Health care

I wear many hats in my day job. Working in healthcare has stretched me in ways I didn’t expect. Some of my tasks are straightforward…arranging meetings, trainings, working with electronic records, learning the work flow of clinic front office processes. Others allow for more creativity, more flexibility, require attention to details of individual need and style.

Recruiting for open provider positions falls into this second category. Selling a vision of professional satisfaction, personal choices, family stability in a new environment, all while keeping yourself and your message honest about the pros and cons of the opportunity you offer…it’s a challenge from the start.

You find yourself trying to read the people you talk with, imagining them in the setting you know well, wondering if they’ll be successful, weathering the difficulties of life in rural Alaska, and celebrating the triumphs.

Rob calls practicing in the small clinics of remote fishing villages “earning the stethoscope.”

I call it brave, sometimes foolhardy, not a choice for the faint of heart.

When you have to ferry out to the nearest hospital, or on a good weather day, take a float plane, advanced care options are not easy to come by. Actual medevacs cost a fortune, most of which we pay for via tax dollars.

I’m always amazed at the folks who live in the middle of nowhere, on tiny islands, and who regularly appear in the local clinic for any and every need under the sun. They travel out of town, going to regional hospitals for specialty consults, surgeries, treatments. They come back home to recover, to live out their days….some to overcome and thrive, others to give up and resign themselves to dying at home, in their own space.

The people who come to work in these clinics are often wide-eyed idealists, imagining they’ll have an Alaskan adventure, experience a frontier with all the romance and excitement the travel brochures promise. The folks who are transplants to Alaska mix with the local staff, people who understand the land, the life, and the limitations of practice here.

The beauty is here, for sure, and the adventure too. But you have to really want it to get much of it…too often the hiking, fishing, exploring, and traveling charms that lure people to work here are elusive…too much of life is consumed with work, and traveling out to visit family, to tend to other life needs…it can be surprisingly difficult to work in Alaska and have much time to really enjoy leisure here, in my experience.

A lot of people come to pay off school debt, to put aside some nest egg money, work in under-served communities to fulfill a service obligation of some sort.

The health care shortage the whole country experiences seems amplified here, where people can’t easily drive to the next community over, likely have one clinic and maybe one or two providers to choose from for their primary care.

Every clinic in this region is recruiting, looking for a few good men and women who’ll be clinical super-heroes, serving patients and trying to keep from burn-out.

If I sound dramatic, I don’t mean to. It’s just the reality of doing a hard job in a beautiful but challenging environment. You never know what you’ll have to deal with, and you may have to deal quite a while before you can send your emergency patient on to a hospital.

We’re interviewing a candidate this week, hoping to connect with a person who’s up to the challenge…someone who will be able to weather the weather, the annual 13 feet of rain that falls in this rainforest, and the small town setting that feels like a fishbowl at times.

The bait…the beauty of the land, the ocean, the trees…it’s amazing when you see it, green and blue and so big you can’t believe it. But it takes a special sort to take the relative isolation, the limited options of restaurants and stores and amenities. The other major resource is the people that live here: resilient, often self-reliant, taking life as it comes.

To be honest…and I am honest with these people…it’s a mistake to be anything but honest…I can only take it so long myself. Working part-time here works because it’s part-time. I love the beauty, but I’m more into eating salmon than catching it. And while I don’t need mega malls or big cities, I’ll admit I miss the road system I so took for granted when it was always just outside my door in the lower 48. And a few other conveniences that can be hard to come by in fishing villages.

But some people wear it like a glove, snuggling into the small town settings, finding joy in the community and the fishing and the boats and the water. That’s the person we hope to find. Helps to find a couple…this is a hard place to look for a significant other. And great medical skills are a must.

Here’s hoping for a good fit! The only thing worse than not persuading a candidate to take your open position is persuading the wrong candidate to take your open position. Trust me, a bad fit is never a good thing.

So we’re honest, but we’re also selling…selling a lifestyle, a place, professional opportunity, financial security.

Know anyone who would be a good fit? Send them my way! I have an adventure to share!

