Archive January 2017 XVIII, No. 1

Business Advisor: A Master's Degree in the Business of Surgery

Graduate school made me a better leader in the OR and the boardroom.

Wolfgang Stehr, MD, MBA

Wolfgang Stehr, MD, MBA BETTER BOSS Wolfgang Stehr, MD, MBA, talks with a more trusting staff at UCSF Benioff Children's Hospital in Oakland, Calif.

Surgical professionals who advance from the OR to the corner office typically learn about the business of surgery on the fly. That happened to me as I progressed from staff surgeon to medical director of perioperative services and division chief at my hospital. Real-world experience taught me a lot about case costing and running staff meetings, but here are a few ways I look at my profession differently now that I've added an MBA to my MD.

1Clear communication
Business school didn't teach me how to make better PowerPoint slides. It instilled in me the universal principles of communication: thinking about what message you want to convey, and how to tell the truth efficiently and clearly without blaming, judging or finger-pointing. That's done by turning the focus on yourself, by learning about what makes you tick before you can communicate better with others. It also involves listening to understand instead of preparing to reply while someone is speaking to you. Listen carefully to every member of your team, so you can clue into what they need in order to do a better job.

Learning about the universal principles of communication has improved the way I communicate in the OR when things don't go as expected. For example, when a needed instrument is missing, aggressive questions such as Didn't you read my preference card? or Can't you do your job? have been replaced with Is there a reason why the instrument is missing, and What can we do to ensure it doesn't happen again? The surgical team is held accountable, but the blame and shame reaction is gone. We thrive by working together as a team to solve problems.

I'll also spend a couple minutes with the staff before surgery begins, especially when members I've never worked with are in the room, to go over the key parts of the case, my preferred way of performing the procedure and the equipment I'll need. Surgeons often walk into the OR with a sense of entitlement, and don't try to connect with the surgical team. Taking a moment to create a collaborative environment beyond the surgical safety time out has an added impact on patient safety and ensures that the entire surgical team has a positive experience.

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