Episoe 41, Season 2. Chuck and Chris take a deep dive on leadership around The Great Resignation. Employees across the USA are reconsidering their job, their careers, and their lives and are resigning in unprecedented numbers. We use 2 HBR articles to frame our discussion. We hope that listeners will engage and share their experiences.
References mentioned:
1) The 3 Phases of Making a Major Life Change, Herminia Ibarra. HBR Augst 6, 2021
2) How to Help Your Team Get Out of a Lull, Merete Wedell- Wedellsborg Oct 12, 2021
We plan a newsletter launch soon. Subscribe here: https://wustl.us6.list-manage.com/subscribe?u=c6fe13919f69cbe248767c4e8&id=10e0c1dd85
Survey Link:
Help Chuck and Chris understand better what you like and what we can improve. And be entered for drawing to win a mug! https://bit.ly/349aUvz
As always, thanks to @iampetermartin for the amazing introduction and conclusion music.
theupperhandpodcast.wustl.edu. And thanks to Eric Zhu, aspiring physician and podcast intern.
Episoe 41, Season 2. Chuck and Chris take a deep dive on leadership around The Great Resignation. Employees across the USA are reconsidering their job, their careers, and their lives and are resigning in unprecedented numbers. We use 2 HBR articles to frame our discussion. We hope that listeners will engage and share their experiences.
References mentioned:
1) The 3 Phases of Making a Major Life Change, Herminia Ibarra. HBR Augst 6, 2021
2) How to Help Your Team Get Out of a Lull, Merete Wedell- Wedellsborg Oct 12, 2021
We plan a newsletter launch soon. Subscribe here: https://wustl.us6.list-manage.com/subscribe?u=c6fe13919f69cbe248767c4e8&id=10e0c1dd85
Survey Link:
Help Chuck and Chris understand better what you like and what we can improve. And be entered for drawing to win a mug! https://bit.ly/349aUvz
As always, thanks to @iampetermartin for the amazing introduction and conclusion music.
theupperhandpodcast.wustl.edu. And thanks to Eric Zhu, aspiring physician and podcast intern.
Welcome to the upper hand, where Chuck and Chris talk hand surgery.
Chris Dy:We are two hand surgeons at Washington University in St. Louis here to talk about all aspects of hand surgery from technical to personal.
Charles Goldfarb:Thank you for subscribing, wherever you get your podcasts.
Chris Dy:And be sure to leave a review that helps us get the word out.
Charles Goldfarb:Oh, Hey, Chris.
Chris Dy:Hey, Chuck, how are you?
Charles Goldfarb:I'm really well, how are you?
Chris Dy:I am fine. You know, I was going downstairs to start recording this with you. And then my son has noticed that whenever I have to record a podcast in the evenings, because my wife is alone with the kids kind of getting them ready for bed. He's like, wait, you have a podcast? Does that mean I can play more? Because he knows that it's no longer man on man, man to man. It's my wife's playing zone at that point. So he loves the pod.
Charles Goldfarb:I love it. I love it, figuring it out early.
Chris Dy:Yeah, well, you know, I've had bath and bedtime duty the last couple of nights, and it has not been a ball so. Thank you for the escape.
Charles Goldfarb:Now do does the family have a schedule for these things? Or is it kind of-
Chris Dy:Oh yeah, we try to be as scheduled as we can. You know, we were scheduled from the get go with the sleep training and everything. Because my wife, also a physician, as you know, we really needed our sleep in order to take care of patients. And I was actually talking to a friend of mine who he's an ophthalmologist in New York City, and he and his wife, another dual physician house, they have a seven month old. And he's like, how do you how do you do it? I'm like, Well, the thing is, on the nights were when we were sleep training, both of the each of the kids, if it was a surgery day, the next day I was allowed to sleep. So I loved my pre op days because I got the sleep. Which is funny because patients actually you know, sometimes they'll come up to you, you go and say hi to them in holding and you're like, you ask them how they're doing. And they said more importantly, how are you? and some will say did you sleep? I was like actually Yes. Thank you.
Charles Goldfarb:Yeah, that that question. First thing in the morning is so important. Because let's be honest, I mean, thankfully, I think both of us are pretty high energy. And when we get there in the morning, we show it but there's days where whatever happened the night before and you're rolling, you're rolling in and you're kind of tired, but you can't let that show.
