Interview with Mike Stahl of PEMBA

This interview with Michael Stahl, PhD, program director of the University of Tennessee ’s Physician Executive MBA (PEMBA) program is the first in a series of interviews dealing with physician leadership.  Physicians who are contemplating leadership roles will benefit from the experience of  physician leaders and mentors of physician leaders.  Medicine’s many challenges can be conquered with the participation of clinicians who have a firm understanding of patient care and have been schooled in modern business practices.  This series of interviews is for our developing physician leaders, we need you.

 

 

Good morning my name is Mike Stahl, Program Director of the Physician Executive MBA at the University of Tennessee.  I’m also a Chaired Professor of Business.  I teach strategy and business planning in both the Physician Executive MBA and the full time MBA at the UT and I attempt to lead the faculty and lead the Physician Executive MBA Program.

  

What qualities do you see coming through in clinicians in their leadership roles that are unique and different from other MBA students?  Pete this is a real easy question for me because you are really asking what was the driving force and the driving theme behind this Physician Executive MBA and its 11 year history.  When we designed this program in 96 and 97 (we taught the first class in 98 ) our guiding mantra was always the issue of physician leadership.  Our guiding mantra was always to empower physicians who wanted to lead.  Because we on the faculty had an underlining theme that physicians, because of Hippocratic Oath, because of Physician’s Oath, because of their understanding of the patient and patient outcomes first and foremost, because of the guiding light of do no harm,  physicians are in a far better place to lead healthcare organizations than non professional employees.  When we train full time MBA students who are not physicians, who are not clinicians, when we train them in a full time MBA program whether at the University of Tennessee or any other accredited MBA in the United States, you can train a 30 something person with all of the tools and techniques of business and they can analyze any healthcare operation, they can come up with lean ways of doing business, they can improve the efficiency but since they are not physicians, they not imbued with that notion of do no harm.  How does this change operation or how does this new outpatient whatever or how does expanding the capacity of the hospital or how does adding another hospital or building another facility, they don’t think first and foremost what does it do for the patient.  They think almost as any other business enterprise; what does it do for the enterprise. The issue of the patient first and foremost is the biggest difference that we see between physicians leaders and non physician leaders in healthcare.

  

Are there particular skills that physicians/leaders have to concentrate on developing more than the average MBA student?  Yes, in the sense  most physicians that we see do not have degrees in finance, do not have degrees in economics; do not have degrees in Accounting in the undergraduate level.  In fact, I should substitute the word almost all for the term most because they have not had that undergraduate background when we designed the curriculum for this Physician Executive MBA.  We’ll start those core areas in business (finance, accounting, and economics).   We’ll start at a level that I’m going to call basics and then try to bring everyone along to the same level.  By the time they graduate they’ll be capable of designing pro-form financial statements for a business plan for a new healthcare enterprise but at the beginning most do not have skills in finance, economics and accounting unlike many other full-time MBA programs where half the class might have degrees in business and the other half might have multiple courses in undergraduate business so you see the different starting point.

  

What advice would you give to Clinicians that are just beginning to get into leadership roles and beginning to think about what they should do to be providing themselves with additional expertise and training?  I guess I would give two pieces of advice.  My first would be know thyself.  Know where he or she wants to go in a leadership role.  If he or she is interesting in influencing the course of health care delivery in a larger context than just his or her own immediate patients, if you know that to be your future then I say develop those leadership skills.  If alternatively you see primarily almost exclusively in a clinical role than ones future in a leadership role is obviously limited.  Now, if the answer to the first question is yes, that the physician wants a broader leadership role my first piece of advice is to go to non degree short courses, whoever offers them.  Some short courses in leadership and healthcare, some short courses on dealing with issues where physicians need to become involved in changing those organization policies concerning the problem.  If those courses feel good, if you take a course in strategy or take a course in leading other professional employees or you take a short course in finance or short course in other issues concerning broader context of healthcare beyond your own immediate patients, if those short courses feel good then you might think longer term in terms of a degree not unlike a Physician Executive MBA (PEMBA).  If those short courses don’t feel good then again maybe your role in the future is not so much in a physician leadership role but maybe more in a classical clinical role.

Green Circle

 

The 30.5 mile Green Circle is a hiking and biking trail looping around the Stevens Point area. It meanders through forests, over wetlands, and along rivers. This image was captured along the Plover River segment in the Village of Whiting, Wisconsin.

To view more photographs, click on Photography in the Categories section in the right column.

Forwarding E-mail

When forwarding e-mails, take the time to write an introduction or summary at the top including where the information originated and why it should be of interest.

Be careful that long e-mail strings do not include information that should not be forwarded. Read it thoroughly and delete sections if needed.

Check to make sure the Subject Line is short and descriptive.

Always use a signature and include your name, title and contact information.

Wisconsin River

The Wisconsin River is approximately 430 miles long running from Lac Vieux Desert in northern Wisconsin (on the Wisconsin/Michigan border) to  Prairie du Chien where it empties into the Mississippi River. It’s basin covers 12,280 sq. miles or 1/5 of the state.

