The Optimized Doctor

Eminently qualified physician


 

Just how good are you? Are you a pretty good doc? A better-than-average leader? Or, are you truly an eminently qualified physician?

Dr. Jeffrey Benabio, director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego.

Dr. Jeffrey Benabio

For all the talk about maintenance of certification and continuing medical education, it isn’t easy to know if you really are a good physician, teacher, or leader. In medicine, we’re careful to show respect to each other and tend to be slow to be critical. This might seem a kind approach to feedback, but I wonder if it is.

There are other professions where evaluations and feedback are more direct. In the military, performance standards are often quite explicit. The Marines, for instance, take performance evaluations seriously. This is evident if you’ve ever completed, or been a recipient of, a U.S. Marine Corps fitness report. Reading it, I realized many of the criteria could apply to us in medicine. Here are a few examples from that form (lightly modified for physicians).

Think about your clinical and technical expertise. Would you grade yourself as “competent. Possesses requisite range of skills and knowledge commensurate with training and experience?” Or maybe the next grade “demonstrates mastery of all required skills. Expertise, education and experience consistently enhance department. Innovative troubleshooter and problem solver. Effectively imparts skills to trainees.” Or perhaps you’re a “true expert in the field. Knowledge and skills impact far beyond those of peers. Translates broad-based education into forward-thinking, innovative actions. Makes immeasurable impact on department. Peerless teacher, selflessly imparts expertise to peers, residents, students.”

What about your effectiveness under stress?

Do you act “commensurate with your training and role?” Or do you have an “uncanny ability to anticipate requirements and quickly formulate original solutions?” Do you always “take decisive, effective action?”

How about your leadership performance?

Are you simply “engaged, providing instruction and direction?” Or do you “achieve a highly effective balance between direction and delegation, effectively tasking subordinates and clearly delineating standards expected?” A few of us even “engender willing loyalty and trust that allow subordinates to overcome their perceived limitations.” And exhibit “leadership that fosters the highest levels of motivation and morale, ensuring accomplishment in the most difficult circumstances.”

We might even mitigate physician burnout better if we had better performance standards. For example, do you simply “deal confidently with issues pertinent to subordinate welfare and recognize suitable courses of action?” Maybe you’re at the next level, “actively fostering the development of and uses of support systems for subordinates which improve their ability to perform.” I’m fortunate to know a few physician leaders who “noticeably enhance subordinate well-being, resulting in measurable increase in department effectiveness and proactively energize team members to ‘take care of their own.’ Widely recognized for techniques and policies that produce results and build morale.” By codifying what the standard should be, we can better hold ourselves accountable for our performance. In doing so, we might be better at recognizing and reducing burnout in our direct reports and peers.

The final question on the Marine fitness report is a comparative assessment. The evaluating officer checks one of the following boxes: 1. Unsatisfactory; 2. A qualified Marine; 3. One of many highly qualified Marines; 4. One of the few exceptionally qualified Marines; or, 5. The eminently qualified Marine.

Which are you? Can you describe yourself as “the eminently qualified physician?” You’ll have to define that standard in order to reach it.

This post was inspired by the “Set Standards. Aspire to Achieve Them” episode of Jocko Podcast.

Dr. Benabio is director of health care transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].

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