Editor’s note: Dr. Tutty is employed by the American Medical Association. The opinions expressed in this article are those of the author and should not be interpreted as American Medical Association policy.
Leading a medical practice is a testament to your resilience. Surviving the uphill battle of managing challenging reimbursement rates, increased prior authorization and claim denials, recruiting and retaining talent, and staying abreast of ever-evolving compliance and reporting requirements is no small feat. Cybersecurity risks and the advent of AI add more complexity to an already turbulent environment. Unsurprisingly, 75% of medical group leaders reported increased stress and burnout in the past year.1
The popular Apple TV+ series Ted Lasso offers a unique perspective on leadership that resonates with medical practice leaders by way of a supposed Walt Whitman quote: “Be curious, not judgmental.” In one of the most poignant scenes in the series, Ted is faced with the seemingly impossible task of throwing two triple twenties and a bullseye to win a game of darts. His approach to this challenge holds a valuable lesson for all leaders, including those in the medical field.
Ted’s revelation, “Guys have underestimated me my entire life, and for years, I never understood why — it used to really bother me. Then, one day, I was driving my little boy to school, and I saw this quote by Walt Whitman; it was painted on the wall there, and it said, ‘Be curious, not judgmental.’ I like that.”
The phrase, ‘Be curious, not judgmental,’ is not just a catchy quote but a powerful mantra for medical practice leaders. It reminds us to step back, disengage from the day’s urgency, suspend judgment and be curious. In the current medical practice environment, every day can seem hurried, moving from one crisis to the next. It can feel overwhelming and as though you have no control over your work or daily schedule. This lack of autonomy and control can lead to frustration and potential burnout.
As a practice leader, you have much more control over your practice and daily schedule than you might think. A study of patients, families, and clinical and non-clinical staff asked what rule they would break or change “in service of a better care experience for patients or staff.” They identified 342 challenging rules. After review, more than 75% of wasteful and obstructive rules were within the organization’s control to change.2 That means while some things may be out of your control as a practice leader, more things than not are within your ability to improve them.
As a medical practice leader, embracing curiosity and asking questions can lead to significant improvements. Don’t settle for “we’ve always done it this way” as an answer. Instead, approach every process, step, form and assignment with a fresh perspective. As a leader, you have the power to facilitate change and improve your practice. Don’t be deterred by initial resistance; instead, explore the possibilities for a better environment for you, your colleagues and your patients.
Improving institutional activities
Practice leaders and frontline clinicians may be frustrated with complex electronic sign-on processes, cumbersome technology, or confusing IT interfaces. These obstacles increase administrative burdens and decrease organizational trust among staff and clinicians, potentially impeding the delivery of high-quality and safe patient care. Initial discussions with IT may reveal that these frustrations are the software’s limitations, and the organization is resigned to these inefficiencies. However, asking more questions may be beneficial. Questions such as, “Does the software vendor have a solution?”, “How are other organizations tackling this burden?” or “What pieces of the process could we improve?” can open a solutions-driven dialogue. Implementing IT products, such as EHR systems, is impacted not just by the software design but by organizational decisions about implementation, workflow processes and training.3
Practice leaders and frontline clinicians may also be frustrated with complex compliance burdens. Many well-intended policies are overinterpretations or misinterpretations of actual regulatory requirements. When this happens, an organization may inadvertently create unnecessary burdens. The organization may accept these burdens as the cost of complying with government regulations, but asking additional questions, in the spirit of curiosity, may identify unexpected opportunities for improvement. In addition, unnecessarily restrictive organizational policies increase the risk in other areas, such as taking time from other essential tasks, creating additional cognitive load on clinicians, and overshadowing important, legitimate compliance issues. Questions to ask compliance staff include:
- “Is this a regulatory or organizational requirement?”
- “Are we currently in compliance; how do we track it?”
- “Can you show me the regulatory requirement?”
Clarifying onerous compliance requirements can go a long way to mitigating administrative burdens.4
Are you doing stupid stuff each day?
Many practice leaders do “stupid stuff” every day. Unnecessary or overcomplicated tasks and processes affect you and your clinicians. You may want to kick off a GROSS (Getting Rid of Stupid Stuff) Initiative within your practice to stop this. According to the AMA STEPS Forward® GROSS toolkit, start by engaging a high-level staff person to champion the initiative. Then, pull in the needed departments early in the process to help identify and support identified changes. Next, the staff should be engaged to collect their ideas of burdens to address and then triage these opportunities for improvement.5 Your curiosity will serve you well in this stage; leave no stone unturned.
When prioritizing ideas, a simple two-by-two matrix can be beneficial. On one axis, the issue identified is easy or hard to address; on the other axis, if the problem identified is fixed, will it have a high or low impact on the organization? Place all the ideas for improvement into one of the quadrants. Prioritize the easy-to-implement, high-impact activities. Secondly, work on the easy-to-implement, low-impact, and hard-to-implement, high-impact activities while putting the hard-to-implement, low-impact activities in the parking lot.
Even as a medical practice leader, one key to addressing identified burdens is getting organizational leadership and/or influencer buy-in. It’s essential to include organizational leadership early in the process. Tailoring your message to the concerns of each leader or frontline clinician is helpful. The chief executive officer will likely want to understand the return on investment (ROI) or improved efficiency and productivity. In contrast, the chief financial officer will likely want to know about cost savings; the compliance team will have concerns about risk, while the frontline clinicians will have concerns about ease of use and workflow. Being curious about the needs of your audience helps you tailor your message so leaders understand the problem and agree to the identified improvement.
Once a successful opportunity is identified and addressed, it is important to celebrate it, even if it is a small win. This includes thanking all those who contributed to making the improvement successful, from the original idea through the implementation. All practice members will be more open to contributing ideas and participating in improvements if they see that change is supported and possible within their practice. Celebrations for smaller wins can be included in regular practice communications, while special gatherings may be appropriate for bigger wins.
Finally, share your successes with other practice leaders. Inspiring stories, creative ideas and unique solutions can encourage others to take on the challenges within their practice. These success stories make great posts in online communities, speaking opportunities at organizational or local events and even formal presentations at MGMA conferences.
When you embrace your curiosity, you will see opportunities for improvement in all parts of your organization. Through a curious lens, these challenges will be opportunities for improvement rather than sand in the gears. When you ignite your leadership superpower to be curious and not judgmental, you will be a more dynamic and valuable leader in your practice and be able to hit the bullseye each time.
Notes:
- Harrop C. “Investing in time management to make space to address stress, burnout.” MGMA. April 3, 2024. Available from: https://www.mgma.com/stat-040224.
- Berwick DM, Loehrer S, Gunther-Murphy C. “Breaking the Rules for Better Care.” JAMA. 2017;317(21):2161–2162.
- Tutty M, et al. “The complex case of EHRs: examining the factors impacting the EHR user experience.” JAMIA, Volume 26, Issue 7, July 2019: 673–677.
- Hopkins K, et al., AMA STEPS Forward®: Reducing Regulatory Burden Playbook, 2024, accessed May 31, 2004.
- Ashton M. AMA STEPS Forward®: Getting Rid of Stupid Stuff, 2019, accessed May 31, 2024.
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