Last year I had a strategy session with a Chief Medical Officer for a large integrated system. As we talked about their goals for the future, I could sense the CMO’s doubt and detected an air of defeat. When I probed this, he was very forthcoming about the source of his frustration and doubt. He queried, “How can we possibly move forward when our providers are still arguing the validity of the patient satisfaction scores?” He went on to say that many were in complete denial. Some would usurp a significant portion of meeting time objecting to the survey, the methodology and, of course, the results.
I asked a few questions to get a better understanding of their situation. My first question was, “How likely are you to stop measuring patient satisfaction?” His response was emphatic that they would not be discontinuing measurement. My next question was, “How likely are you to discontinue reviewing the scores with doctors and using scores as part of their incentive plan?” Again he was emphatic that the data would still play an important role in accountability.
A Culture of Excuses
To this outsider looking in, it was obvious that the train had left the station. Yet a significant number of passengers (physicians) were still glued to the platform. It turns out that, in an effort to be inclusive, leaders had inadvertently created a culture where complaining and excuses were accepted. Why? Because in the past, the squeaky wheel got the grease. The providers had learned if they complained loud enough and long enough, they would get their way. Some would even hijack meetings as a platform for their personal causes. This pattern was clearly holding them back.
We discussed how the CMO could approach the issue in order to move forward. As he talked through the situation, he discovered that he and the other leaders had inadvertently created a culture of excuses. Accepting excuses can be the difference between progress and stagnation. What excuses are worming their way into your culture?