Our immediate past president, Dr. Gorman, emphasized the crucial role we serve as leaders. Recognizing the tremendous development needs for skills and knowledge to effectively lead, SHM has created Leadership Academies and is working on e-discussion forums and mentoring programs to promote longitudinal learning. While we must unlearn some of the behaviors and beliefs seared into our brains during our traditional medical training, we must position ourselves to forge high-performing teams and lead the quality agenda.
At a dinner during the SHM Annual Meeting in May, I sat with a senior leader from the American Medical Association’s Organized Medical Staff Section (AMA OMSS). He had flown in with other AMA representatives to meet with us on common interests. By the end of the evening, the late-career surgeon took me aside and said: “I have to tell you how touched I am by your organization. The passion, drive, and commitment of your membership is what’s missing in so many professional societies today. You must bring this passion to the larger house of medicine.”
As SHM enjoys 10 years of explosive growth and remarkable success, we need to balance the right to celebrate success with the duty not to rest on laurels. Much has been accomplished, but more than a life’s work lies before us. The road is complex and fraught with uncertainty. We might become frustrated with mounting complexity, tired with resistance to change, and fatigued with leading against the status quo. It is hard—and lonely—to confront the systems and issues that desperately need to be confronted on our journey to transform care. And it might be easy for us to become distracted from our core commitments to teamwork and leading quality by allowing our medical society to become more of a guild that defends our professional incomes and way of life. Yet I believe—I know—a much brighter future lies ahead than emerging as a casualty of temptation.
If the best predictor of behavior is past behavior, then our future will mirror the spirit in which SHM was founded. It’s the spirit an invited guest observed in a few short hours at our annual meeting. It’s the spirit that binds teamwork, quality improvement, and leadership into a unified approach to our professional endeavors. That spirit has a name: accountability. It’s the fundamental understanding that we are answerable to others, including patients, families, the community, hospital and medical staff, as well as each other, for the performance of the care systems in which we work.
Being accountable means we must rebuild trust of the broader public in hospital care, and that we follow through on the promise of hospital medicine. It means we own our mistakes, we agree that transparency and measurement will lead to better outcomes, and we commit to being part of the solution.
Accountability also mandates that we eliminate blame and “victimhood.” We cannot first think of ourselves as victims of a broken reimbursement model, or a lack of data or a hospital administration that “just doesn’t get it.” The real questions are: What can I do today about improving management of scarce resources? About the nursing shortage? About incorporating patient-safety principles into a new facility? About access to care and overcrowding? About the needless hospital deaths due to ventilator-assisted pneumonia (VAP), acute myocardial infarction, and methicillin-resistant Staphylococcus aureus? About ensuring seamless transitions of patients throughout the care continuum?
Several years ago I spoke with Brent James, MD, executive director of the Institute for Health Care Delivery Research and vice president of medical research and continuing medical education at InterMountain Healthcare in Salt Lake City, Utah. At the time, I was trying to learn quality improvement methods and practices. He reminded me of a quote Sir William Osler, the father of internal medicine, made at the end of his career when he gave an address at the Phipps Clinic in England to a group of young physicians who had recently completed training. They were about to embark on their careers early in the 20th century. “I am sorry for you young men of this generation,” he told the physicians. “Oh, you’ll do great things. You’ll have great victories, and standing on our shoulders you’ll see far. But you can never have our sensations. To have lived through a revolution, to have seen a new birth of science, new dispensation of health, redesigned medical training, remodeled hospitals, a new outlook for humanity. That is not given to every generation.”