Chris Dy:Yeah, exactly. But I think you know, you're up pretty early. I'm up pretty early, I've made a routine of doing the exercise thing. And, you know, that's so you know, starting going to see a patient and holding all this feels like, you know, the end of the first quarter.
Charles Goldfarb:It's true, it's very, very true. I love it.
Chris Dy:So how are you what's going on in your world?
Charles Goldfarb:Well, I think that what's going on in my world is one of the is the topic, we're going to tackle today. And we don't want to jump into it quite yet. But what's going on in my world is managing a department that has more than 500 people of varying categories, but really struggling with employment and keeping people happy keeping people engaged. There is a constant. We've never seen turnover like this before. It's really super interesting. And we are really struggling to figure out how to get to the bottom of this if it's possible at all.
Chris Dy:Well, I mean, the enterprise is so much bigger. I mean, as a resident, you feel like you only see the faculty and the other trainees and you kind of get a sense of the staff, but you have no idea how big of an enterprise that this department is. I mean, just to give people a sense, I mean, how big is our department in terms of surgeon and then non surgeon physicians and then APPs?
Charles Goldfarb:Well, we continue to grow. We have more than 50 surgeons, about 25 non operative physicians including physical medicine rehabilitation doctors and sports medicine doctors. We have about 15 APPS and as I mentioned earlier department have more than 500 people so we are a big complex organization sitting in the faculty practice plan of Washington University and while we're a great place to work there are just challenges with an organization this large as people are reassessing who they are and who they want to be and what work means in their lives. So it's it's really interesting as we'll get into, but I'll turn it back over to you for a bit.
Chris Dy:Oh, man. Well, you know, one of the things that keeps us excited about coming to work is the podcast and we do love our podcast community. And I wanted to read a fantastic five star review from Chelsea Crowder, so this was left earlier this month. Thank you Chelsea. And it says, as a hand therapist, I love hearing the hand surgery perspective from Chris and Chuck. So often I am left guessing how surgeons make their decisions. Me too. And it has elevated my clinical practice by hearing their well informed perspectives. I'm excited To hear more episodes where guests hand therapist chime in. Well, Chelsea, I think you got your wish with the last week's episode where we, we were up there on the stage with Becky Neiduski from Elon University, and formerly from Miliken Hand Therapy Center. And so hopefully you liked hearing Becky's perspective and for sure we will have more therapists on.
Charles Goldfarb:Oh, absolutely. I think you and I have super fun with that. Because it, it's always educational for us. And it's just a fun engagement. It's it's, you know, we've talked about this before, but to some degree, we trust our colleagues so much that we don't always get into the nitty gritty with them on a daily basis. So to hear their thought processes with difficult problems is, is really always good for us to hear as well.
Chris Dy:Yeah, me, as we learned at the ASHT session, Chuck, this does sends the eval and treat prescription. Whereas I actually sit and think and fill out my prescriptions thoughtfully. But I guess when you've reached a level of running the department and winning the Weiland Medal, you can just say eval and treat. I mean, it's nice.
Charles Goldfarb:Now we just, the therapist and I have kind of one train of thought, and so they know what I'm thinking, which is the beauty of our relationship. It really works for us. You got to get that get to that level.
Chris Dy:Kind of like an MJ and Scotty in their heyday kind of thing. No word spoken. Just looks, looks exchanged.
Charles Goldfarb:Exactly. I have to say I'm super excited to engage back on TV. That's been awesome. You know, tip off was Tuesday night, and yeah, I missed it.
Chris Dy:So who's taking it all the way this year?
Charles Goldfarb:I mean, everyone's picking the Nets like literally everyone's picking the nets. First, I don't know what's gonna happen with Kyrie and I do think Kevin Durant's remarkable. I'm going to go with a dark horse. I'm going to Golden State.
Chris Dy:Oh, that is a dark horse. I've heard of that theme before it kept.
Charles Goldfarb:If Klay comes back where he could come back, they have a real shot. If he doesn't get back to his previous level before the two injuries then that'll be look like a really bad pick.
Chris Dy:Where he had a second I thought he had the ACL, right?
Charles Goldfarb:Yeah, the ACL and then was recovering from the ACL and he had an Achilles.
Chris Dy:Oh, yeah. So he's not coming. I mean, come on.
Charles Goldfarb:Well, KD came back for I mean, KD, I never would have predicted KD would come back after the Achilles injury like he has. So who knows? Who knows?
Chris Dy:Ipsilateral Achilles and ACL?
Charles Goldfarb:I don't know. I don't know.
