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Beware Office Politics

Hospitalists routinely confront clinical, administrative, and ethical issues. Sometimes they face less-identifiable issues, such as office politics. Webster’s Dictionary defines office politics as “factional scheming for power and status within a group.” Wikipedia describes office politics as “the use of one’s individual or assigned power within an employing organization for the purpose of obtaining advantages beyond one’s legitimate authority.”

How much does office politics affect hospital medicine?

“Of course there is office politics in any work environment,” says Heather A. Harris, MD, former director of Eden Inpatient Services in Castro Valley, Calif., and currently splitting time as a hospitalist at the University of California San Francisco and the Palo Alto Medical Foundation. Dr. Harris, however, believes office politics is rare within hospital medicine because, “It is a young field and a growing field; everyone is growing together, so things tend to be pretty democratic. This is especially true of newer groups.”

Then again, there are times hospitalists find themselves embroiled in office politics. When this happens, what should you do?

Take the High Ground

Although she’s encountered few cases of office politics in her career, Dr. Harris’ general advice for hospitalists is, “First, recognize it, and then try to be a good team player.” Stay above the fray and try to tread carefully around political situations, especially if you’re a manager or informal leader.

Mary Jo Gorman, MD, MBA, CEO of Advanced ICU Care in St. Louis, and former SHM president, advises hospitalists and group directors to “take the high ground, no matter how frustrated you become.” She stresses discretion: “You can talk about it to your spouse, but if you’re a leader, you can’t even [comment on someone’s behavior] in front of your group. You never know, especially if you’re in a relatively small community, when you’re going to need someone’s support. You need to stay on good terms with people.” Dr. Gorman’s advice for leaders holds true for individuals hospitalists caught up in office politics.

Prune the Grapevine

Workplace gossip can be just as harmful as hardcore office politics. Dr. Gorman, a physician executive overseeing hospitalists and other doctors since 1991, says HMG leaders should invest in proven methods to squelch potentially harmful rhetoric. Here is her advice on how to handle rumors in the hospital.

The Rumor Mill: “Sometimes people on the medical staff will start vicious rumors,” Dr. Gorman points out. “Say you hear that a physician’s credibility is being questioned, rumors that he isn’t really board certified. You can’t confront the people who started the rumor, even if you know who they are, because they’ll just deny it.” Because you can’t “out” the rumormongers, instead go to the recipients of the rumors to set the record straight: meet with the nursing staff or send out a letter to the entire medical staff. “One can address the specific rumor without confronting individuals,” Dr. Gorman says. “This can happen with clinical issues, as well, when someone attacks a process. You need to educate that person, as well as others; the nursing staff, for example, who is trying to determine which physician is correct. Go to the recipients of the information.”

Personal Attacks: Address gossip relating to an employee’s personal life immediately and directly. For example, you hear a rumor that a doctor is leaving the group because of so-called group dynamic issues. The truth is the hospitalist is leaving due to family medical issues. “You can make sure that in the doctor’s lounge or the dining room you communicate what is really happening,” Dr. Gorman says. “This works. You know who to talk to in your organization to get your own correct information out there and fed back into the grapevine. You also can share your message with informal leaders, so that they can help disseminate information and counter gossip.” In other words, circulate your own “truthful” bulletin, memo, or e-mail on company letterhead. Once the grapevine reads this imperative, the issue should disappear.—JJ

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