Learning Organizations and Hospitals LO21906MY.MIL>

John Gunkler (jgunkler@sprintmail.com)
Mon, 14 Jun 1999 09:38:27 -0500

Replying to LO21893 --

Bill, and others,

A quick note of empathy for anyone who tries to work with healthcare

I led a large clinic and hospital through a merger, several years ago.
The problems of habitual behavior, entrenched mental models, self-respect
and ego issues, etc., were all continually present. [I suppose I should
admit that the change process was successful and the organization is
healthy and growing today, many years later.]

I had to resort to a cheap trick in order to make any headway in meetings
and learning sessions involving physicians. I bought a set of
baseball-style caps lettered on their fronts with the various roles
physicians play: PRACTITIONER, MANAGER (of a hospital department), OWNER
(of the clinic), CUSTOMER (as practitioners they controlled admissions to
the hospital), PARTNER (peer of other physicians.) And there were other
roles that were appropriate in other contexts. I refused to let any
physician speak in the meeting until they had chosen the appropriate hat
and put in on their head! You may think I exaggerate, but I'm telling the
literal truth. "No talking without choosing the role from which you are
coming." It helped a lot.

The problem, I found, was that physicians (and we all would love to be in
their position with regard to this - admit it!) were in love with the
"practitioner" role -- you know, the one where life and death were in
their hands. Because, in this role, when they said, "Jump," people
jumped. And it was appropriate to do so. But the physicians wanted to
wear that hat all the time. It took a silly prop to teach them (1) that
they abused this role and (2) to think about what role they were playing
before speaking and acting.


"John Gunkler" <jgunkler@sprintmail.com>

Learning-org -- Hosted by Rick Karash <rkarash@karash.com> Public Dialog on Learning Organizations -- <http://www.learning-org.com>