Physician Administrator Right Stuff

Question: What do a Department Chair in a medical center and a two-year-old have in common?
Answer: They both wake up screaming at 2 a.m.

I heard this quip from a former neurology department head about three months after I assumed a similar role in 2008. Funny then, but less so over time. In my case, I was usually still trying to get to sleep at 2 a.m., clock-watching every 10 minutes instead, while knowing I’d be on the M-14/I-96 racetrack between Ann Arbor and Detroit a few hours later.

There’s nothing like starting your day with a testosterone-charged guy in a pickup gesturing at you in your rear-view mirror because you’re only doing 80 mph to fry up your nerve endings.

If you get to work unscathed you still have to have the right stuff to be a physician administrator. What’s the right stuff, and how much of it do you have to have is the subject of this piece. Below you is a recipe list, in no particular order of importance of the ingredients.

You need to have all the ingredients at your own disposal – they may lie within you, be on your regular payroll such as your personal assistant or administrator, come ad-hoc such as outside consultants or coaches, or come gratis such as the support provided by your spouse/partner, who, willingly or not become part of an intimate team that keeps the ship afloat. All ingredients are needed in bulk. Think Sam’s Club or Costco, not your local delicatessen.

Last time I checked, the average tenure in office of individuals in Department Chair or Dean positions at US medical schools was about 3 years. The real surprise is that it is that long, given how physicians like to chew up their peers who head for administrative posts. It’s a jungle out there.

But if you have a yen for it, here’s my shopping list:
1. When people speak of your work habits, words like organized, disciplined and methodical are in the air.
2. When people speak of your character, words like integrity, sincerity, and reliability emerge.
3. You advance your career through the success of others, not by riding their backs.
4. You continue to be polite and courteous even in the face of impolite discourteous behavior.
5. You can tolerate incredibly long dull meetings and appear engaged even if your mind is in Maui.
6. You elect to fight battles, not daily skirmishes.
7. You accept responsibility for the actions of one of your direct reports.
8. No elephant has skin as thick as yours.
9. You sleep like a baby (not the 2-year old above) after making a tough decision.
10. Your major goals are 3-5 years ahead, not making it to the weekend.
11. You’ve done time in similar trenches to the ones your reports now occupy.
12. You can keep your mouth shut, and your eyes and ears wide open.
13. You avoid appearing condescending or patronizing.
14. You are skillful in leading others to make good decisions while leaving them feeling that it was their brilliance in the first place that thought of it, and you are just useless administrative overhead.
15. You build a close working relationship with your assistant and administrator.

There are others, I’m sure, but if you can say yes to all 15, you’ll be fine. How about 14 of them you say?
Sorry, 14 out of 15 won’t cut it. You’ll be one of those who keeps the mean duration in office at 3 years.