Chris Dy:That's got to be some kind of case. I'm sure there's some resident out there. Looking at how to study fantasy basketball stats to evaluate the return to play after a combination ACL and Achilles. It's either an orthopedic resident or some Moneyball GM out there.
Charles Goldfarb:Well, we you know, we did the shared podcast, as you recall with the fantasy doctors, which I thought was pretty fun. And my God, I just love watching how my kids interact with sports. It's all about fantasy. It is all about it.
Chris Dy:Well shout out to Omar Patel for the fantasy Doc's podcast actually ran into him at the ASSH meeting. And he was telling me that we got a lot of hits. We got a lot of clicks, we probably made him a lot of money. Happy, Happy somebody is making money off of the podcast.
Charles Goldfarb:Yeah, I wish I could say the opposite was true.
Chris Dy:Anyway, we do love our listener community. So thank you, Chelsea, for that awesome review. Send us an email, Handpodcast@gmail.com. If you want to sign up for the, for the newsletter that's coming, and you can also find a link in the show notes. Again, we're gonna do a mailbag episode coming up very soon. So get those questions in. And Chuck will answer all of them. And I will ask all.
Charles Goldfarb:Yeah, I want to share briefly a case which was not in and of itself a crazy case, but the approach was, for me something very different. I'd love your thoughts. So youngest patient, which you know, younger than you. It's all relative. MVC and a scaphoid fracture. And the scaphoid fracture was a kind of little bit distal but waist. And, you know, I looked at the X rays and it was displaced. No suggestion of another injury to the corpus. And, you know, the ER ordered a CT scan, which I did not think was necessary, but it confirmed it was significant displays needed to be fixed. And I so prefer going dorsally, and we've talked about this, this simplicity of that mini open approach is great, but we have a displaced fracture, it's a little trickier, so it wasn't reducible close, I was not going to do a scope to help with the reduction I think that would have been a huge challenge. And so I went dorsal, and I carefully took care of the blood supply. The dorsal Ridge blood supply to the scaphoid and treated almost like I would treat a trans scaphoid perilunate and it was really satisfying. I was a little nervous, I just don't go dorsal for displaced fractures, very often But I was really happy I did. So I don't know if you'd had experience doing that or whether you would automatically have gone volar?
Chris Dy:I don't think I would automatically go volar The question is so the path I thought you were leading me on was that it was a high energy injury with comminution and making a really hard reduction read, which I have seen and that is not fun at all. When you talk about treating like a perilunate, did you do the wagon wheel of pins around to secure the carpet? Or do you just fix just fix the scaphoid?
Charles Goldfarb:Yeah, I made the point to the trainee that we have to rule out an LT injury, because there's no bony injury but only had to fix the scaphoid. But it was that perilunate, transcaphoid perilunate type fracture, there was some comminution. And those are not always easy to get the reduction. I think the reduction came together reasonably well. But really a huge amount of focus on preserving the blood supply.
Chris Dy:So have you ever seen it where that blood supply is just because of the energy of the injury has just avulsed it off?
Charles Goldfarb:In perilunates I have when everything kind of goes to hell, but not in this case, thankfully.
Chris Dy:Now in terms of getting your reduction read, in some of the more common use cases, I've really relied on that kind of distal scaphoid, scaphocapitate relationship in order to get the reduction and then how do you how do you gauge your reduction of the proximal aspect of the scaphoid I mean theoretically it is still attached to the lunate, right?
Charles Goldfarb:Yeah, so for this one we did use the capitate to help us with our reduction which was super helpful we immediately put in a derotation wire a 4-5 free wire which really seemed to help us and then we could really check our reduction both clinically radiographically and then it allows us to flex the risk to get that antegrade k wire in so once once you know the bloodspot is protected we got the derotation our derotation wire in the case was done which was really satisfying and I guess I walked away thinking I don't know why I was nervous about it in advance and maybe some readers will will tell me or some listeners will tell us tell me that I shouldn't have been nervous but I felt good afterwards that we had done the right thing for this patient and simplified the surgery and simplify the recovery.
Chris Dy:So I will go classic Chuck style do things I love it so I think that this is a point for the trainees at least the surgical trainees that this is where that Semi pronated view to the profile of the scaphocapitate joint is super useful so don't get locked into just getting your standard PA and lateral views that semipronated view is useful. Maybe very basic in terms of you know, some of them are more advanced surgeons that are listening. And the second thing you mentioned about assuming that the LT could be compromised. Did you go actually look at the LT or do you just pin across it or did you look at it radiographically?
