This post was originally published on 7/23/2013

How many of you are average drivers?

How many of you have average spouses? How many of you are average spouses?

How many of you want to care for your patients in an average or below average way?

We all want to excel and be better than average, but that is a statistical impossibility. So where are the below average? And how do we know?

I recently read a blog that espoused physician leadership and the elimination of ICD-10, CPT coding and compliance, meaningful use, face-to-face evaluations, HIPAA and purported to, by so doing, eliminate billions of dollars in waste. I appreciate the sentiment, if only.

There is a presumption that we are all honest, high quality, caring professionals. But we are not all.

So how do we as a profession improve ourselves?

It is by lack of this self-improvement that we place ourselves in a position that others judge us. They judge our honesty, clinical acumen, clinical skills, and ability to follow the guidelines of our own learned colleagues and experts.

They impose rules, protocols, judgments, and ways and means to derive the data to make those judgments. It is not sufficient to let the market decide, because there are not enough of us to make real competition work as it should.

Truly bad physicians are driven out of practice by licensing bureaus, legal troubles, and being caught for something really bad, but I wager those represent less than 0.01 percent of practicing physicians, and not enough of bad clinicians who might improve if given the opportunity.

No ‘leave us all alone’ answer

What is the solution? Why, yes, it is physician leadership. It is not the easy, “Leave us all alone” answer.

It is driven by new payment mechanisms that will use financial force to pay only for high quality care, not volumes of care.

We must participate in defining, extracting, and profiling for that quality, and finally, policing ourselves.

There are services that help physicians who have fallen behind in clinical skills or are struggling with addiction or physical/mental challenges.

Here’s one example of how physician colleagues helped an internal medicine resident save his career by confronting him about his alcohol addiction.

In addition, if we wish to protest ICD-10, CPT, etc., we have to come up with realistic, doable now or very soon solutions to deriving, extracting and profiling ourselves to ensure that any of us below the average know it, have the opportunity to get better and learn, or find other jobs.

A major part of leadership is not criticism, for it is easy to criticize. A major part of leadership is finding ways that we determine are correct to help ourselves be even better.

What do you suggest? How can you work toward bringing us all up?