Thursday, August 29, 2013

Reflections on first chapter -- Inside the Physician's Mind

I am writing this primarily to you, my students, as an example of the kind of reflective posts you will write in your own blogs soon. I just now read the first chapter of the book, Inside the Physician Mind: Finding Common Ground with Doctors by Joseph S. Bujak, MD. This post is not an attempt to summarize the chapter. It is only a reflection on some specific things in the first chapter that caught my eye. Bujak affirms the value that physicians place in their professional autonomy. They don't want to be told what to do and they avoid presuming to tell other physicians what do to. This makes the role of a Chief Medical Officer in a hospital difficult. This also makes the tasks of CEOs and other administrators difficult. To physicians, time is money -- in many cases a lot of money. Administrators would like to work with physicians in groups to conserve effort and time/money, but physicians prefer one-on-one one relationships with administrators. In group settings, physicians (according to Bujak) prefer a vote to the drawn-out discussion that might (possibly) lead to some kind of consensus. When a (premature) vote is taken it is likely that most if not all of the "participants" will be unhappy with the outcome.

The most shocking statement (to me) by Bujak in chapter 1 is that physicians tend to be linear thinkers and, therefore, do not understand the complexities of administration. Wow! If that is true, heaven help us. If they are only linear thinkers how can physicians diagnosis medical problems correctly, given the complexity of human bodies, and the complex relationships among subsystems within our bodies? I pray that Bujak means that physicians may not appreciate the complexity of administration; not that they tend to be linear thinkers in all domains, including medicine.

In summary, I find this first chapter surprising, interesting, and provocative. I look forward to what I may learn in the other chapters.

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