Engaging Physicians--a Great Book

“Over the weekend, Jaded Julie, I read a great book. It’s called Engaging Physicians by Stephen C. Beeson (1). Remember when we talked about Physicians and Lean back on June 25, and I said that a hospital-wide Lean transformation must involve the physicians? Well, Beeson’s book goes into the subject much more deeply than the IHI white paper that I cited. This book was written principally for hospital administrators, while Beeson’s earlier book, Practicing Excellence: A Physician’s Manual to Exceptional Health Care (2), was written for the physicians themselves.”

“But Curmudge, how can you even comment about physicians? Without an MD after your name, your credibility with physicians is zilch.”

“I was an undergraduate with premeds, I later taught chemistry to premeds, and now I see doctors every day. All of that plus the fact that Beeson is a physician ought to raise my credibility to at least zilch-and-one-half.”

“Good luck, Curmudge. So if we acknowledge that physicians must be involved in a Lean transformation, why must so much ink be devoted to how we can make it happen?”

“Consider premeds and engineering students, Julie. The engineers’ grades can be B’s and they can be successful. The premeds must be sufficiently intense to earn A’s in order to get into medical school. In addition, the engineers learn about systems, collaborating with teams, and eventually working for an organization. In contrast, all the way through college, med school, and residency, physicians focus on developing their individual autonomy and personal responsibility for their patients. Systems and organizational issues—so critical in a Lean transformation—are rarely considered.”

“Curmudge, you sound as if you’ve known a few engineers over the years. Are there other ways that they differ from physicians?”

“It seems to me, Julie, that physicians are a bit more outgoing than engineers. The story goes that when you meet an engineer when walking down a hallway, he is always looking at his shoes. When you meet a doctor in the hallway, he is looking at your shoes.”

“You can’t say that, Curmudge! Somebody might be offended.”

“Okay. Sorry about that, physicians. How about this? Sometimes when you meet a physician in the hallway, he seems to have a ‘thousand-yard stare.’ I once met a guy with that appearance who was hiking down from the summit of Mount Rainier. He looked as if he had really been through the wringer.”

“That’s better, Curmudge. A physician might be thinking intently about his most recent or next patient. So what is your explanation…er, conjecture, Professor?”

“I once read that people can be changed by a significant emotional event—like marriage, motherhood, or in the present case, medical school and residency. My speculation is that med school transforms serious undergraduates into extremely intense practicing physicians.”

“Now I understand, Curmudge. That’s why Beeson wrote a whole book about how one should proceed to engage physicians in a hospital-wide renewal.”

Affinity’s Kaizen Curmudgeon

(1) Beeson, Stephen C. Engaging Physicians: A Manual to Physician Partnership. (Fire Starter Publishing, 2009)
(2) Beeson, Stephen C. Practicing Excellence: A Physician’s Manual to Exceptional Health Care. (Fire Starter Publishing, 2006)