I held an office party at my house this weekend. The summer party is fun because it's a family affair, whereas in December we have a more formal holiday party--with couples, dancing, and the ribald laughter and racy gift exchange that are typical of medical staff gatherings. The tension of life, death, sickness, anxiety, rules, regulations, time constraints and the inexorable demands for perfection during clinic office hours give way, in our leisure time, to something approaching all-hell-breaking-loose.
I chided the employees before the party: "Your admission ticket is a child." Therefore, we had the pleasure of watching lots of children galloping and cavorting across the broad yard, and I was able to cradle in my arms one chubby-cheeked baby after another. At my insistence we held many contests--the kids were all for it, but the adults had to be coaxed away from their lawn chairs and the grilled chicken. When was the last time you played "Musical Chairs," and had to bump bums with your office confreres? When did you last watch a couple dance "The Shag" for a prize of a toy skeleton, or a bottle of Crown Royal? Still, the box full of colorfully wrapped gift-prizes was not enough to lure all the self-conscious adults onto the deck for the dance contest, or onto the trampoline for a flipping tournament, or into relay races or swim competitions--but they did play some rowdy volleyball, and I saw some cutthroat personality traits during rounds of ping-pong and air hockey. The "Limbo" challenge was not to be missed--participants finally lowered their bellies beneath a rope suspended only fourteen inches from the ground! And one adult beat all the kids in jump-rope, making it to 147 jumps before the rope hit her shins.
One year the party lasted late into the evening, and under the stars there burst forth from my straight-laced employees' wide-open vocal cords such big voices, and such sultry melodies, and such voluptuousness and beguilement that I knew I had a lot to learn. I thought to myself, "I don't know these people," and "We need more parties."
Employers like me are in danger of seeing our employees in only one dimension. This encourages us to pigeon-hole the very people we depend on for our survival, and then to react to them as though they are nothing but workers. In fact, small businesses are most successful when people work together as a unit, depending on one another to get the big jobs done, and offering moral support and even physical sustenance in times of need.
"Need a beer, Doc?" I sometimes hear from one or two of my staff at the end of an especially difficult week. They sense my level of tension, and my exhaustion. When one or another employee is having car trouble, there's always, "I can give you a ride," or "Can I help you with some jumper cables?" When the security system gets tripped in the night, my nurse practitioner will rush in to turn off the alarm and figure out what went wrong. When one employee has foot problems, the others give her sit-down work to do. When another is sick, they all change shifts to make sure the office has maximum coverage. Everyone in the front desk area is cross-trained to do every job, and there are no slackers--if there were, they wouldn't last. The nursing area functions like a big, well-oiled machine: if one person misses a beat, the whole operation comes to a halt. "What's going on?" I'll demand of the first person I see, when we've run out of forearm splints, or Toradol injections, or when an IV isn't set up in short order for a very sick patient. "Whose job is this? Who's not up to speed?"
When an error is made, however small, I ask each employee the same question: "How many errors are allowed in a doctor's office?" The answer: Zero. Why is medicine so intolerant of incompetence? Because one error could cost someone his life.
Small businesses can't tolerate the lassitude, ennui, imperfection, and malingering that are so common in bureaucracies and large corporations In a small clinic, everyone knows when one person isn't pulling his weight--and the pressure to "do the job or disappear" is strong. Colossal businesses solve the problem of shirkers and idlers by "laying off" large numbers of employees in one fell swoop when it becomes apparent that the work performed doesn't come close to expectations for the aggregate. But lay-offs aren't necessary in small offices, because staff members are self-selected for the job. Personalities have to mesh, and people must perform--and in medicine, they must perform perfectly. For this reason, I no longer hire applicants who have spent years working at University of Florida, or Shands, or in nursing homes. Perhaps this bias is unwarranted, but my experience has shown that these applicants don't have the stamina or work-ethic to meet the standards of a small, freestanding medical clinic. They complain, or call in sick, or log onto Facebook, or answer their cell-phones while on the job--or they simply quit. The job is just too tough, if you're used to being coddled by corporate parent-equivalents.
Office parties are a chance for me to see my employees as human beings, who are responsible to--and important to--others. While this may not make me more sympathetic when it comes to errors, it increases my appreciation for what these special people are trying to do in their lives, and how heroic their lives are. I understand how much I need them, precisely because they are who they are, and I begin to realize why they are so good at their jobs in my clinic.
There is always a measure of conflict when people work alongside one another, because none of us sees the world in exactly the same way. But human beings are communal creatures, and our conflicts are our greatest strength, if we move toward them rather than avoiding them. In the minor abrasions we sustain as we bump up against one another in the workplace, in our disagreements and our little laments, are the seeds of self-revelation and the possibility of something greater being accomplished. Each person's input has merit, and the effect of our work together is a greater force than all the separate units added up. When I interact with my employees outside the work environment, at these parties, for instance, I have a chance to see how unique each one is, and I remind myself: These are real people, with a lot more going on in their lives than what I see every day--I need to take care of them, and cherish them, because they are taking care of me.