Life In The Hospital

The 6 Words

As the medical director of a hospital, my job is not to cure disease and save lives. My job is to create an environment where other doctors can cure disease and save lives.  And that’s where the 6 most important words for a medical director comes in.

Being a hospital medical director is a lot like being a hotel manager. When I first get up in the morning, I check the hospital census to see how many open beds we are starting the day with. I usually start my day by rounding in the hospital. First, the physician lounge to catch any doctors who are pre-rounding on their patients on the computer over a cup of coffee. Then through one or two of the nursing stations to get the pulse of inpatient care for the day. Next, the cardiovascular cath lab to see what what the morning’s invasive procedure schedule is looking like and how any emergency STEMI catheterization cases from the night before went (STEMI = ST-Elevation Myocardial Infarction). Then down to the OR to see which surgeons are operating that day and how many post-op patients are anticipated to need to be admitted (and thus require an inpatient bed). The ICU comes next and I’ll check in with the ICU hospitalist to see how many ICU beds we have and whether there were any patient care issues overnight. I have my cell phone set to get a text page with every STEMI and Code Blue (cardiopulmonary arrest) 24 hours a day so in the ICU, I’ll check in to find out how any STEMI patients or Code patients did overnight. After the ICU, I go to the ER to see how many open ER beds we have, how many are being occupied by patients that need to be admitted or that are being held for psychiatric care. Next is the endoscopy suite to see how many cases are on the schedule and which gastroenterologists or surgeons are doing procedures that day. Last, it is upstairs to the Education Suite to check in with the residents to be sure that their service census is reasonably full and that they are getting a good educational experience in our hospital.

At each stop, I use the 6 words.

Some leaders think that a leadership position is all about them. Its not – its all about the people that you are leading. As an example, a few years ago we were interviewing candidates for the Division Director for my division, Pulmonary and Critical Care Medicine. One of the candidates who came through for an interview visit asked whether as Division Director, he would be able to add his name to all of the manuscripts submitted for publication from the other members of the division. You see, he thought that being the Division Director was a way to make him more famous. He didn’t realize that being a Division Director is all about making everyone else in the division famous (and he didn’t get the job).

He didn’t know the 6 words.

Being a leader for a group of 50 physicians is a lot different than being a CEO of a company. That’s because leading 50 physicians is like leading 50 CEOs. They are fiercely independent and have to be when they are the one ultimately responsible for a patient’s life or health during a surgical procedure, in the ER, in the ICU, or during an emergent cardiac catheterization. What those physicians want during their work day is know that someone has their back, that their efforts to take care of patients is recognized and valued, that their needs are being heard.

They want to hear the 6 words.

As a medical director, the doctors don’t work for me, I’m supposed to work for them. My success is defined not by my personal successes but by their personal successes. So what are the 6 words?

“Anything I Can Do For You?”

November 19, 2016

By James Allen, MD

I am a Professor Emeritus of Internal Medicine at the Ohio State University and former Medical Director of Ohio State University East Hospital