Mar 8, 2021
Jim Adams, MD is direct,
transparent, and unapologetic in his ‘tough love’ management
strategy. In this episode, Jim breaks down: how setting
expectations early helps to manage complaints later, managing those
who degrade social capital, redirecting conflict to mutual benefit,
and how understanding what motivates others’ behavior keeps you
from taking things personally.
Jim Adams, MD is professor and chair of the Department
of Emergency Medicine at Northwestern University Feinberg School of
Medicine. He is also the senior vice president and chief medical
officer at Northwestern Medicine.
This episode is in support of World Bicycle Relief. World
Bicycle Relief delivers specially designed, locally assembled,
rugged bicycles for people in need. They’ve developed an efficient,
innovative, and scalable model to empower students, health workers,
and entrepreneurs in rural developing regions with life-changing
Zen and the art of scheduling
coaches his chief residents on making the work schedule. He has
some unique ideas and approaches that are well thought out and have
years of field testing.
recommends that they lay out the ground rules and expectations in
advance (ie. how many days off will be honored), arguing that this
is an enormously important part of management (and of
also makes sure everyone understands that life’s not fair (and
maybe your schedule won’t seem fair as well).
Why you might not want to be a
making the schedule for the attendings, Adams makes sure everyone
understands that he’s going to give the extra bad decisions (for
example, fewer weekend days off) to the person who’s most likely to
complainers are going to complain no matter what. I might as well
give you something to complain about.”
can extinguish those behaviors (and the tendency to complain) by
not rewarding them.
can't reward bad behavior. Otherwise everybody's going to behave
badly. That's tactical management rules.”
The benefit of assuming people
are unreasonable and crazy [08:10];
A strategy for handling people
who degrade social capital [10:30];
You’re either building social capital or degrading it.
People who send nasty emails, are the target of complaints, or talk
negatively in the ED are not building culture or camaraderie.
They’re degrading social capital.
charges those people at an hourly rate for the time it took him to
handle the complaint. Then he distributes the money back to the
people who never complain.
people are creating problems, we charge for the cleanup of the
problems because that takes time away from us building and
advancing the department”.
enforcing this a decade ago, the department rarely gets complaints
and morale has improved significantly.
starts with extinguishing the negative behaviors and rewarding the
heck out of good behavior.”
Blend and redirect, a technique
for negotiation and collaboration that’ll make you much happier
than combat [14:00];
confronted with a conflict, instead of fighting and butting heads
against the other person, blend your ideas and put them on the same
frequency. When you're on the same frequency, you redirect in a way
that's in everyone's interest.
can be right or you can be happy. Choose a path that is not going
to cultivate resistance. Try to solve the problem together, because
combat's not going to make you happy.”
This idea: “People are not
against you. They're just for themselves.” [16:15];
you realize that people are just asserting something for
themselves, then you don't take it personally. You don't get angry,
feel belittled, or offended.
you don't act offensively or angrily, you can get to better
“Nobody's against you, they’re for you. Everybody's on
your team, they just don't know it yet. You can get them
Shownotes by Melissa Orman, MD