Teamwork
Teamwork, like Mom and apple pie, is something everybody says they are for. But do we really mean it? It seems to me we like to pay lip service to it, but only when required. After all, is it not Peyton Manning and the Indianapolis Colts? What about the other 21 men who play starting positions? Further, it matters what kind of game we are playing. Arguably, a quarterback in football is more important than any of the other position players. But is that true in baseball? Even a player of the caliber of Albert Pujols cannot assure the Cardinals a pennant if the starting pitching falls apart.
What does teamwork mean in the context of the hospital? It has been my observation over the years that the hospital tends to think it is playing football. They want someone to call a play, and for everyone to know what they are supposed to do when the ball is snapped. Physicians, in my view, are generally playing basketball. Feed the hot hand, get the ball to the open player, run like mad, and maybe have one or two special plays for difficult situations, like in-bounding under the opposing basket.
I suggest we really need to learn to play baseball. In baseball, each individual player has to play his position expertly, but it is rare to find a pitcher who can bat .300, or a catcher who can play the outfield. In other words, specialization is the name of the game. If each player is competent and effective, the team will be more likely to play in October. Also, everyone knows where the ball is fair and where it is foul, and there are umpires to judge the close calls. (Peer review?)
So who is on our team? I suggest that every time you order a lab test or a procedure, you create an ad hoc team of specialists who need to interact for a short time to get that particular patient to a particular place at a particular time to get a particular procedure. Our ability to do this depends upon everyone knowing how to “play their position.” The downside is that the same people will be unable to see how their part interacts with the other parts to generate quality patient care, and even managers can get so focused on keeping the gears meshed and turning that they can forget the objective of the team. Besides, it is easier to measure time, money, and personnel than it is to measure efficient, effective, high quality care.
So what is our role? I suggest that it is up to us to keep our “team” focused on the objective—taking care of the patient. I also think it is up to us to coach the team so they know how their play impacts the outcome. This means providing meaningful data as well as ad hoc tutorials. Our goal should be to build the morale of our team so that they stay together long enough to learn their jobs, teach it to others, and then figure out how to do it better.
Written 28 April 2010, revised 3 May 2014.
Teamwork, like Mom and apple pie, is something everybody says they are for. But do we really mean it? It seems to me we like to pay lip service to it, but only when required. After all, is it not Peyton Manning and the Indianapolis Colts? What about the other 21 men who play starting positions? Further, it matters what kind of game we are playing. Arguably, a quarterback in football is more important than any of the other position players. But is that true in baseball? Even a player of the caliber of Albert Pujols cannot assure the Cardinals a pennant if the starting pitching falls apart.
What does teamwork mean in the context of the hospital? It has been my observation over the years that the hospital tends to think it is playing football. They want someone to call a play, and for everyone to know what they are supposed to do when the ball is snapped. Physicians, in my view, are generally playing basketball. Feed the hot hand, get the ball to the open player, run like mad, and maybe have one or two special plays for difficult situations, like in-bounding under the opposing basket.
I suggest we really need to learn to play baseball. In baseball, each individual player has to play his position expertly, but it is rare to find a pitcher who can bat .300, or a catcher who can play the outfield. In other words, specialization is the name of the game. If each player is competent and effective, the team will be more likely to play in October. Also, everyone knows where the ball is fair and where it is foul, and there are umpires to judge the close calls. (Peer review?)
So who is on our team? I suggest that every time you order a lab test or a procedure, you create an ad hoc team of specialists who need to interact for a short time to get that particular patient to a particular place at a particular time to get a particular procedure. Our ability to do this depends upon everyone knowing how to “play their position.” The downside is that the same people will be unable to see how their part interacts with the other parts to generate quality patient care, and even managers can get so focused on keeping the gears meshed and turning that they can forget the objective of the team. Besides, it is easier to measure time, money, and personnel than it is to measure efficient, effective, high quality care.
So what is our role? I suggest that it is up to us to keep our “team” focused on the objective—taking care of the patient. I also think it is up to us to coach the team so they know how their play impacts the outcome. This means providing meaningful data as well as ad hoc tutorials. Our goal should be to build the morale of our team so that they stay together long enough to learn their jobs, teach it to others, and then figure out how to do it better.
Written 28 April 2010, revised 3 May 2014.