different perspectives and that's how I learned a new approach. I learned that when I was engaging in negative chatter, when I listened to all the others around me complaint, I got drawn into it. And that was fueling my own anger, my own frustrations. And when that happened, my brain wasn't open to finding solutions either. I was stuck in a negative thought loop. And in all the things that were wrong and why it couldn't be right. And how nothing would work anyway. And that wasn't very productive. So I decided to try a new approach. My first step was to stop engaging in the negative chatter at work. Then instead of looking for people to blame, I started to be proactive and ask questions. I started getting curious. About the processes. I decided to pick one problem. At a time and focus on trying to find solutions or even trying to find what was the problem. What were the parts to the problem? What were the parts of the process that created the problem? Who were the key players? What was the agenda they have been given. What were their deliverables? What standards are they held up to? And what did they have to achieve? what was the penalty for them not meeting the metrics. So many questions to ask. So I started looking at the root cause and not just the symptoms. Up until now. I've been looking at the symptoms and getting frustrated about all of it. So I'll give you an example. This is the example of our pre-op clinic. So our pre-op clinic in the hospital is where we make sure the patients who have been booked for elective surgery have all the information that comes in so they can be assessed and made sure they are ready for their surgery. So for months, I had struggled with frustration because the medical data my team needed to effectively make sure the patient was ready for surgery was not available in a timely fashion. Every time I went to the preop clinic or one of my physicians went to the preop clinic, the charts would be incomplete. We wouldn't have what we need and it would be an exercise frustration and anger. mostly at the preop nurses because they were the one supposed to get all this data. So. One day. I decided to try my new approach and I sat down with both of them And without judgment because it's so very easy to label someone as lazy or in competent. instead of just mentally prejudging them, I asked them to explain to me the entire process. From when the surgeon's office booked a case to the patient to the hospital on the day of the surgery. What were the steps involved? What was the process? How did they get all the information? How did they do it? So I wanted to find the root cause and not just examine the symptoms of the missing information. As I started looking to the process, I started noticing gaps. There were several versions of the booking sheets that the surgeon's offices were faxing to the preop office. And several of them were missing necessary information. So then the nurses have to chase the office staff to get the information, which is frustrating to both our nurses and the surgeons office who had to then field calls multiple times from my pre-op clinic. And who got frustrated with that. To the point that sometimes they wouldn't even pick up the calls. The surgeons' office also had to collect all the medical clearances from all the specialists in a timely fashion and send it to us. So if the patient didn't go to the specialist until the day before surgery, you can imagine how that process would fall apart. Each step of this process, as I started looking through it. I saw so many possible pitfalls that it was no wonder that information wasn't being sent to the preop clinic in a timely fashion. And no wonder that the nurses had incomplete charts when we went to check the charts and everyone was frustrated with each other. So once I understood all the steps in the process that were failing, I started working on each step at a time. We scrap the multiple booking forms. We created one with all the information required. And one central email that the surgeon's office could send it to. Previously, we had a fax and a couple of different emails and several different ways that they could send it to us. So now we created one system. Then we give the surgeon's office, the same email to give to the specialist to send in the information directly to us. There were several other changes that we've made, all of which ultimately resulted in less angry phone calls between our pre-op clinic and the surgeons offices, less frustration for our physicians when they went to the pre-op clinic and found that most of the information was available when we needed it. And of course the surgeon's office staff was so much happier because they were not getting calls multiple times during the day to get multiple pieces of information. So a process got streamlined. Can you imagine how much of a difference that made, not just to our preop nurses lives, but to all our physicians who had charts that were complete to check. And didn't have to wait in the morning of surgery to find missing information and to fight with the surgeon because we didn't have everything we need. Ultimately the preop staff was happy. The surgeon staff was happy. The Orr staff was happier because we were not delaying surgery. And my staff and the physicians were happier And the frustration levels with this part of the process came way down. So, this is just one example of how we as physicians can be part of the solution and not part of the problem. When I coach female physicians, as they talk through some of the challenges they are having at work. We start with breaking down the symptoms and finding out the root causes. So they can then present a solution to their medical directors or their C-suite or their administrators. So think of how much more effective you can be. If you take a problem that your group is facing and you present your CEO or your director with the solution, rather than just showing up there to complain about how bad everything is and how things are not working. So, what is one frustrating situation you've had in your workplace today? That is challenging. You. I'd love to offer you the opportunity to bring it to a complimentary call with me so we can figure out how you can start this process. I'll put the link for the call in the show notes. If you found this valuable. Please give me a five star review and share this with any of your friends that might find this useful. And I'll see you on the next episode. This is Asha. Padmanabhan signing off for this episode and I will see you on the next.