Dealing with privileging turf wars

It seems like a small issue, but sometimes what appears on the surface as an inconsequential turf battle among well-meaning physicians trying to maintain market share can result in everyone loosing. Take the following example.

 

In developing a comprehensive cancer program for melanoma, one hospital ran into an issue of different specialties all claiming expertise in the field, especially in the area of surgical intervention. The health system was looking to invest heavily in this comprehensive program, and success—which they had already achieved in other areas like breast and GI cancer—would mean an increase in patient volumes for all the affiliated physicians. But back to the issue: the general surgeons, the plastic surgeons, the dermatologists and even an ENT physician were all claiming expertise with melanoma surgical excision. Adding to this complicated scenario was the fact the hospital had recently recruited a fellowship-trained melanoma/sarcoma surgeon who was willing to help train others, but the turf lines had already been drawn.

 

The challenge is of course the short-sided nature of everyone wanting to protect their “slice of the pie” when the focus should be on how to increase the size of the pie. This is not an uncommon scenario, especially in this time of major healthcare transformation when everything feels unstable and we regress back to protecting what we can see today. Strategic thinking is out. Now more than ever we need to anticipate potential turf conflicts, be willing to view solutions in a different way, and think of a more strategic outcome that will be better for all. Otherwise, we all suffer holding onto our preconceived notions of what is fair. Preparation and developing a process in advance as well as having the right people at the table goes a long way to avoid the above scenario.