In Gordon MacKenzie’s 1996 book Orbiting the Giant Hairball: A Corporate Fool’s Guide to Surviving With Grace, the “hairball” refers to ever-increasing rules and red tape that can entrap both leaders and employees in an organization. The hairball is never untangled. It only grows.
Health care consultant Jack Valancy name-checked the book in a 2007 FPM column on HIPAA and all the rules it spurred health systems to create, depending on their various interpretations of the law. His advice to physicians is still apropos. Physicians should resist being pulled into the hairball, “immersing themselves in the minutiae of policies, procedures, processes, surveys, statistics, and methodologies that consume 33 cents of each dollar Americans spend on health care and obscure their organization's higher purpose.” Instead, physicians should orbit it.
Within your organizational boundaries, try to find new, invigorating, and satisfying ways to practice medicine. Here are some ideas.
1. Try open-access scheduling, group visits, or other ways to improve access.
2. Use email (or electronic health record portals) to communicate with patients.
3. Offer services not covered by patients’ insurance, for a fee.
4. Insist on communicating across departmental lines rather than indirectly.
5. Start an incentive plan that rewards group success.
Read the full FPM article: “Health Care’s Giant Hairball.”
Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights," featuring practical, peer-reviewed advice for improving practice, enhancing the patient experience, and developing a rewarding career.