Archive for June, 2008

Life 101: Elevator Etiquette

Monday, June 16th, 2008

With all of the emphasis on reading, writing and arithmetic in our educational system it leaves little time for courses that could also be beneficial to our society.  They would fit under the broad heading of “Life 101”.  These would be a series of courses that teach all that stuff that can make everyday life run much smoother.  For example, how about a short course on “Elevator Etiquette”.  We can start the course by having everyone memorize ten simple rules. 

Rule #1: Pressing the up or down button multiple times does not make the elevator move any faster.  The corollary to this rule is that pressing the button harder (or punching/kicking it) also does not make the elevator move any faster.

Rule #2: While waiting for the elevator do not stand in front of the door.  You can’t get in until the current occupants of the elevator make room for you and they can’t do that unless you get your big butt out of the way and make room for them to exit.

Rule #3: Do not, repeat do not let children under the age of ten press the floor button.  It’s like eating potato chips; they will not be satisfied with just one.  They just can’t resist the urge to press every floor button.

Rule #4: The “close door” button: A) is broken and will never be repaired. B) was never hooked up and was only installed to make you feel like you are doing something by pressing it repeatedly. C) has a delay built into it and the doors will close when the time delay has elapsed. D) once worked but was disconnected because of too many complaints about people closing the doors too quickly. E) All of the above.  (Correct answer “E”)

Rule #5: Under no circumstances is anyone allowed to pass gas.  This is especially true for those who are about to disembark.  That’s just rude.

Rule #6: Unless you have a health problem or are moving things (furniture, packages, baby carriage, etc.) the rule for using the stairs is “one up, two down”.

Rule #7: The elderly, disabled, people carrying stuff (babies, packages, food) and those with nothing better to do move slower and must be allowed adequate time to board the elevator.  (Yea I know it seems to take forever but just remember, some day it may be you who needs that time.)

Rule #8: Regarding speaking on cell phones in public places, don’t say anything you wouldn’t want printed in tomorrow’s paper (or blog).  And BTW, “CAN YOU HEAR ME KNOW!”, speaking louder does not improve your cell phone reception.

Rule #9: As a general rule the personal body space  distance in social situations is about 18 inches (OK, OK it varies by culture but for most people in the US it’s still about 18 inches.).  The personal body space distance in intimate situations is less than 18 inches.  Just because we break from convention to allow more people to fit in the elevator doesn’t mean we’ve become more intimate.

Rule #10: Eighty-five percent of buildings with at least 13 floors do not have a named “13th floor“.  It’s considered unlucky or superstitious to have one.  That’s just the way it is so the next time you are on an elevator and some smart-ass gets on and asks you to press floor thirteen just tell him to press it himself if he is feeling lucky.  (BTW for all of you who live or work on the 14th floor in building that don’t have a “13th floor” it is really the 13th floor.  Sorry to ruin your day.)

Well that is it for today.  If you can think of any more add them to the list.  Who knows, someday we may have an “Elevator Etiquette” course manual.

Is the MD, MBA Worth It? (Part 2)

Friday, June 6th, 2008

This is a continuation of my previous post on this subject.  I am at the halfway point in pursuit of an MBA degree and have found myself reflecting on this question once again.  The first time I did this was before I applied to the Executive MBA program at ASU.  This time it is after a year of study and a great deal of “If I knew then what I know now would I still make the same decision” thinking.  The short answer is yes but I’ve made some observations over the last year that may be of interest to any physician considering the same decision.  (For the initial three observations click on the previous post link above.)

4) Nobody will value your investment in an MBA degree more than you.  This may seem obvious but it is an extremely important point.  When you invest time during the course of your studies this time commitment will mean someone else will be responsible for covering your practice in your absence.  The people who cover you may be your business partners, employees of the hospital or colleagues who you have asked to assist you while you are away.  At first it will be easy for them to cover but if they are doing it out of the goodness of their heart that arrangement will grow thin over time.  At some point in time it will become obvious to them that if they do not feel like they are benefiting from the arrangement the deal will go bad.  While you are away studying they are covering you and despite all their initial support for your endeavors they will come to regret it.  The looser your coverage arrangements the quicker the deal will derail.  If there is some value they will get in return for your endeavors the greater the likelihood they will support you.  If they perceive no value in return, while covering for you, the greater the likelihood they will sabotage your efforts.  That is painfully obvious to me now but I was completely unaware of this a year ago.

