November 18, 2005

Elevate: Answering the Tough Questions

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Medical Center leadership answers the tough questions about what the elevate program is and what it means for the people who work at VUMC.

Question: What about physicians under elevate; will they be expected to participate fully?

Answer: Physicians are a critical part of everything that happens at Vanderbilt. We want our medical center to be built around patients. But there would be no patients if it were not for the doctors that we can attract to practice, teach and research here at Vanderbilt. Our reputation and demand for our services could not exist without a talented and motivated physician staff. Under elevate, we will devote considerable time and attention to making Vanderbilt the best place possible for our physicians to practice.

But the flip side of that commitment to make Vanderbilt the best place for physicians to practice (or teach or conduct research), is that the physicians commit to making Vanderbilt a great place for patients to get care and for staff to build rewarding careers.

We have put physicians in an interesting and sometimes difficult role that, if well understood, could help in building better physician-patient and physician-staff interactions. Many of the people who provide services to physicians at Vanderbilt do not report to the physician. This includes nurses, techs and patient care staff on hospital units, and nurses, receptionists and staff in their clinics. Every physician will readily acknowledge that when these staff do great work both the doctor and the patient benefit. But when staff do not perform well, physicians and their patients suffer.

Now, consider the staff nurse in the clinic who reports to a clinic administrative unit. If the clinic administrator and the physician are not in perfect harmony in setting expectations for the staff nurse, there will inevitably be problems and conflicts. Because the physician does not directly manage the staff nurse, both the nurse and the physician can feel uncomfortable.

For the Medical Center to become a world-class institution every person here needs to value the contributions and roles of everyone else and this must include physicians. We plan to begin conducting a physician satisfaction survey among our faculty to learn what is good about their working environment and what is not. But we will also expect them to help us improve our staff and patient satisfaction.

— Harry Jacobson, M.D., vice chancellor for Health Affairs