Charles Goldfarb:Yeah, fair enough. I did not go look at it directly. But I did two things I clinically-
Chris Dy:Of course you did two things
Charles Goldfarb:I clinically shucked it, and under live fluoro. And I looked very carefully to glue those arcs and I feel pretty comfortable that those two will tell the story.
Chris Dy:So you you spent your or time recently putting scaphoids back together, and I just took one out earlier this week, because it was weird. I had a day where I had an LRTI as part of your study. And and then I also had a scaphoid excision four corner fusion. It was I was hoping it would just be a PRC, but the capitate cartilage was absolutely gone. And I did those two cases in sequence. And I looked over at the trainee who is going to be going into spine. I was like, Well, I guess we're just taking out bones today. Sorry, not as much an elegant surgery today.
Charles Goldfarb:Sometimes it's what you got to do. All right, I want to share some stats. You ready to pivot?
Chris Dy:Yeah, let's do it.
Charles Goldfarb:All right, I want to share some stats, which to me struck me as just really remarkable. In the month of September, about 2.9 million Americans left the workplace just stopped working not because they had another job, just decided they did not want to work anymore. I mean, that's stunning. And of those 500,000 were in health care. Not to mention we've lost some, unfortunately, I heard you know the number I heard that across the world. There's been 125,000 healthcare deaths. But forgetting about that piece of the puzzle for missing health care workers in America 500,000 in the month of September left their healthcare occupations. So that's one just remarkable stat to me. And the other is right now, people consider the job market tight, which is interesting. There are 8 million unemployed Americans and by I guess, technically that means they are looking for work. So not Americans who have left the workforce, but there's 8 million which is a you know, very high number. And there are essentially 10 million jobs and so we're competing to Find the best people. Healthcare, obviously what we know best, but it's just a really super interesting time unprecedented in every way, and we're, you and I are feeling this every single day, and creating the right culture, and really engaging everyone in what we do every day is just so important.
Chris Dy:I think the stats that you shared are staggering. And, you know, I think it affects people differently based on their roles. So, you know, I think our fellows last year, were terrified about the job market, just because you know, that's it's still very hard to find a job as a physician coming out of training right now, because of I think now it's a little better, but the financial uncertainty that the pandemic had made it really hard for practices and departments to start investing in people. And eventually things came around and ended up many of you know, people found jobs. But so it's different, if you're a physician that's looking for a job. Now, I don't know how it's affected our therapy colleagues in particular, but what we feel on a day to day basis is, you know, the team in the support that we work with. So you know, it's I feel like that our teams are turning over. So many of the our nurses, I would imagine the floor nurses in the ICU nurses are also changing. And because of this competition for resources, you have this entire group of nurses that are working as traveling nurses, because they can make a ton of money. And in some places, you know, get hazard pay, if they choose to do so. And so that's leading to this incredible turn of a system where you have the dismantling of the teams and the people usually work with, which can have certainly implications for the flow and the efficiency of the OR, and I'll let you know, talk a little bit about what it does in the outpatient clinic support staff.
Charles Goldfarb:Well, yeah, so one great example, I agree with everything you just said, One great example is we have an injury clinic. And we've had an injury clinic for I don't know, five, six years. And traditionally, the hours were from 12 to eight. And then when that pandemic had, we cut that back to 7pm, just because there wasn't a need, and then 6pm, because there wasn't a need. And now there absolutely is a need to open our hours back up. But we cannot staff our injury clinic. So yes, we can generally staff our clinics pretty well. But anything that's outside the ordinary is just less appealing to potential health care workers. And so we're having trouble filling the void. And so you can throw money at a problem. And there's all kinds of problems with all kinds of challenges with just throwing money to solve a problem. But that's part of the solution. Honestly.
Chris Dy:I think that's the short term solution until we figure out kind of the cultural moment that we're in. And actually brings us to the article that you suggested for today's podcast. So we're back in our leadership series right now. And so we picked a couple of different articles from Harvard Business Review, like we usually do. And the one you suggested is a great one from Herminia Ibarra. And this is published early in August of this year reprints is h06hXJ. And that'll be in the show notes. But it's called the three phases of making a major life change. I thought this was a really interesting one, I mean, it really kicked off by, you know, talking about all of the different self reflection that we've been going through during the pandemic, and really trying to assess, you know, what brings you purpose and fulfillment. And I think that was one of the biggest things, at least personally, for me that I felt early on in the crushes of the pandemic. And then the other thing that I thought was really interesting to go through during the pandemic was how, you know how to assess value and how you feel valued by your organization. Now you're clearly on you know, you're, you're living this too, but you're on the leadership side of me, how did you reflect on things during the pandemic?
