by Nick Jacobs

The fundamental charge of a hospital administrator is, and always should be, patient care. All too often, however, we immerse ourselves in the daily tedium of trivia that deals with mundane issues that can only be described as the fundamentally messy drivers of day-to-day life among human beings. We deal with those issues that cause our in-baskets to bulge, our voicemails to fill, and our Blackberries to show memory overload; but, for the most part, they are not essential issues that contribute directly to patient care.

The vast majority of these problems are very similar to those that were part of my daily challenges as a teacher some 30 years ago. They often deal with egos, with jealousy, or with seeking ways for the individual employees to save face after engaging in confrontational behavior. There is also one very true description as well that states that "the problem is never really the problem." If you look under the surface, you will find the reality of every situation.

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Unfortunately, our degree programs do not teach us much, if anything, about Emotional Quotient (EQ). We often times as managers do in management what has been done to us, and that is to recreate parent-to-child interactions with our staff. When we encounter an employee/employer relationship that demonstrates domination through a parent-to-child interaction, it most likely will lead to future problems on many levels.

One sure way to cut down on dysfunction is not to embrace dysfunction. If an employee, administrator, or physician acts out inappropriately, steps need to be taken immediately to demonstrate that these types of outbursts will not be part of a healing environment. These steps should be taken not by administration, but rather by those individuals who would be considered peers, and on an adult-to-adult basis. This is a much more effective way to disarm hostilities with peers than through administrators.

Read "I'm OK, You're OK" by Dr. Thomas Harris. Learn to control your decision making through a better understanding of the people with whom you work and interact, and make employee-centered care a precursor to patient-centered care. Take care of your employees, and they will take care of your patients.