Leaders Eat Last

By Vinh Chung, MD, Dermatologist/Mohs Surgeon, Colorado Springs

The patient-doctor relationship has been ingrained through our long medical training and remains at the center of our decisions in daily practice. Based upon trust, this relationship demands that we make decisions that are always in the best interest of the patient. The coronavirus pandemic has brought to the forefront another type of critical relationship – the staff-doctor relationship. While antagonistic staff-doctor relationships are notoriously common and can drive physicians to burnout, they do not have to be this way. When healthy, the doctor’s relationship with staff can be an incredible source of pride and joy.

After executive orders suddenly limited medical services and procedures, the revenues of our medical practice dipped by 90 percent. This unsustainable situation had no end in sight. The cash reserves in our practice were bleeding out and would be depleted if changes were not made immediately. Even before any federal loans or financial assistance became available, our leadership team took action.

We committed to follow our motto that “leaders eat last.” Financial setbacks are scary for everyone, but we recognized that our hourly employees have it much worse. They need their paychecks to buy groceries and to pay rent, so we committed to protect them. Starting from the top down, our executive team took an 80-100 percent cut in our salaries. The rest of the medical providers also voluntarily took significant pay cuts. After we announced our decision, other staff members stepped up and followed suit. Our managers asked to “work more and get paid less.” Some staff members even volunteered to work for free. Across our medical practice, team members who earned the most sacrificed in order to protect those who earned the least.

Watching our team members care for each other is an incredibly beautiful moment that I’ll never forget. I’ve always been proud of our staff because of their excellent work. This time I’ve been humbled by their character. Generosity, selflessness, and the desire to protect one another flourished and became so much more contagious than fear or self-preservation.

Our practice has since received the Medicare stimulus payment and funding from the Paycheck Protection Program, which will buy us more time as we ride out the pandemic. While we had to accelerate departures for team members who were already transitioning out, we have not had to lay anyone off. Two-thirds of our tribe volunteered to furlough, cut pay or reduce hours. There are glimpses of light at the end of the tunnel, and we really do believe we can make it through this crisis with our entire team intact. When we make it to the other side, we plan to restore everyone’s pay and hours in the reverse order from bottom to top. The leaders will eat last.

Similar to the patient-doctor relationship, the physician’s relationship with staff is based upon trust that must be earned. When trust is absent, any relationship can become a thorn in our side or an obstacle we must work around. These unhealthy relationships with staff and administrators are often the root cause of physician burnout. They must be addressed if physicians want to have fulfilling careers.

There is no better way to earn trust than to walk with our staff through a crisis. When our staff know that we are willing to protect them, they will do the same for us. And I believe wholeheartedly that in the long run, our patients will be better cared for as a result.

Vinh Chung, MD, works for Vanguard Skin Specialists in Colorado Springs, Colo. He has a passion for instilling meaning and purpose into the workplace. He can be reached at [email protected].

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