“Get caught doing something right.”

I started working in the field of health care in 2006. I had a side-door entry, coming in through an administrative role. My experience of health care is from largely from the business perspective. Still, though I have no clinical skill myself, there’s a lot of overlap with the clinical world, specifically with staff.

I spend a lot of time working to recruit providers and nurses, to coordinate meetings, trainings, and arrange for temporary provider coverage. I write newsletters and policies and the occasional grant.

I swim in corporate email.

Sometimes it’s overwhelming…all the technology, regulation, terminology, bureaucracy, acronyms, staff changes, opinions, personalities…and that’s before patients are added to the mix…the world of the modern family practice clinic.

There are so many patient needs that this community addresses every day, with a shared commitment to ethical care and a standard of best practices.

In the midst of this busyness, there are lessons to be learned, lessons worth observing and passing on. In the whirlwind that envelopes the day-to-day of the clinic, these are the practices I believe in.

This list isn’t a standard for the delivery of health care; it’s a standard, period. You don’t have to be a health care worker to treat someone with dignity, and you can be a leader with great vision and skill even if you were first trained as a provider. These attributes are not incompatible. I’ve known people who exemplify the wonderful blend of compassionate care giver with a head for business and leadership.

These worlds, the often competing worlds of business and health care, overlap so much: they intermingle, and there is no separating them. Sometimes it is to the detriment of each. But it doesn’t have to be that way. We can all learn, and perhaps remove some of the cynicism in the process.

I have to believe it’s possible to bring out the best in each other. And with all the meaningless and trivial, there is actual good accomplished.

Here’s how you do it, pure and simple. Turns out, good business and good medicine have a lot in common.

People rise to their potential when they have clearly defined structure and expectations, and work in an environment of trust, integrity, and transparency.
Right makes might! Doing the right thing commands respect and gives moral authority. Leaders are most effective when they are respected. Respect is a product of living with character and integrity. (If you’re unsure about a decision you’re making, visualize yourself explaining your choice to someone you respect. If you can’t feel good about sharing your decision, you should probably reconsider.)
The greatest deficit in most organizations is at the leadership level. Leaders need to set the tone, remove barriers to success, then get out of the way.
Principles are timeless, process is not.
Promote an environment of creativity and thinking outside the box. When an idea has merit, it deserves recognition and promotion. But don’t get caught in the trap of thinking that because a decision or method has been accepted, it is set in stone. Leaders understand innovation is the balancing tool of structure. Great organizations regularly evaluate and adjust process.
Do one thing at a time. Focus! Concentrating on one thing at a time is actually more productive than multi-tasking.
Define the problem. When something is not working, take the time to get to the bottom of the issue. Sometimes the most obvious difficulty is only a symptom of a greater problem.
When you’re problem solving, listen and then ask questions. Survey everyone involved. The perspective of an entry-level employee may be just as valid as the opinion of a department head. People with different roles in an organization have very different insights into how things work, and every point of view is important.
Separate noise from the real issues. Sometimes people are just focused on the drama, rather than the root cause. If you correct root causes, the noise will usually go away.
Change is inevitable. No individual, position, or process will last forever. Change can be unsettling, but it can also be refreshing.
Acknowledge mistakes. Apologize when necessary. Be gracious when someone apologizes to you. Set the example.
Express ideas as simply as you can. Be direct. Don’t use “corporate speak.” Simple is best, and people know when they’re being patronized with a lot of flowery words.
Promote an atmosphere of calm. Chaos is unsettling and leads to loss of productivity. People do not thrive in an atmosphere of uncertainty.
Promote a positive environment. Discourage gossip. Catch people doing something right. Reward that. Honor that.
Give honest value and treat people fairly, and both you and your organization will reap the rewards. Perhaps not every time, but in time. Plus, doing the right thing has an impact on the doer. As Abraham Lincoln said, “When I do good, I feel good. When I do bad, I feel bad.”
What you reward, you repeat. What you permit, you promote. Set the tone, and most people will rise to the expectation.