Same-Day Surgery Manager: Environment dictates how you should manage
Environment dictates how you should manage
By Stephen W. Earnhart, MS
Earnhart & Associates
Mary Parker Follett, described as an influential social commentator and writer in the early 20th century, defined management as "the art of getting things done through people." She described management as philosophy. I would check "like" if she were alive and on Facebook.
We all manage. We manage our finances, our resources, our children, our surgeons, anesthesia, our back table, our supplies, our staff, and hundreds of other processes required to just get things done. Just about everything we do involves management. It would be difficult to take a vacation and not manage how long it takes to get to the airport for our flight. The same goes for managing our surgical block times with the surgeons.
I find that managing people is one of the most difficult functions we can do. Some managers think that every person in their department is an idiot and not capable of original thought and, therefore, they have to micro-manage every process to get things done. Others manage as if every person is a part of the whole and understands their jobs and collectively achieves their goals. Rarely do either extremes exist or work in today's environment.
However, I have noticed in my clients over the years that there are mutations of both. See where your employer fits. It will help you deal with managing, either put upon you or delivering.
• Surgical Environment A.
This facility is just getting started and wanting to be successful by not losing money too rapidly, yet keeping an eye on eventual breakeven and beyond. Clearly these are the most difficult facilities for a manager or for a staff member being managed.
More than likely, members of the group have never worked together before, and egos and hormones are raging. Most want to be noticed and grow with the new company, while others are just working for a paycheck. Lots of hands-on or micromanagement needs to occur in this scenario because, for the first year or two, it truly is going to be a group of individuals and not a collective unit just yet. There are typically lots of turnover, shifting of roles, authority, and tears. This department's goal is focused on a distant point of light and not immediate egos and interpersonal relationships.
• Surgical Environment B.
This facility has been up and running for a few years now and continue to grow and expand. These are the easiest facilities to manage because to get to this point, members of the staff have been working as a unit rather than as a group of individuals with a common outcome.
To get here, though, there usually is a lot of trial and error with staff. I have never seen a facility where the original staff is still in place after two years — ever! Some just do not play well with others, and no amount of training or cuddling will change them. Passive-aggressive individuals have no place in a small, intense environment that requires teamwork and cohesiveness. The truly ignorant have been gone a long time ago.
• Surgical Environment C.
This facility is established, successful, reached its peak years ago, and is in maintenance mode. Job security is not the issue here, but rather boredom and mediocrity. Keeping yourself and staff motivated often is difficult because it is the same thing day after day, year after year.
The staff typically is more set in their ways, which can make new ideas difficult to be accepted or implement. It is hospital departments with these staff that spawned the birth of freestanding surgery centers as younger and more aggressive surgeons wanted change that the staff was content not to accommodate.
It is critically important that managers in this environment be aware of the perceptions by surgeons. Managers should proactively meet with them and find ways to remove barriers to their productivity and facility efficiency.
So where are you? Where would you like to be? Obviously there are exceptions and nuances that change each of these examples, but as I said, these examples are from my experience and not yours.
So your managing and being-managed style is very much decided upon by where you are in the life cycle of your surgical environment. Most of us pick our workplace based upon such examples. Do you? [Editor's note: Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates' address is 238 S. Egret Bay Blvd., Suite 285, Houston, TX 77573-2682. Phone: (512) 297.7575. Fax: (512) 233.2979. E-mail: [email protected]. Web: www.earnhart.com.]Mary Parker Follett, described as an influential social commentator and writer in the early 20th century, defined management as "the art of getting things done through people." She described management as philosophy.
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