Charles Goldfarb:You're part of this article, let me just let me just share one quote, which I really I've thought a lot about and it's it's basically says, We rarely think our way into a new way of acting. Rather, we act our way into a new into new ways of thinking and being, I really like that. And so part of the gist of this article is getting to the whole reconsideration of our values. And, and the point is that not that I'm not that I'm encouraging anyone to take a break. But if you took a break, just like a lot of our employees took a break during the height of that pandemic, then you had time to get out of the daily grind and to really self reflect. And during that time, people took up new hobbies and did new things. And that I think, is contributing to people saying, oh, why would I want to go back and do exactly what I did before it was really tough and not all that fulfilling. And I wasn't paid enough. And so you know, there's different ways to take this article. I'm taking this article and applying it to the problems we're seeing. You could also flip it around and take it to a different direction, where we're talking about what opportunities how do you create new opportunities for yourself, and I think doing doing that In the daily grind is really hard to do.
Chris Dy:Yeah, I think your point is interesting. And let's be clear, though, you know, you talked about some of our staff taking a break, that was not an elective break. That was a, that was a mandatory break, you know, for a number of reasons. And I, there's a quote that I also thought was really interesting that touches upon what you said, here, it says, enough has happened to make us aware of what we no longer want. But the problem is more feasible alternatives have yet to materialize. And I feel like that is exactly where so many of us are right now is that we're like, wow, like having time to reflect and you know, get out of the, you know, the day to day makes me realize, here's what's important to me, here's what I like about my job, here's what I don't like about my job. But then you're like, Well, what do I What do I do, and some are in the types of positions where you can take some time and really, you know, look for better alternatives. But the danger is really, as they stay in here getting sucked back into your former job and your former way of working. And, you know, they they go on to break down you know there, this article into three sections. And one of them is this concept of the benefit of separation. So I talked about this habit discontinuity, which was a very fancy term to me. But they talked about how we all become more malleable when we're separated from the people and places that trigger old habits. Now I was it's kind of toxic touches upon what she talked about, about how all of a sudden you're no longer in the day to day for exhausted clinical environments. And wow, you know, maybe I don't need to live my life like this.
Charles Goldfarb:Yeah, that's exactly right. That's exactly right. And their, their argument is that change, whether you're looking for change, or whether it's thrust upon you, you know, starts with separation, getting outside your normal self. And the follow up quote is that recent research has shown how much our work networks are prone to the quote, narcissistic and lazy bias. The idea is that we are drawn spontaneously to, and main, maintain contact with people who are similar to us. We're not we're narcissistic, and we get to know and like people whose proximity makes it easy for us to get to know and like them are lazy. And so that's why you got to get out of the ordinary, out of your routine, to have a chance to make a change. And just circling back to what you said before, you know, I think what what sort of as an employer we're hoping for is that people, certain people have, even if they don't know what's next for them, they've still quit their jobs. And so they are looking for what is next? And ultimately, hopefully enough, realize that either Yeah, that job was good enough, or others might say, Yeah, I want to get into healthcare, because what a great field to be in, but that we're waiting for all this to play out. And we don't know how long it's gonna take to play out.
Chris Dy:Yeah, I think it doesn't help that we're still in some ways in the throes of the pandemic, certainly not at the peaks. But it's still obviously top of mind for everybody, and it's going to continue to be an issue. I'm wondering how many of our listeners realize that Chuck and I probably have fallen victim to this narcissistic and lazy bias by continuing to do a podcast throughout the entirety of the pandemic.
Charles Goldfarb:We are lazy.
Chris Dy:We started in January of 2020. And here we are, you know, 20 months later still doing it.
Charles Goldfarb:Talking about what we know, or maybe we hope we know, talking about what we can talk about.
