50 SEPTEMBER•OCTOBER 2004 THE PHYSICIANEXECUTIVE

Disillusionment sets in

Results of a study conducted by David A. Kindig andcolleagues over a decade ago revealed that non-physicianexecutives often valued the contribution of physicianexecutives to organizational performance more than thephysicians did themselves.4

Some of the most highly ranked objectives included:

• Improving quality assurance activities

• Establishing effective relationships with medical staff

• Evaluating practice patterns for efficiency

• Defining goals, priorities and directions for the organization

The investigators believed that physician executiveswould be reassured to know that lay managers in theirorganizations value their role.

However, changes in the health care field since thetime of Kindig’s research further eroded relationshipsbetween physicians and organizations. Physicians areincreasingly disillusioned by the practice of medicine andorganizations are constantly changing as societal valuesand the composition of the workforce change.

Organizations are more diverse and competitive, andthey are affected by technology’s influence on behavior.Attempts to engage physicians in mutually beneficial part-nerships frequently result in frustration and disappointment.

Organizational behaviors are a key part of a compa-ny’s people strategy. These behaviors are essential to thesuccess of the organization and help form the basis of itslong-term growth. Organizational behaviors speak to how

Organizational behavior is the study of humanbehavior in the workplace, specifically the interac-tion between employees and the organization.

Although organizational behavior has been studiedfor over a half-century, health care leaders only recentlybegan to understand the steps physicians can take toimprove organizational effectiveness and how to engagephysicians in support of organizational goals.

Some physicians fail to appreciate the importance ofaligning their behavior with the goals of organizationsthey work in or come in frequent contact with. Medicaltraining fosters autonomy and physicians often workindependently. Indeed, major reasons for failure amongphysician executives include inadequate interpersonalskills, lack of concern for others as individuals and poorrole models for subordinates.1

Even physicians in solo practice have been forced torecognize the significance of organizational behavior, atleast the importance of connecting with people.

According to Ronald N. Yeaple, author of The SuccessPrinciple, solo practitioners should think of themselves asCEOs of a “company of one.” Yeaple writes: “As CEOof your company of one, you recognize that your effec-tiveness is determined in large part by your ability to getthings done with and through other people. The oldcommand-and-control model of management—‘do itbecause I’m the boss’ is becoming less prevalent, andmanagers are increasingly dependent on their own personal leadership skills to get things done.”2

Richard L. Reese examined the effect of managedcare on physician organizational behavior and concludedthat “physicians don’t necessarily have to become an‘employee’ of an outside entity, or be herded into anorganization to which they don’t want to belong. Butthey do have to become stronger financially, more collab-orative, better organized, and more business-like.”3

Reality Check: Is Your Behavior AlignedWith Organizational Goals?By Arthur Lazarus, MD, MBA, CPE, FACPE

Strong, well thought out organizational behaviors helpinstill confidence in patients and allow physicians totake a leadership role in health care.

IN THIS ARTICLE…

Dealing with Disruptive Behavior

THE PHYSICIANEXECUTIVE SEPTEMBER•OCTOBER 2004 51

the company intends to succeed;they need to be brought to life byeach employee incorporating theminto his or her daily work andinteractions with customers andcolleagues. All parties need to be inalignment to achieve maximum business impact.

Here are seven critical organiza-tional behaviors that should be ahigh priority for you and your organ-ization, even if your organization is acompany of one. Each behaviorincludes descriptive statements tobenchmark your performance:

1. Demonstrate Technical and Professional Proficiency

Organizations cannot succeed withmediocre employees. When JackWelch ran GE, under-performingemployees who did not improvedespite coaching and developmentopportunities were asked to leavethe company.5 You must possessthe medical and technical knowl-edge required of your position,enhance your role through presen-tations, publications or innovation,and facilitate knowledge transferwhen interacting with key stake-holders. Communication skills areessential and you must gain insightfrom listening to others.

2. Focus on CustomersAsk whether you are focused oninternal and external customers.Think of a “customer” in the broad-

est sense—a patient, colleague,administrator, vendor, etc. Do youbuild and maintain relationshipswith key customers, understandtheir needs and deliver concretesolutions that meet the needs ofboth the customer and the business?Recognize the diversity of your customers and consider them in virtually all decisions you make.

3. Drive Business PerformancePerformance and development ofpeople are high on the agenda forjust about any company. Successfulcompanies learn how to develophigh-performing employees andalign them with their business strat-egy. Your personal goals and objec-tives should closely match those ofyour organization and contribute toits success. Work with a sense ofurgency to deliver quality resultsfaster, effectively and efficiently.Learn from your experience andshare best practices with colleaguesto improve output and businessresults. Take informed risks and setexamples for others; if you makemistakes, make sure someone elsecan learn from them.