5) An MBA degree, or any other investment in human capital for that matter, expands and alters your view of the world.  What you do with that new view is up to you so ultimately the answer to the question of whether it is worth it to pursue such a degree will always be in the hands of its possessor.  An MBA degree provides a view of the world in which you live and work that is different than the one you previously held.  It also provides specific tools you can use to re-evaluate how you approach your work.  It’s similar to what I experienced the first time I used the Internet.  I thought “That is really cool”.  Little did I know at the time how indispensable it would become in my life.  Anytime we can view the world differently and that knowledge can add a significant benefit to our lives it is worth it.

6) The immediate non-financial return on investment (ROI) from an Executive MBA program is the contact and connections you make with your classmates.  They come from a wide variety of industries and cultures but in many ways they are like minds.  They have the same love of learning and need for intellectual stimulation as you do.  They wish to acquire a new skill set and view of the world which will further open their field of opportunities.  Regarding the long-term ROI I liked the response Hugh O’Neill, the Associate Dean of the Executive MBA program at UNC, gave.  MBA programs attract “climbers”, “shifters” and “launchers”.  The climbers are already established in a company and wish to move up the corporate ladder.  The shifters are those who wish to change their career or move to a different type of job in the same industry in which they currently practice.  The launchers are the entrepreneurs who wish to start their own business.  Each of these types of people wishes to enhance the quality of their life and for that reason alone, for them, the pursuit of an MBA is worth it.  Follow this link if you want to see the relationship between an MBA and the financial ROI regarding salary.  As a general rule it increases but physicians should note well it can also decrease if they are in the shifter category.

In Pursuit of Intellectual Capital: Is the MD, MBA Worth It?

Thursday, June 5th, 2008

Less than a year ago I entered the Executive MBA program at Arizona State University to scratch an intellectual itch that I’ve had for the last decade.  Throughout my career as a physician it became increasingly obvious to me that the business of health-care plays a dominant role in what we as physicians can do for our patients.  It permeates everything we do in medicine.  It determines what tests can get ordered, what medicines can be prescribed and what treatments can be provided.  Instead of fighting the beast I decided it was better to learn from it.  It begins with learning the language of business and immersing oneself in the culture.  It is like the Grateful Dead once sang, “What a long strange trip it’s been.”

Since I have another year to go before I complete the program and actually receive an MBA degree it is a bit premature for me to make any grand conclusions to the question I proposed.  What I can do is offer a few observations I’ve made so far.  In future posts I plan to add to the list.

1) Physicians, particularly older docs (myself included) tend to prefer to either work alone or work within a pyramidal type of team structure.  I know that may sound harsh but it’s true for many of us.  In our program we are assigned to groups and much of the work done for class is the result of teamwork.  When I first met with my team I explained to them that they need to understand that as a Trauma Surgeon my idea of teamwork is when they do what I tell them to do.  It was meant as a joke but the one or two nervous laughs it got proved it wasn’t all that funny.  It is easy to forget that there are different types of teams with different approaches to problem solving.  A pyramidal form may work well with a severely injured patient in the trauma room but can be a disaster when leadership must be a shared activity.  I learned a great deal from my team members and classmates this past year and so far that has made it worth it.

2) Physicians tend to be suspicious of physicians who study business.  I was warned about this prior to starting the program but considered it paranoid thinking on the part of the person who said it.  It’s amazing but if a physician develops their human capital through lessons on golf, skiing, painting, gardening, woodworking, wine-tasting, a new language, statistical methods or any other form to improve their mental or physical capacity they are rewarded by their colleagues with smiles and approval.  Mention an MBA degree and all you will see is raised eyebrows.  Since beginning the program I’ve been told that I have “gone over to the dark side”, “taken up with the enemy” and begun to “practice in the dark arts.”  It has been a disappointment to see so many who value education so highly to so easily dismiss the value of a business education.  It reminds me of Plato’s Allegory of the Cave.  Once you leave the cave there may be no turning back.

3) An MBA is to the business world as an MD is to the medical world.  It’s a starting point.  It lays the groundwork for understanding how that world functions.  It is not meant to replace the real world knowledge and experience gained through years of training under the guidance of senior management or attending physicians.  The degree is a way to get your ticket punched and it is the punched ticket which allows you to access the next level where the practical education occurs.