Chris Dy:Well, you know, they go on to talk about how maybe the pandemic will encourage people to be a little bit more selective in how they spend their time and with whom they spend their time. And I'm wondering how much of that is not only in people's personal lives, but also in the workplace? I mean, maybe we have a little more liberty to say, you know, what, I that doesn't really do it for me, I don't want to take care of that kind of condition or, you know, I don't want to go to this clinic or whatever. I don't know, has that materialized then as you've looked at things from a leadership perspective,
Charles Goldfarb:I think it's more just about do I want to do this health care thing and I you know, let's be honest, it's, it's we're struggling most with the lowest paid employees. Because, you know, right now, there's such a big push about the minimum wage and and, you know, I can comfortably say that the, you know, our workers are all paid above minimum wage, but some of them not that much above minimum wage, which is shocking. We trust, you know, we're going to give trust to our health care workers, to take care of patients and to interact with patients. This not a minimum wage job. But embarrassingly, that's the standard for many of these positions. So I really do think it's, it's about valuing people correctly for the work they do. And we in healthcare, as well as every other industry have to do better.
Chris Dy:Yeah, and I think that, you know, to be honest, I think there were moments, clearly the physician and the surgeon, you know, income level and comfort level is very different. But even beyond kind of the dollars and cents of it, I think many of us throughout the pandemic, we're just kind of saying, well, do I feel valued in what I bring to the table? So obviously, comes down to the patients that we see and the surgeries that we do for many of us, but also the other things that we do, are these things, you know, valued, because a lot of other things that we do, and you know this, well, we're doing one right now, they're not compensated. So what are the you know, it does that bring enough joy and fulfillment to my life to continue doing it. And I think that lens of the pandemic has been helpful, and I personally have, you know, reprioritize, some of the, you know, quote, extracurricular activities based on what brings me happiness.
Charles Goldfarb:That's really well said, and that is absolutely right. And you and I've talked about what the podcast should look like, should we continue to do this. And if it stops bringing both of us satisfaction and joy, then we stop it. And thankfully, we're both enjoying it and getting getting a lot out of it. And so we're going to continue it. But I think, you know, we need to continue to emphasize that about each of the activities we choose. And you know, ultimately, I think you and I agree that I don't consider my work, a real job in the sense of me, certainly, it's a job I get paid. I like, but I like it, and I impact people and, and so we're really lucky with our day job. I guess the question becomes, what do we do outside of the day job?
Chris Dy:So why don't you bring us to the next point, and I had to look this word up, because I'm not as fancy as you liminality. What the heck is that?
Charles Goldfarb:Well, I was ready to pivot to your article. Essentially, it's transitional. So liminal learnings. And so essentially, the point of this, and we'll keep it brief, is that if there is a transition time, use that period of time to experiment, and I think there was a transitional time for many people during the height of the pandemic, do new and different things, deal with new and different people, and learn about ourselves. And this really kind of figure out what you like, and what maybe you don't get into our last little conversation.
Chris Dy:So what are what's something that you picked up in the liminal period that you think is going to stick I mean, I'll go first, I mean, because I can see that you're racking your brain, it's not the Spanish we clearly know that I realized how much I like to cook. And I think that having that you know, extreme period of time where basically all non essential health care was, was stopped. I got to cook a lot. And I really enjoyed that. And that is carried over because now you know, before you know, my wife, and I would kind of figure out a meal plan, get things going for the week, and it would be pretty rudimentary kind of, you know, quickly slap things on the table. Now a lot more goes into the planning. And I kind of plan out a menu and I do some meal prep, but I think about things that I would want to eat that I want my kids and my wife to eat, and I really enjoy it. And you know, before the pandemic, you know, I'd always knock on my dad saying, oh, he never had hobbies, but then somebody would ask me what my hobbies were. And I said, I don't know. So I'm realizing now that I, my hobby is cooking. To the point where on the way back from a recent road trip, I binge listen to like, three or four hours worth of cooking podcasts. Of course, my family was asleep because I was the one driving on the road trip. But then I was like, Wow, there it is. There's my hobby.
Charles Goldfarb:That is something I you and I do not share that. You know, I don't think I had a liminal period, as I really doubled down on the workload with administrative duties. But I would say that I do feel like I have hobbies outside of work. And I think in the last six months, I've kind of like you been really focused on fitness, take care of myself, which you know, we all need to do both mentally and physically, physically. That's where I've spent my time. Alright, let's close off this article. Move to the next the last section is reintegration a time for new beginnings. And so you know, the the author's share that people who have had this pandemic experience, were hesitant to return to their hectic lives, the businessman who travels all the time, the long hours away from home. And so what's interesting to me about this section, I certainly want to hear your thoughts is that, you know, if if we just jump back into our old routine, then we've accomplished nothing. We have to take advantage of the habit discontinuity. And if we don't do it, then nothing's changed.
