r/Residency•
pixelmonkey

Lack of management experience for attendings

My partner is a PGY-3 in a tough top-rated academic program. I am a technology executive who has spent an entire career in programming/tech, at both startups and enterprises.

My question for this group is, "To what degree is managerial inexperience among attendings hurting your residency?"

Let me explain. You are doctors. You are elite, motivated, smart, passionate, diligent, and well-educated. As residents, you are also overworked and underpaid.

Any experienced manager who would have to lead a self-motivated technical staff such as the kind just described would see this balance plain as day. The focus of management would therefore be on supporting the staff, protecting their vacation and personal time, eliminating red tape, avoiding micromanagement, reducing office politics, and minimizing scut by hiring administrative help.

Yet, what I see in my partner's residency and residency programs that friends are in across the country is the opposite. It is amateur hour, management wise, on a massive scale.

The people in charge don't protect vacation/personal time, don't hire to solve for admin burden, and do create highly political, finger-pointing, red-tape-laden cultures.

So, what gives? My only answer is that attendings, who are charged with "managing" residents, don't manage them as if they are the highly valuable irreplaceable staff they are. They don't lead their teams. Instead, they are constantly in a defensive firefighting mode. But, they put out fires by lighting a match and pouring gasoline.

If I did what typical managers in health systems do to residents to my employees, they would quit, and for good reason. I'd also be worried about (justified) workplace lawsuits and the end of my company.

But the inexperienced managers in residency programs are not held accountable in this way, since residents can't quit, and residents don't sue.

I recognize that since most doctors are "straight through" (that is, science undergrad, med school, residency, practice, with no real world experience in between) they are never exposed to how proper companies and organizations operate. Large dysfunctional health systems are all they ever know, so the inexperience of their mentors compounds into their own inexperience, while also coming off as "experience".

But, this problem strikes me as solve-able, at least once recognized. As an outsider, did I nail the problem, in your view?

Posted Aug 25, 2017, 11:43 AM UTC

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