by Tony Chen

Okay, I think it's time to talk about the big pink elephant in the middle of the room. Time and time again, we have skirted the issue. But no more.

Has anyone read the book Men are from Mars,Women are from Venus? I skimmed it quickly once standing at a Borders, and it's surprisingly good. It's like men and women are talking a completely different language. A lot of words are exchanged, but somehow nothing is connecting. Is there that much of a difference?

In the hospital world, the stereotypes go like this:

Physicians are greedy. All they care about is money, money, money, just trying to make that extra buck, squeezing in that extra patient.

On the other extreme, physicians and nurses don't care about money or business at all - they don't care if we lose our shirts and close shop. While we applaud their compassion, they have no sense of the system and how things need to be run to be sustainable.

As for adminstrators, they are just heartless and clueless. They have no idea what happens on the front lines of patient care. They have no idea that every patient has different needs, different issues. Every patient has a family. Administrators are just about bean-counting. They just care about numbers and metrics and these spreadsheets that have nothing to do with anything. Isn't healthcare about helping people in their greatest moments of need?

Okay, so there, I said it. It's out there.

Now, let me just be clear that most of the physicians and administrators I know don't fall into these extreme stereotypes. Most physicians are patient-focused to the core but also have a sense of the bigger systems picture. Most administrators care about healthcare, care about the long-term health of the hospital, and desire better results for the right reasons.

The problem is that this perception has been ingrained by so much previous bad experience and miscommunication. How do we begin to turn the tide?

1. Spend a day in my shoes. This goes both ways. Spend a day (or even just an hour or two) shadowing your counterpart. So many people gave me this advice when I first started working for the hospital. For administrative and corporate folks, go on rounds with physicians. Spend 4 hours on a nursing floor (during a shift change) and you'll begin to understand how many split-second decisions are made with such precision and finesse by your front-line clinicians. And for clinicians, take some time to listen to the pressures and challenges that the administrator faces. Think about how one seemingly "small" decision sets a precedent for a thousand others and the potential impact on the whole organization.

2. Get to know the people behind the roles. This probably goes without saying, but I haven't seen this done nearly as much as it should. And I'm just as guilty of this, too. When you know that Lucy has 3 kids and one of them is having a hard time at school, when you know that Dennis went into healthcare finance because his 3 aunts went broke from hospital bills, it's that much easier to work together. We're all just people. And eventually, we are all patients, too.

3. Begin to learn each other's lingo. This goes with the previous points. More and more, I'm realizing that it really is a different language. Literally. The acronyms, the abbreviations, the slang, the inside jokes - sometimes we spend so much time in our own little world, we forget that others don't understand (or worse yet, misunderstand) what we're trying to say.

4. Give people the benefit of the doubt. I know this is soft and fluffy, but remember that those stereotypes above probably don't apply to 90-95% of the people you work with (Nick just commented that only 10 out of his 550 physicians fall into that "greedy" category).

5. Realize that you need each other. Like it or not, someone has to see each patient, and yet someone has to focus on the aggregate. More importantly, there are some issues and problems that may never be solved without the two working together. Some finance guy looking a spreadsheet doesn't understand why a cost started going up, while the clinician may not even notice that it's gone up. Working together and bringing both expertises/perspectives, a better, more creative solution can be found.

What else would you suggest?