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Affecting Positive Change by Putting Patients Second


For all the talk of patient-centered care in the health industry, hospitals and practices might need to put their employees first and patients second to succeed.

Paul Spiegelman says he knows that the title of a book matters.

That’s why the chief executive officer of BerylHealth and co-author of Patients Come Second: Leading Change by Changing the Way You Lead chose such a provocative title: Patients Come Second. But it also happens to be what he and co-author, Britt Berrett, president of Texas Health Presbyterian Hospital Dallas, believe to be true.

“In any organization we have choices to make about priorities, about what comes first, and what are the leading and lagging indicators of success,” Spiegelman says. “The choices are usually financial, customer or employee. Our belief is that the employee comes first, and health care is no different.”

Spiegelman also knows that, at first blush, many would disagree with the concept behind the book’s title. They might still disagree after reading the book. He says that’s okay. The message is what’s really important.

“The industry needs to be shaken up,” he says. “The fact is all the talk about patient-centered care, the buzz-words of the last few years, is going to be less successful if we don’t fix our internal cultures.”

Domino effect

Don’t get the impression that Spiegelman doesn’t recognize the importance of customers/patients and financials. He points out that health care organizations, medical practices and hospitals are businesses. And businesses have to be profitable in order to survive, and to invest back in their people and their infrastructure.

The reason these entities exist is to care for patients, but, he adds, there needs to be an order. And the order is important because it drives daily decision-making.

“Look at the non-health care world,” Spiegelman says. “Companies that drive business decisions solely on financials as the leading indicator are not as successful as companies that put the employee first.”

He points to companies like Southwest Airlines, Whole Foods and the Container Store, as those that are well known for their employee focus.

“These companies have far outperformed their competitors in terms of financial success because they put the employee first,” he explains. “And if you just think about it from a common sense standpoint, if I wake up in the morning and I love what I do, and I’m happy at work, passionate about the work that I do, I’m going to do better work. And that’s going to lead to a better outcome for the customer. And then it follows that there will be a better financial reward.”

Spiegelman says to put employees first because they will talk — especially in today’s social media world — to family and friends about their positive experiences. That means, collectively, thousands of employees singing the praises of where they work, which makes recruiting easier, and leads to hiring better talent.

“Nobody wakes up in the morning and says, ‘I want to go to the hospital today,’” Spiegelman points out. “So we have to do an even better job when people do have to visit the doctor or the hospital. That type of internal public relations can make a huge difference in the reputation of a medical practice or hospital.”

Where to start

Spiegelman suggests that the best place to begin to bring about this change within a medical practice is by measuring the organization’s culture IQ, a five-minute, 10-question self-assessment tool contained in his book.

If you’re a physician who has read the book and agrees with the concept, don’t simply hand out the questionnaire. Today’s best leaders, he says, get the best results when they engage their staff as a team.

So, sit with your staff, and tell them that as a practice you could probably be more patient focused. And the way to achieve that focus starts with how everyone interacts as a team and works together. Explain that you want to spend more time working with them toward that goal, doing it together. Then suggest that everyone respond to the questionnaire.

“That’s a critical point; this has to be an inclusive exercise,” Spiegelman explains. “Even if it’s an ugly number that you come up with, the culture IQ gives the leader a way to benchmark or baseline where they are today. And it also identifies those things that are actually important. So now they’ve got the ten things to focus on, they have a baseline, and now they can work with their team to create a plan to improve over time.”

Then, he says, work collaboratively to develop a set of core values and a vision for the practice.

“Don’t just put it on a plaque, but live it every day,” he says. “The physician can’t just write it down and pass it out. That would be very dangerous. This needs to be done as a team, so people feel empowered and involved in the process, and will buy into it.”

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