Qualy #125 - Hierarchies in healthcare, physician burnout, and a broken system

Today's episode of The Qualys is from podcast <a href="https://peterattiamd.com/zubindamania/">#37 – Zubin Damania, M.D.: Revolutionizing healthcare one hilariously inspiring video at a time</a>. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for "qualifying round," which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., "fast"), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: <a href="https://peterattiamd.com/podcast/qualys/">https://peterattiamd.com/podcast/qualys/</a> Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a> Connect with Peter on <a href="http://facebook.com/PeterAttiaMD%5dFacebook">Facebook.com/PeterAttiaMD</a> | <a href="http://twitter.com/PeterAttiaMD%5dTwitter">Twitter.com/PeterAttiaMD</a> | <a href="http://instagram.com/PeterAttiaMD%5dInstagram">Instagram.com/PeterAttiaMD</a>

Actionable Insights

1. Bypass Flawed Command Chain

When a superior is clearly wrong and patient care is compromised, bypass the immediate superior and go directly to the next level of authority. This action, though potentially carrying personal consequences, ensures the patient receives better care and prevents future regret.

2. Think First, Then Speak

Reverse the common professional advice to ‘speak, then think’ by prioritizing critical thinking and questioning established practices. This is especially important when you perceive issues or seek root causes, even if authority figures discourage such questioning.

3. Disregard Rigid Hierarchies

Actively cultivate less respect for rigid hierarchies, as individuals who disregard them often achieve ‘amazing things.’ This mindset helps avoid being constrained by potentially flawed systems and allows for greater innovation.

4. Prioritize Patient Connection

Shift your focus from rigid protocols or hierarchical adherence to genuinely connecting with patients. This human connection is fundamental to effective care and can alleviate moral distress caused by systemic failures.

5. Train and Support Subordinates

If you are in a leadership position within a hierarchy, focus on training, lifting, and supporting those underneath you. Avoid inappropriately treating them as equals or demanding competence they don’t yet possess, as they need guidance to grow.

6. Publish Your Work Online

Share your speeches or significant work publicly on platforms like YouTube. This can significantly launch your career and provide broader reach for your ideas.

7. Avoid Steamrolling Superiors

Do not ‘steamroll’ superiors you deem incompetent or less knowledgeable, even if you disagree with them. This behavior can lead to significant professional trouble within a hierarchical system.

8. Insight 8

If you carry guilt from a past professional decision involving a patient, consider seeking information about their outcome (if ethically and practically feasible). This act, though not always possible, can potentially alleviate moral distress.