How to quickly run a specialist health service in the trench

19.04.2016, emergency doctor Thomas Paine published a chronicle on the Kevinmd.com website. How to destroy a great is: a step by step guide.

In the chronicle, Paine lists 8 points that he believes is crucial if a leader aims to destroy a well -functioning emergency room. His frustration is easy to recognize, even 9 years after, and in a completely different health system.

Finnmark Hospital Director Ole Hope is a self -proclaimed clear and clear leader, with a doctorate in strategic management and change, and the role of the middle managers. Hope’s leadership career is consistently characterized by conflicts with employees and varying support from the boards. He is employed by the Finnmark Hospital to clean up an economy with a stroke, a task he has fully heard in to perform.

Have to listen to health care professionals

The president of the Medical Association, Anne Karin Rime, has challenged Hope on how to succeed in this clean -up work without bringing along the « wardrobe ». Health Minister Vestre said in his hospital speech « We must find good local solutions. We must listen to health professionals and understand their everyday lives. ”

Director Hope has repeatedly emphasized that there is a close cooperation with union representatives. It is no exaggeration that the Medical Association’s union representatives in the Finnmark Hospital do not recognize this.

We are repeatedly said that in a health enterprise it is the board with the chairman of the board and the director’s duty and responsibility to make decisions. Some of these decisions may entail tough priorities. I agree with this, but at the same time will note that these decisions must also be justifiable and be taken on an enlightened basis.

Professor of Law Anne Kjersti Befring has pointed out that according to the law, Hope as director of the Finnmark Hospital is required to investigate the consequences of its leadership decisions, including by obtaining advice from the professional communities. When the Finnmarish Hospital’s leadership consistently chooses to ignore input from their own professionals, and instead prioritize consultants from the outside, this is not exactly a declaration of confidence to their own employees.

The situation in the Finnmark Hospital is now characterized by uncertainty among professionals about how their working life will be in the future. There is great concern about which specialist health service offerings, and not least what emergency preparedness, Finnmark will be left with after the health enterprise’s budgets have been tried in balance. I write here « tried », because I have little faith that this will balance with the measures that have been implemented. Some of the tiny positive tendencies we have seen lately are due to less substitute use since you have got their own permanent employees. Own permanent employees are a result of long -term work done long before Hope took over the helm as director of Finnmark Hospital. The new strategy, on the other hand, does not take care of its own professionals. The Finnmark Hospital must therefore take into account increasing expenses again if the professionals begin to choose their own.

Uncritical coverage

The news newspaper and the trade magazine for health professionals and other health sector staff, Dagens Medisin, have provided director Hope plenty of space, but to a small extent asked critical questions about Hope’s way of dealing with the challenges in Finnmark Hospital. On the contrary. Responsible editor, Martin Gray, stated in December last year that « Finnmark Hospital can solve some of the specialist health services challenges »! My response to this is no! This is not how you lead a personnel -intensive high -competence business. Then things go wrong. In conclusion, I will present a Norwegian variant of the emergency pine advice to leaders who will run their health institution in the trench. It is meant humorous, but at the same time with a serious undertone. Hope is in the process of achieving its list, but if you read this is a health leader somewhere else in the country it may be you still have something to learn.

1. Ignore and underestimate clinical expertise.

2. Don’t ask clinical personnel what they need to do their job, tell them what they get.

3. When clinical departments show signs of struggling to perform all their tasks, show action by taking action such as creating more positions in the administration.

4. Reject any request from clinical personnel by referring to the need to save money.

5. No one knows the unique problems and challenges of your clinical departments better than external consultants.

6. Make sure the clinicians are aware that they are not in a negotiating position.

7. Take a starting point that you can compare any department elsewhere. For example, regardless of size, population, distances and climatic conditions.

8. Make sure to establish an environment where the clinicians can not succeed- and then blame them for it.

Of course, one must strive to fill as many as possible of the above points. Only a couple, three points are not enough. It can even be the weakest leader. After all, the slogan at this year’s hospital leader conference was « MOT in management! »

Paul Olav Røsbø

Leader of Finnmark Medical Association

The post was first published at Today’s Medicineand is printed in the Altaposten with permission from Røsbø.

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