Chris Dy:Yeah, I think you know, they make the point about how external shocks rarely produce lasting change. And it's kind of like New Year's resolutions like if you don't jump on it and turn it into a new habit. So you take your habit discontinuity you learn what you learned in your liminal stage. Then you got to make a new habit of the thing that you learned during the liminal stage. And we are totally in that window of opportunity. Because if we do not, you know, change the way we you know, or maintain the change that we looked at the world or how we approached work, it's just not gonna happen. And because enough stuff is back to quote, normal now, at least at work, where it's easy to lose, you know, any intended change. So I think that it's honestly at this point is probably just kind of forcing yourself through if it's something that you really want to change. But honestly, I find that we are in a law right now, in many ways with how we, how our teams feel. And that kind of leads us into the second article.
Charles Goldfarb:I like that segue. So we started the podcast by talking about how our teams are not in continuity anymore, because we're missing key members of the teams. And we're all feeling that in the operating room. But I love this article that you suggested, it's called How to help your team get out of a lull by Merete Wedell-Wedellsborg. And this is from October of 2021. And you want to jump in with this one first?
Chris Dy:Sure. Well, I mean, I think that as we talked about, I mean, we know that the pandemic has, I think a lot of people's change has changed a lot of people's sense of purpose, and perhaps identity. And all of us, not all of us, many of us are piping are we gonna go back to the same kind of person that we were before, you know, working for hours on something, and without maybe a real purpose, I mean, just maybe, in the surgeon world, grinding away in clinic and doing case after case, but not really seeing the forest from the trees. And they make the point about how traditional ways of motivating people, whether that's through productivity incentives, you know, kind of the rah rah speech, etc, aren't going to work in this setting. So how do you approach that from a leadership perspective? Because, as you mentioned, you're in charge of motivating, you know, a substantial number of physicians and, you know, health care providers, and then also staff. So how do you approach that in the current moment?
Charles Goldfarb:Yeah, we there's so many ways, in different tactics we're trying, we want to connect with people on a way that we haven't done in a long time and shame on us, let's be honest, what you know, in the name of efficiencies and sensitivities, you know, we we don't have a golf term in the department anymore. And, and we stopped having a Christmas party, at least the whole department, and communication from leadership to frontline employees, has been limited. And I think we've always done a pretty good job of communicating with physicians, but I think doubling down there, but getting getting to the real point, is engaging with each and every member of the department, having them feel not just feel but really have a role of purpose, and share our department goals, missions, impact on our community, we want to understand what people think about different situations. And of course, leadership ultimately has to act in the best interest of the department, which won't necessarily align with everyone's thoughts and, and personal goals. But is that engagement, which, which we have to accomplish in a way we've never done before?
Chris Dy:Yeah, I think Well, I think realizing that the engagement and the energy and the connection are probably the most important things in the current environment. I mean, because the environment now is different than you know, when the department was established in the mid late 90s. And two, when the department was really hitting its, you know, peak at that point in terms of productivity in the last few decades. It's just different now people, people expect different things out of their employer now than they did before. And I think the pandemic has brought that into a crystal clear focus. I think one thing that.
Charles Goldfarb:No, well I was just gonna say people expect something different than their employer, and they're looking for something different for themselves and their families. Sorry, I didn't mean to interrupt.
Chris Dy:Oh, no, I actually brings me to the the one of the main things I thought was interesting about this article was this concept of a psychological contract. And, you know, they go on to define this as the often unwritten and unspoken. contract is the psychological contract is what makes you feel bound to your team. I've never even considered that. But it makes absolute sense. why somebody would you know, for me, for example, moving from New York, having no ties to St. Louis, coming in joining this department. Before you I come from my fellowship, there was some kind of psychological contract there that I kind of thought I knew what I was signing up for. And what I wanted to be a part of, is this psychological contract, something that you consider at a leadership level, or even Personally?
Charles Goldfarb:I've never named it but I absolutely see it There's people that, you know, have job offers, and especially a place like our institution where departments are independent, you know, functional units. And we in orthopedics have been really lucky to have different manager type personalities that are really good at what they do. And I've often wondered why they're not hired to other departments. And of course, some of them are. But it is a psychological contract with the work they are doing and the people with whom they work on a daily basis. And I absolutely feel that's why the interactions, the interactions that you Chris have with your team creates that contract. The interactions that I have with management teams for different areas, the department hopefully creates that. But I think it does get back to the team. It's about really, everyone's a part of the team. And I think, you know, we the surgeons may leave the team, but our role is, is evolving and is perhaps considered differently than it was 20 years ago.
