Tuesday, May 22, 2007

Physician Practice Ideas - “Busyness” The Bane of Health Care Businesses

"The world is moving so fast these days that the one who says it can't be done is generally interrupted by someone doing it."

Harry Emerson Fosdick, 1878-1969

"It is not enough to be busy; so are the ants. The question is: what are we busy about?"

Henry David Thoreau, 1817-1862

Back-to-back meetings all day long are a sure sign of organizational backwardness and of failure to know one’s time, not of an individual’s importance. That’s the message I convey in this blog. Constant “busyness” leave little time for innovative thinking.

As a “connector,” a word Malcolm Gladwell coined in the Tipping Point (Little Brown, 2000) to describe individuals with wide social circles and broad connections, who seek to make the right things happen, I spend a lot of time on the phone trying to reach influential friends and health leaders.

It’s a frustrating experience.

• First, there’s those long interminable uninterruptible telephone menus, in English and Spanish, directing you to those eight departments you don’t want to reach, then reciting them again if you don’t push the right button.

The purpose of these menus, of course, is to direct traffic without human intervention and to protect the “busy” executive. One trick here is to push “0” before you get too entangled listening to the menu merry- go-round.

• Second, there is the protective bodyguard “associate” asking you to state and defend your reason for calling, your relationship with his/her imminence , and telling you the boss is “busy” now in meetings, on conference calls, or is out of the office and won’t return until he or she is good and ready to answer your call, which may be never.

• Third, there’s the “busyness” excuse. So-and-so is “terribly busy,” Or, Doctor Jones is a an “incredibly busy physician, “ Or, “Mr. Smith is busy, he/she’s in meeting all day, all week, and is booked solid for the rest of the month, “ unable ,presumably, to talk to ordinary mortals outside of the organization. Sometimes I feel like saying, “I’m terrible busy too,” But I hold my tongue.

I understand this is a busy world and busy executives have a lot on their plate and spend a lot of time at meetings.

But I maintain there’s a lot of unnecessary busywork going on out there and one can get so caught up in “touching base” to satisfy office politics and to coordinate the bureaucracy that one forgets the world is made up of people.

Others have said of meetings and phone calls.

• Peter F. Drucker (1909-2005) -- “Another common time waster is meetings. The symptom is an excess of meetings. Meetings are by definition a concession to deficient organization. For one either meets or one works. One cannot do both at the same time. If any executive in an organization than a fairly small part of their time in meeting, it is a sure sign of malorganization.” Drucker also said any organization in which executives or managers spend more than 25% of time in meetings is “dysfunctional.”

• Marshall Zaslove, MD, a physician productivity expert, wrote, ”Most doctors don’t like meetings, because we recognize intuitively that they’re not only an interruption, but usually a waste of our work time. On this point we differ from executives and managers, who love meetings and who will even boast to each other. ‘So-and-so gave me a meeting.’ The difference stems from the fact that as physicians we usually do our work one on one; that’s just the nature of our tasks. In contrast, managers are not rewarded for the work they do as individuals, but for how much work they can get groups of other people to do.”

• Robert C. Townsend, the legendary executive who launched Avis Car Rental’s campaign, “We Try Harder,” and who wrote Up the Organization: How to Stop the Organization from Stifling People and Strangling Profits,” said the best way to humanize the corporation was to have every employee, from executives on down, spend two weeks at a year at reservation desks answering phone calls. On a personal level, while on the road, he would call Avis headquarters, and ask for himself, “Try calling yourself up to see what indignities you have built into your own defense.”

So there, I’ve worked off my frustrations over “busyness.” One person I enjoy calling is Mike Martin, president and CEO of Practice Support Resources, Inc, an independent health care publisher in Independence, Missouri. His firm publishes 500 titles a year for physicians and hospital executives. Mike is always available to personally respond to calls. Mike is a refreshing touch of humanity.


1. Peter F. Drucker, The Effective Executive, Harper & Row, 1966

2. Marshall O. Zaslove, The Successful Physician: A Productivity Handbook for Practitioners , An Aspen Publication, 1998.
3. Robert C, Townsend, Up the Organization, How to Stop the Organization from Stifling People and Strangling Profits,, Mass Market Paperback, Fawcett, 1981.

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