Glaciation has changed the course and the character of the river. The River between Merrill and Stevens Point drained meltwater away from the retreating glaciar.  As it flows south of Stevens Point through central Wisconsin, it meanders across the flat bottom of the former glacial Lake Wisconsin. This glacial lake was formed by an ice dam near Wisconsin Dells some 15,000 years ago. When the ice dam catastrphically burst, the entire contents of glacial Lake Wisconsin emptied carving the rock formations seen at Wisconsin Dells.

This image was captured at sunrise near Stevens Point, Wisconsin.

 

Questions are Good

I just love questions after sending out a communication. A question means:

• They read what you sent
• The issue was important to them
• You engaged them
• You know additional types of information to include next time

Make sure to answer every question personally.  An e-mail response to a question sent via e-mail works, a phone call or a personal visit works even better. Assume if one person asked the question others are thinking of the same issue. I often send a follow-up communication with answers to all the questions asked.  If the topic is ongoing, consider starting a Frequently Asked Questions intranet page and do not forget to send out the URL.

Any Questions?

Triage E-mail

If you want to get a handle on your e-mail, triage it.  I use a number of Outlook e-mail folders that seem to work fairly well for me. I based my approach on one advocated by David Allen in Getting Things Done. One of the key’s to success is to make sure the subject line describes the content of any e-mail that is saved. Here is my triage process:

 

 

A description of my Outlook e-mail folders

• Somedaymaybe: contains anything I want to keep available for future use as a project and should be reviewed on a periodic basis.  The file contains potential projects and personal projects (such as vacations) that I might want to do.
• Reference: contains material I want for future reference.  From time to time, I move all the contents to a network location that is backed up on a daily basis.  Moving the files reduces the size of my mailbox. Having a good subject line facilitates searches for files.
• Project: any item requiring two or more steps is considered a project.  The folder is reviewed weekly.
• Waiting for: contains items that have been delegated or sent elsewhere asking for information. The folder is reviewed weekly allowing me to address overdue items.
• To Do: contains items requiring one step to complete that I choose not to complete when originally triaging.

Other ACTIONS in Outlook

• Do IT: complete any associated actions and delete the e-mail at triage.
• Move to Calendar: e-mails and attached documents needed for meetings are saved in the description of the meeting in Outlook, then deleted from e-mail.
• Future E-mail Delivery: the future e-mail delivery function can be used as a ticker file. I forward the e-mail to myself for future delivery then delete the original.

 

Field-O-Trillium

During the month of May, there is a carpet of trillium at Powers Bluff County Park located west of Wisconsin Rapids, Wisconsin.  This image is a panoramic composed of five separate images stitched together on a computer.

JCAHO and Disruptive Behavior

My recent post, No Assholes Allowed, generated comments from a number of readers and reminded me The Joint Commission on the Accreditation of Healthcare Organizations is now addressing disruptive behavior. Standard LD.3.10 (Culture of Safety and Quality) states each organization should have “a code of conduct that defines acceptable and disruptive and inappropriate behaviors.” The Standard further adds that leaders will “create and implement a process for managing disruptive and inappropriate behaviors.”

Good work JCAHO.

Trillium

 

Just west of Arpin, Wisconsin is Powers Bluff Maple Woods State Natural Area. Early in the spring, prior to the maple trees leafing out, an amazing display of spring flowers can be found on the forest floor. A sweeping carpet of trillium is especially impressive.  Trillium gets its name in part due to it’s leaves, petals and sepals occurring in threes. To many, trillium blooming in the spring is also a reminder of Easter and the Trinity.

 

Managers and Leaders

Physicians are trained to be doers or active managers of health.  Most every clinician is considered to be a leader in their own work unit, providing trusted direction as to how care should be provided.  When clinicians step forward and take leadership positions as department chairmen or temporary officers of a hospital medical staff, their primary mode of operation continues to be as doers.  Even though these roles are often thought of as leadership positions, they are actually operating as managers. The difference is important.

What is the difference between managers and leaders?  The best analogy I have heard to date is as follows: managers make the trains run on time, leaders determine where the tracks will be laid.

Organizations need both managers and leaders. When there is too much management and not enough leadership, the status quo is maintained unless external influences cause a deterioration. When there is too much leadership, day to day management is neglected resulting in chaos.

Most clinicians rise to the level of leaders because of their ability to get things done. However the ability to develop vision and inspire others are traits necessary to be a great leader. The more a leader personally does, the less the organization accomplishes.  As clinicians become leaders, the mind set must change from being a doer to becoming an inspirer of others.  Only by working within an organization to develop vision and long range focus can the leader challenge the various managers to direct their work along the correct path.

Consider the situation of a large logjam.  The manager will know that by removing one log at a time, the logjam will be eventually freed. The leader seeks vision and long range focus by climbing to a vantage point and determines where the key log is likely to be. With much less effort, the key log is removed allowing the logs to flow freely to their destination.

I believe most clinicians are good managers, but only a few clinicians are natural good leaders.  The rest of us can learn to be leaders with proper training, guidance and insight.