Chris Dy:Well, so now that we can put our finger on this thing that we all kind of was in the air, but we never could quite point out the psychological contract. How do you adjust that contract? And both the dynamic of that contract in the setting of people, we're all exploring our identities now and trying to figure out who the Who the heck we want to be. And you know, what matters to us? I mean, how do you approach beating people in the middle of something, they're still trying to figure out?
Charles Goldfarb:Well, and not trying to denigrate other industries, but we, we have the luxury of working in industry that gives purpose, every single person in our department has skin can see the purpose in our work, and can get the direct verbal feedback of the impact of our work. And I don't think there's anything more valuable from a contract perspective than that. But ultimately, we also have learned, we have to meet people, you know, it's not Chuck's way or the highway, we have to meet people where they are in kind of their lives and what they're looking for. And you know, not every job situations flexible and fluid, but we have, we have to be different. We can't be rigid, like we have been historically.
Chris Dy:So to bring us to a close, I mean, if we were to re examine this podcast in six months or a year, what do you think is going to be different? At that point? Do you think it's, we're still going to be in the thick of it? Or do you think we'll be at the tail end of this kind of American reckoning, not American, but I think a global reckoning of kind of individuality and sense of purpose.
Charles Goldfarb:Again, I think healthier is going to be fine, because I do think people are going to, I think there's gonna be better pay for all employees and health care, I think that'll be important. But I think we're going to even out as people figure out what their future holds and, and gravitate towards jobs with purpose. I really believe that I hope, hopefully, it's not fantastical thought, but I really do believe that. But I do think we're looking at 9, 12, 15 months before things reach a steady state. And so all these open positions we have in orthopedics, in our department in St. Louis, Missouri, are not going to be filled in the very near future. And so our work is going to continue to evolve. You know, just like we involve with tele evolved with telehealth things are going to change we're going to have to find different efficiencies to work around our shortcomings. Because let's face it, when you have as many job openings as we have, what happens? Well, the burden goes on those that are remaining in the last thing. So we are really focused on retention more than recruitment now because the recruitment path is just tough.
Chris Dy:Thanks for painting such a rosy picture for all of us.
Charles Goldfarb:You know, I feel passionate about what I do. But the realities are tough. I'd be interested from with other listeners, if they're experienced, I can't imagine the experience is different no matter where you live, but certain organizations may fare better. I would wonder whether, you know, more holistic organizations do better in situations like this? Do they maintain their employees? My gut sense is, is the same because we hear about strikes in health care organizations in places where we wouldn't expect that so I think we're all struggling with the same thing.
Chris Dy:Great. So we've recorded this episode, and we've come to the conclusion that we're struggling we don't really understand the thing that we tried to understand 30 minutes ago.
Charles Goldfarb:Yeah, that we talked about loving our podcast. So I hope you get after that rosy outlook.
Chris Dy:Awesome. Let's revisit this in a year and see where we are.
Charles Goldfarb:That sounds great. Great talking.
Chris Dy:Great talking. Hey next week, we're gonna have Jeff and Steve back on, very excited to hear, hear how they're doing in practice, bring back some of our favorite recurring guests. And it'll be good to talk to everybody then.
Charles Goldfarb:It will be fantastic and I can't wait to hear about their instructional course lecture at the hand society meeting.
Chris Dy:And if anybody has any thoughts on how the pandemic has affected them and their organization Please let us know handpodcast@gmail.com and hopefully you have more answers and a rosier picture than we just painted.
Charles Goldfarb:Take care.
Chris Dy:All right.
Charles Goldfarb:Hey, Chris. That was fun. Let's do it again real soon.
Chris Dy:Sounds good. Well, be sure to check us out on Twitter@handpodcast. Hey, Chuck, what's your Twitter handle?
Charles Goldfarb:Mine is@congenitalhand. What about
Chris Dy:you? Mine is@ChrisDyMD spelled d y. And if you'd like to email us, you can reach us at handpodcast@gmail.com.
Charles Goldfarb:And remember, please subscribe wherever you get your podcasts.
Chris Dy:And be sure to leave a review that helps us get the word out.
Charles Goldfarb:Special thanks to Peter Martin for the amazing music. And remember, keep the upper hand. Come back next time.