Curbside Consult by Dr. Jayne 3/6/12

The League of Extraordinary Gentlewomen

A few days ago, I had lunch with some friends. Anyone walking by might have thought it was simply a table of ladies who lunch, but it was much more than that. The reason – three of the five women at the table were, at one time or another, my boss. I’ve written before about bad bosses and bosses who don’t know what to do with CMIOs but today I wanted to talk about bosses who do it right.

I haven’t always been a CMIO – I’ve been an EHR pilot (read: guinea pig) as well as the nebulously-named Physician Champion. I’ve been a Department Chief, faculty member, and front-line physician depending on which hospital I was rounding at on a given day. I’ve also been a teacher, worked retail, and changed my own oil. The point is that many of us come to the table with a variety of experiences. A good boss will recognize the way in which experiences shape employees and draw from those experiences. They will seek to get to know their employees and what they can bring to the table besides title and credentials alone.

All three of these extraordinary bosses saw different things in me. One saw a fairly-green but passionate physician who had a vision and passion for technology. Choosing me over other ‘safe’ choices to provide clinical oversight for my first major IT project could have been a career limiting move for her (and more than once I pushed it to the limit, I’m sure.) Still, she cared enough to get to know me as a person as well as in the capacity of being her employee. Understanding what made me tick and how I reacted to change helped her advise, counsel, and mentor me and increased my value to her team.

She taught me how to dig in when the going got tough as well as how to quickly assimilate huge quantities of data into something useful for physicians to evaluate. I learned about process and methodology, how to work with consultants, and how to recover after getting one’s posterior handed to one by other physicians. She taught me how to leverage those difficult physicians and involve them in the project so that it became “our” project rather than the loudest physician’s idea of what things should be.

With different management styles, different bosses can motivate people to achieve in different ways. My second boss was able to build on what her predecessor had done – taking it to the next level with lessons in political strategy and operational tactics which have been invaluable to me as a CMIO. Although I was familiar with physician to physician politics, when hospitals and payers are involved there is an entirely different level of gamesmanship needed. She taught me to be confident in what I knew to be right as well as how to stick up for it without being obstructive.

She also taught me how to survive when being forced to do things I absolutely didn’t want to do or didn’t believe in – skills which have been critical when dealing with certain kinds of disagreeable organizational strategies that we all face. She gave me space when I needed it and didn’t micromanage, letting me find my own groove and set my own goals.

The other extraordinary gentlewoman at the table was my peer before becoming my boss, which happens to many of us at least once in our careers. We learned together how to swim in the choppy waters of health IT and having shared that experience she knew how thoroughly I would be willing and able to back her up when things got tough. She understood the way physicians make decisions and our ability to take multiple pieces of complex information and quickly arrive at a conclusion that balances patient safety, quality, and efficiency. She understood that I saw the applications we supported as patients and that I was constantly assessing their new ‘aches and pains’ and integrating new discoveries and features to try to come up with the best diagnosis and treatment plan. With that background, she was able to help others in the IT department understand that although it may have seemed like I was just throwing out an answer quickly, it was well-reasoned and also helped me learn to better explain my thought process so that people weren’t spooked.

(So help me, though, if you ever show up as a trauma patient in my Emergency Department, don’t expect me to explain what I’m doing in gory detail just so you can feel better about how quickly I arrived at a conclusion. When you’ve got a chest wound, I guarantee you want the doc to be rapidly processing the situation at the same time she’s giving orders and executing a well-thought and rehearsed plan. There’s no consensus-building when someone’s bleeding out and my reflexes are going to take over and get things done. I do promise though that I’ll explain it to you when you regain consciousness.)

Besides leadership styles and management skills, I learned another key lesson from these extraordinary women – that work/life balance is essential to avoid burn out. We worked in extremely complex situations, short on budget and resources and long on demands and expectations. They taught me how to care for myself so that I could continue caring for others (and also so that I could continue working my tail off for them, which I happily did.)

I truly wish that each of you has, at some point in your careers, one boss that you would walk through fire for. When you do, you’ll understand what I mean – someone who so totally inspires confidence and motivates you, that you’d do anything they ask. And if you’re really lucky and the stars align – you might just be lucky enough to have three.

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