Collaborative Roots

November 5th, 2011 by Kenneth Cohn

Dr. Cohn keynoting annual meeting of the Nebraska Private Practice Association

Last week, I had the pleasure of returning to my professional roots and speaking with a group of physicians in private practice about ways that they could build a culture of collaboration from the ground up.

After my talk, two physicians asked important questions:

Do we really need to pay attention to Accountable Care Organizations?  Will they control the way that we practice?

I was not sure how to answer that question, since I knew that their health system was in the process of forming an ACO with physician representation. I believe that I answered:

I am not smart enough to know how the process will play out at the federal level, but as I travel around the country, I hear repeatedly that we will all need to work more interdependently to provide more coordinated, cost-effective care, not only for economic reasons, but also because it’s the right thing to do.”

The second question came from an internist who asked:

Dr. Cohn, how do we collaborate without losing control?

My mind was racing over the number of ways that I should respond to her question. First, I described the double meaning of collaboration, in which the Latin word “collaborare” means to work together, and that treason statutes make it a crime to collaborate with the enemy. Then, I asked her what she meant by control.  She said, “The ability to make decisions affecting my patients’ care.”

I told her that it was important to have conversations with her administrators about what each wanted to control.  Most physicians seek control of their time, efficiency, and effectiveness, whereas administrators with whom I have worked think about physical assets like property, plant, and equipment when they hear the word “control.”

Going back to my roots, I told her  a story about a friend who said that he felt stupid that it had taken him over 50 years to learn that by giving up (a little) control, he gained influence. Many times, I experience frustration when faced with situations beyond my control.  On my better days, I think about what is making me upset and what I can do to influence the situation. To remind myself, I frequently close talks with John Miller’s prayer from his book QBQ: The question behind the question:

God grant me the serenity to accept the people I cannot change, the courage to change the one I can, and the wisdom to know… it’s me!.

As always, I welcome your input to improve healthcare collaboration where you work.Kenneth H. Cohn© 2011, all rights reserved

Disclosure: I have not received any compensation for writing this content. I have no material connection to the brands, topics and/or products that are mentioned herein.

Posted in Healthcare Collaboration Vision

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