Five dynamic tensions in contemporary medical staffs part 1: Balancing collegiality and excellence
Editor’s note: Mark your calendars! This series on the five dynamic tensions of the medical staff will run on the first Thursday of every month.
Dear Medical Staff Leader:
In its work with medical staffs around the country, The Greeley Company has found that medical staff culture can best be understood as a series of underlying dynamic tensions, sometimes referred to as polarities. This series will examine five in particular that characterize many medical staffs:
- Collegiality and excellence
- Freedom and commitment
- Appropriate independence and mutual accountability
- Appreciation and continuous performance improvement
- Stability and change
As a member of the medical staff, your fellow physicians should have your unconditional respect as a colleague. This is the “social grease” of physician-to-physician relationships as we all want to work in a collegial environment. In short, people who trust each other, value each other’s company, and socialize together outside of work have a harder time fighting.
Although collegiality contributes to a strong medical staff culture, it must be balanced with the pursuit of excellence. To achieve this balance, the medical staff should first ask “Is our culture one that expects excellence or aims for mediocrity?”
If we are only concerned with collegiality, with greasing the social wheels in our medical staff, then we cannot hold each other to the highest standards. Therefore to achieve a truly effective medical staff, we must have a culture that embraces and expects collegiality and excellence from all physicians.
Consider peer review in a culture characterized by excessive collegiality. Doctor A reviews a case from Doctor B. Although Doctor B’s performance was below par, Doctor A lets it slide, knowing that next month, the tables could be turned. Contrast this with a culture characterized by an excessive push toward excellence. Doctor A may approach Doctor B about his performance in a forthright and impersonal manner such that the element of collegiality is lost.
The take-away message here is that an effective medical staff captures and manages the best elements of collegiality and excellence. Where does your medical staff fall?
Next time, we will look at the second polarity: freedom and commitment. Until then, stay well and be the best that you can be.
William K. Cors, MD, MMM, CMSL
Vice President Medical Staff Services
The Greeley Company