Weaponized Praise Does Harm in Healthcare

Weaponized praise is an unfortunately common tactic used by many leaders and administrators in the healthcare industry to manipulate physicians and even other healthcare professionals into doing more work, often in lieu of a raise, a promotion, or helping us solve our most pressing issues. I also think that there is a more sinister twist to how it is used against physicians.

Weaponized praise is a pervasive tool used in medicine by most leaders and the entire healthcare system. I would describe the technique of weaponizing praise as leveraging a doctor’s ethics and drive for quality and the passion to provide patient care. In fact, I have been victim to this and I see many other victims, where the praise is weaponized to get doctors to make up for the failings of a system.

In my first job, I was given titles and lots of praise. For a while, I responded to it with increasing case volume and continued effort to receive that praise. It was confirming of my worth as a physician and provider of care. Within my second year, I had the second highest RVU's (a measure of productivity) in the department. I responded to the praise by picking up other people's responsibilities.

I received encouragement to delegate more, whether to the residents or to my administrative assistant, but I was not guided in the process of HOW to do that.

I was added to committees. I had ever increasing responsibilities.

 
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This might describe almost every early academic career. It is a common tactic for onboarding others in private practice as well. When it comes to raises or promotions, I was told that it was beyond my boss's control. Promotions had to go through the university process. Appropriate raises were just not possible due to departmental financial constraints or the shrinking dollar in healthcare.

Sounds like a flawed process.
Sounds unsustainable. And it was.

When I finally started adjusting my work schedule to more sustainable levels, the only thing that seemed to change was that the praise went away.

I think that navigating this complex dynamic would have been easier with professional coaching. It is a balance between operating at high performance and the understanding that simply taking on more work does not necessarily equal greater results. Creating efficiency and building strategies to develop a lifestyle-friendly surgical practice that is sustainable would be a more effective process. If I was taught then the 8 PRACTICEs of Highly Successful Surgeons, and if I was provided coaching, I might have stayed in an academic practice. I know I would have been much further along in my career growth. Knowing how to operate and take care of patients is simply not enough.

So what are the shields and opposing weapons to this kind of weaponized praise?

“Accept your boss’s praise. Politely decline extra work, and try to offload what you’ve already taken on.” - Jessica Wildfire

In a recent article on the topic, Jessica Wildfire outlines the following recommendations for combating weaponized praise:

  • Accept the praise

  • Don’t whine about doing extra work

  • Politely decline extra work, and even try to offload what you’ve already taken on

  • Learn and implement a strategy to say “no”

  • Highlight your desire to do high quality work

  • Remind your boss of what you are already doing

  • Only take on projects that will raise your knowledge or value**

  • Find out who should actually being doing the work and redirect

  • Doing extra work should eventually lead to some kind of reward

Each of these tips has potential value. Most are often part of an overall strategy of learning to say “no” and setting priorities.

**Since many physicians want to gain new skills and knowledge, one needs to proceed here with caution. There must be a limit to the work or the timeframe over which it should be completed. Research notes that rest and recovery are necessary in between these periods of challenge. Has your boss accounted for that?

We can certainly challenge ourselves. Research shows we often grow the most when we are challenged just outside our comfort zone. Your boss might not have a clear picture on where that threshold is for you. You might not even know that threshold yourself. Are we being realistic with ourselves that the increased value and reward will be achieved? Could it be done over a more realistic timeframe?

I hope you can incorporate some of these tips into your shield against weaponized praise.

If not, these challenges are a great reason to use a coach.

SurgeonMasters is building a community of surgeons and physicians looking to change the culture in medicine. A coaching mindset and skills are powerful tools to start creating the change we need. Email Team@SurgeonMasters.com to get involved.

Source: Watch Out for Weaponized Praise

Seeking Help for Something Rotten

A recent article - “There is Something Rotten Inside the Medical Profession” - written by an anonymous physician and published on kevinmd.com, discussed the issues in the medical profession that can lead physicians to burnout and suicide. During my first 5 years in practice alone, I knew three physicians who committed suicide at my institution. One was a renowned burn surgeon who seemed, from a distance, superhuman - respected by patients, peers and trainees alike.

These experiences impact me deeply in many ways. I imagine their lives and experiences as surgeons were much like mine. Early in my career, I did not know what to make of it. At the time, I knew I was pretty unhappy, and I started getting a sense that I would rather get out than feel stuck in a job that could lead to me taking my own life. Now that I have been studying the issue for several years, I am much more knowledgeable on the causative factors.

Seeking Help

Many doctors of all generations and at all points of their career feel they do not have many options. Often the feeling is if we admit to suffering or struggling, WE are the outlier. Simply wanting to talk to someone or seeking help suggests weakness or failure.

According to the article:

“Medical training has long had its culture rooted in ideals of suffering. Not so much for the patients — which is often sadly a given, but for the doctors training inside it. Every generation always looks down on the generation training after it — no one ever had it as hard as them, and thus deserve to suffer just as much, if not more. This dubious school of thought has long been acknowledged as standard practice. To be a good doctor, you must work harder, stay later, know more, and never falter. Weakness in medicine is a failing, and if you admit to struggling, the unspoken opinion (or often spoken) is that you simply couldn’t hack it.”

Surgeons, physicians and trainees voluntarily seeking help is very rare. There is a sense that if we do, there are potentially career-threatening consequences that await us. How does one go on when your lifelong dream is over? Mandatory reporting programs further discourage physicians from seeking help. If you don’t seek help, there is nothing to report.

How can we expect physicians to seek help if the system is set up to fail them? More importantly, how can we help each other?

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What are Potential Positive Steps? 

Let’s look at four potential positive steps we can take to improve the practice environment for physicians.

  1. Stop the shame and stigma. We are all human. Burnout is not a weakness, but rather a symptom of chronic and/or acute injury or abuse. Show compassion to your peers.

  2. Remove mandatory state reporting requirements. A mental health history should not disqualify anyone. Treated mental health issues are much much better than untreated and unrecognized. Current impairment may be an issue, but past impairment is not.

  3. Offer mental health services to ALL health professionals and trainees.

  4. WHAT IF all physicians were able to reach for support from psychiatrists, psychologists, coaches and others outside their institution or local environment to receive confidential assistance?

At SurgeonMasters, we are committed to helping physicians struggling with burnout. We offer coaching services, wellness programs, podcasts, webinars, and much more aimed at arming physicians with the tools they need to thrive in their careers.

Contact us today to learn more about our programs and join our mailing list to get regular updates.

Source: https://www.kevinmd.com/blog/2017/01/something-rotten-inside-medical-profession.html