How to Manage All of Those Bosses

Very few doctors, including those who are employed physicians, have only one boss. Most have several, including patients, leaders of matrixed teams, committee chairs, department managers, and the person who signs their checks. In some instances, an industrial partner or CEO of a startup you are consulting to might be on the list as well.

Then, there is the alpha dog at home.

The larger organizational benefits of reporting to multiple bosses are both numerous and long proven, says Kevan Hall in Making the Matrix Work: How Matrix Managers Engage People and Cut Through Complexity. In the book, Hall identifies four key advantages to the organization: to break silos and free up talent otherwise inaccessible to the rest of the organization; to manage supply chains and integrate business regions, functions, and processes; to respond more quickly to changing priorities; and to develop talent with broader perspective and greater skills.

The flip side of the multiple medical boss dilemma is real or perceived conflict of interest. The problem with serving many masters in medicine is that every doctor takes an oath to serve one primary master: their patients. To paraphrase Peter Drucker, the purpose of a doctor is to serve patients. The other masters are costs.

So, how should you serve many multiple masters while keeping the patients’ interests primary?

1. Learn to say no to worthless, make-work assignments, like committees, thus eliminating another non-value added boss.

2. Work for yourself.

3. Use your patient responsibility assignments as a reason to refuse. "Sorry, I have clinic on that day" is a useful mantra.

4. Prune your bosses periodically by resigning from a bunch of stuff. It also helps to pick a place to work that still does not use EMRs.

5. Get out more, instead of being a "corporate peasant."

6. Separate what's interesting and what's important by asking your bosses.

7. Prioritize your to-do list.

8. Hold a boss playoff. Since you only have so much time, someone will need to prioritize projects. If you play your cards right, the winner gets to reward you.

9. Have Plan B when your bosses die, retire, or get fired

10. If one of your bosses gets promoted, put that person on boss reserve. If you get promoted above your former boss, remember to smile to them on the way up the ladder. It's likely you will see them again on the way back down.

Part of the problem with getting employed physician engagement is they have multiple affiliations and allegiances and, usually, their employer is far down the list. They feel more attached to their patients, colleagues, professional associations, colleges, medical schools, residency programs, branches of the military they may have served with, and their political party than their employer. Don't expect them to wear your sneakers. They wear too many brands already.