Bringing Balance to the Lives of University Physicians
Unless they are high-end surgeons, university physicians who have chosen academia and work in a university hospital over private practice have decided that less is more – less money and more work. Perhaps it’s idealism that drives them. What we do know is that in most instances, they are boundary-less and they are being pulled in many directions – clinical work, teaching, research, evaluations, management responsibilities, task forces and more.
Through our work with physicians at one large university we discovered that they were overstressed, overworked and undervalued. Our challenge was how to bring a semblance of balance to the lives of these individuals in a particular university department.
As part of a two day, off site retreat, we demonstrated a performance management process that demanded two to three hours between each physician and his or her supervisor every year. Rather than the predictable resistance to the idea of so much time, the group of twenty-five physicians resonated with the questions of our supervisory dialogue. We hypothesized later that these individuals had virtually never had the opportunity to be heard before, to talk about their interests or needs. Most of their previous reviews had been based on numbers of patients seen, or research published. Little of it had to do with them as a human being, as people attempting to balance careers, family and other obligations, for which there was virtually no time.
Physicians have the problem of rising rapidly to positions of influence with little training or awareness of the power of their personal impact. As part of a highly participative governance process that we had introduced earlier, once the issues of life balance and personal feedback were raised, the physicians could see how dysfunctional their approach to performance management was.
The result was the establishment of a three-year, staggered supervisory cycle. During year one, 1/3 of The Department received personal 360 feedback, along with a detailed action plan. Year two, the plan was evaluated in terms of successful attainment of agreed personal / professional goals. Year three, no formal in depth review occurred. In addition, each year, every physician received the three/hour supervisory dialogue, with each individual’s performance matched against agreed upon departmental standards, goals and hours contributed.
These series of interventions altered the entire departmental culture, providing a better quality of life and greater accountability for its members.