I once got lost in Rome using an English language map. No matter how much I turned it, how much I tried to match the names, I couldn’t find that damned Coliseum
Then I realized I had pulled up a map of Rome—Texas.
Practicing medicine within a large organization is exactly the same.
The roadmap I had created as a resident in an academic medical center was useless when I tried to find my way in a large healthcare organization.
I wasted a lot of time and suffered far too much frustration trying to construct a new map—until I came across “Rules for Dictators.”
It’s a peer-reviewed roadmap with great predictive power that will allow you to navigate your way to success in any large organization.
It will teach you everything your residency should have taught you but didn’t.
We’ve already reviewed a general summary.
Now let’s look at specific tactics.
In my first corpmed experience, I was having trouble figuring out who my boss was.
I was closing in on a panel that was effectively 3000 patients strong—far too many to care for enjoyably, or even effectively.
I wanted to see under what conditions I could close my practice to new patients.
In response to my inquiries, every administrator and Medical Director I worked with walked on eggshells, as if fearful of telling me too much.
It was very frustrating trying to get a straight answer out of anyone.
Even my former partners who were trying to advance into administration were having problems looking me in the eye.
So I took a more direct approach.
I sent an email up the entire hierarchy announcing I was closing my practice to new patients.
I immediately received a reply stating I could not do that.
I had found my boss.
He was three levels above me. I had only met him a few times before. But now I knew where the real authority lay.
And thus I started my campaign of finding out what value he needed me to supply.
Some, like volume and metrics, I could. Some, clinician leadership for example, I elected not to.
Interestingly, revenue generation never came up, though cost-control certainly did.
Eventually, I wearied of spending my time generating value that was meaningless to my personal and professional fulfillment. But I still left with a great reputation.
Why?
I found my true boss. I identified specifically what it was he wanted from me. And I gave it to him.
And he left me alone.
And because of that tactic, I had some benefits I could send my constituent’s way.
And I had little left over to keep for myself.
You don’t have to take my direct approach to find your boss.
Start with who you perceive as your immediate supervisor. Ask who they report to in the organizational chart. Ask them what that person expects of them. Deliver it—for a while.
Then ask for a desired modification in your work environment. It should be something pretty straightforward with an obvious benefit. For me, it was a cap on patient numbers. For you, it could be a slightly later start time, or a perhaps a scribe.
Nothing too major, something doable.
If your immediate supervisor cannot immediately meet your request with a yes or a no, ask them to take a meeting with you and their immediate supervisor. It’s important to meet all together so they don’t think you’re going to do them an ill-turn behind their back.
Frame it as a collaboration.
At that meeting do the same thing that you did at the first meeting with your immediate supervisor—find out what your boss’ boss expects and how you can help deliver them deliver it.
Then outline what you’re prepared to do to meet their needs and set up a follow-up meeting to assess your progress, say three months later.
At that meeting, push for your desired clinical change.
If no direct response to your request is forthcoming at that meeting, repeat the process with their supervisor.
And so on….
Until you get the person who can immediately grant your request (or refuse it).
Then you’ve found your true boss.
The one for whom you ultimately generate value and from whom you can garner benefits.
You are one of their constituents.
And now your relationship will be explicit, you will understand who’s interest your serve and they will know you understand it.
And targeted value generation will bring rewards—rewards that you can distribute to your constituents.
The administrators and medical directors in between? Well, they’re dead wood.
Treat them with respect, but direct your efforts toward generating value for your real boss.
Sound like a pain?
Well spinning your wheels powerless, confused and adrift will be an even greater one.
And the frustration you experience will eventually pay dividends its in burnout, disengagement and loss of Joy Time.
So find out who your real boss is, serve them and enjoy the benefits.
And you will thrive in the corporate world.
Need unbiased guidance finding your ideal medical practice? Contact me, no obligation just help and value.