4. Show Passion in TeamsDo you work with colleagues onshared goals and celebrate yourwins? Do you support and encour-age each other, consider diverseperspectives, and present a united

front when there are differences ofopinion? Are you able to lead mul-tidisciplinary work groups to devel-op medical strategies and actionplans? Only by leveraging the talents of teams can organizationscontinue to be innovative and thrivein a competitive environment.

5. Solve Problems EffectivelyProblem solving requires a combi-nation of analytical thinking andstrategic thinking. The formerinvolves gathering and evaluatinginformation as a framework forexamining an issue, whereas the lat-ter considers the organizations’competitive positioning when mak-ing strategic decisions. Ask whetheryou can respond to medical crisesbased on a deep understanding ofthe issues and medical facts. Canyou create meaningful analyses ofmedical and market data that drivethe organization in a new, moreproductive, direction? Can you helpyour company pursue and maxi-mize cutting-edge opportunities thatmay have broad, long-term businessimplications, e.g., a merger, productextension, or expansion of services?

6. Plan and Organize Activities Around SMART Goals

In a truly unified company, peoplewill have a line of sight to the busi-ness strategy as they work towardscommon goals. Understanding howto align personal and organizational

goals requires planning along a timehorizon. But much of what physi-cians have been trained to do is reac-tive rather than proactive. Developingpersonal goals and business plansrequires appropriate resource alloca-tion, anticipation and adaptation tochange, and timely and successfulexecution of objectives. Objectivesmust be prioritized to reflect currentresources and forecasted demands.Your goals must be SMART—specific,measurable, attainable, realistic, andtime-bound. People tend to procrasti-nate setting goals, but goal setting isthe foundation for personal and busi-ness success. In fact, you should con-sider additional goals beyond SMARTgoals.

Beyond SMART Goals

• S means specific, but stretching,systematic, synergistic, significantand shifting are appropriate.

• M stands for measurable, butmeaningful, memorable, motivat-ing and even magical round outthe picture.

• A is an attainable goal, but Aalso needs to stand for achiev-able, action plans, accountability,acumen and agreed-upon.

• R means realistic, but it alsostands for relevant, reasonable,resonating, results-oriented,rewarding, responsible, reliable,rooted in facts and remarkable.

• T means time-bound and it alsorepresents timely, tangible, trackable and thoughtful.

52 SEPTEMBER•OCTOBER 2004 THE PHYSICIANEXECUTIVE

7. Exhibit Leadership and Influence Others

Both you and your organizationwant to be viewed as leaders in thefield. Ask yourself whether youexemplify the core values of yourcompany. Do you build awarenessof issues and gain support for yourideas? Are you a mentor to juniorcolleagues and a source of adviceto others? Are you recognized as athought leader in the communityand within your organization? Ifnot, what steps do you need to taketo achieve distinction? Your goal isto exert strong influence on behalfof your company using facts, logic,and credible personal presence inthe service of leadership, inspiringothers to embrace your vision anddevelop a plan to get there.

Health care organizations havebegun to sharpen their focus on thecritical behaviors necessary for suc-cess. In order to succeed in achanging and challenging environ-ment, an organization must have analigned workforce and be able toregenerate itself through its people.

The way we behave and han-dle our responsibilities really doeshave a dramatic impact on the com-pany and the patients we serve.Knowing the elements that have thegreatest impact on physician behav-ior is essential to understanding andimproving both patient and busi-ness outcomes. This informationcan be used to achieve optimumalignment between physicians andhealth care organizations.

References

1. Peters RM. When Physicians Fail asManagers. Tampa, Fla., AmericanCollege of Physician Executives, 1994.

2. Yeaple RN. The Success Principle. NewYork, Macmillan/Spectrum, 1997.

3. Reese RL. “Impact of managed care onphysician organizational behavior.” ThePhysician Executive. Jan-Feb 1999,25(1):14-20.

4. Dunham NC, Kindig DA and Schulz R.“The value of the physician executiverole to organizational effectiveness andperformance.” Health Care Manage Rev1994, 19(4):56-63.

5. Welch JJ. Straight From the Gut. NewYork, Warner, 2001.

Arthur Lazarus, MD,MBA, CPE, FACPE, issenior director of clinical

research for AstraZenecaPharmaceuticals based inWilmington, Delaware. He is a fre-quent contributor to The PhysicianExecutive and editor of MD/MBA:Physicians on the New Frontier ofMedical Management (AmericanCollege of Physician Executives,1998). He can be reached by phone at302-885-4542 or by e-mail atarthur.lazarus@astrazeneca.com.

Thanks to Glenn Gormley, MD,PhD, for elucidating several of theorganizational behaviors discussedin this article.