How to Manage Your Boss

This unlikely title has real relevance to practicing doctors today because more than half of us, and counting, are now salaried and there is a lot of knowledgeable opinion available that substantiates the need and means to actively manage our work with our boss. And this information shows the mutual benefit to both boss and employee in meeting collective and individual goals. Harking back to my endless mantra that there is a large gap in docs' training for business and organizational literacy, let's do a quick drive-by for some of the basics.

First of all, what does a “boss” do? He or she sets priorities, makes connections and is responsible for obtaining resources. Also, the boss tries to accomplish the organization's goals while compatibly accomplishing his or her own personal agenda, career-wise. What a boss wants from an employee starts with cooperation, reliability and honesty.

As a physician employee, one has three primary aims: the first and most important is always the welfare of our patients; and the second is that we as employees are obligated to assist the organization in achieving its goals.

But there are potential conflict of interest issues with patient care, which we need to be mindful of. After patient care and helping our organization comes number three: our personal goals for economic and career advancement. This third aim should be prioritized last because we further it along best by helping the first two aims.

To be able to integrate these three sometimes-diverging interests in a compatible way, we have to focus on clear communications with our boss ­— in both directions. To do that effectively, we first need to learn and accommodate his or her work style. It may, or may not, mesh with your own, so it really pays to start with a sober assessment of what your style and preferences really are. Once you have each person's preferred style clearly in mind, don't be shocked to realize you may have to meet your boss more than halfway. But don't worry, your effort will be noticed and appreciated.

It is prudent to function effectively within an organization to realize that all information given to you should not necessarily be taken at face value. As often happens with presented information — as in with patient visits — there is always a good reason provided and, sometimes, there is also the real reason for the information given to you by your employer. Whether or not this difference is intentional, it is your job, as both a doctor and as an employee, to parse those two reasons apart, if there is a difference to be found.

A key fact of employment, especially for doctors habituated to be their own boss, is that there may be some latent frustration and even anger as an employee, which has to be recognized and managed by the employee. Resentment can arise from many directions: conflicting goals, poor communication, unequal treatment, withheld recognition, clash of styles and/or personalities and so on. If these feelings are not recognized and promptly resolved, the result can be resentment and/or withdrawal leading to not doing your best.

And if your boss senses negative feelings on your part, trust will be lost, which may prove difficult to ever be regained. That well may be poisoned permanently and you can believe that it happens every day somewhere. If unresolved conflicts are not nipped in the bud corrosion will occur.

And do remember that your boss is human and has neither ESP or magical powers, so keep open communication and realistic expectations for what your boss will, or even can, do. In that regard be mindful that your boss never wants to hear you say “It’s not my fault,” or “It’s not my job,” or other evasions of adult responsibility. Whining — for that's what it is — never works. If you are a parent, you know what I mean.

I was watching the Masters Golf Tournament the other day and noticed that winning types tend to manage their emotions and stay on an even keel while performing at a high level, even under pressure. This is true in golf, in life, in medicine and in employment.

The good news is that as a trained doctor, you have a leg up as an employee if you can use the same kind of professional approach to your boss that you have learned to use with your patients. Being observant, thoughtful, and helpful should do it.