A storm is an unruly, unpredictable, uncomfortable thing. Sometimes, that’s exactly what you need. 

You have to look for a subtle sign of what’s going on beneath the surface. Poker players call this a “tell.” In the workplace, one of the most common tells for toxicity is gossip.

For a lot of physicians, “productivity” is kind of a dirty word. It’s not that they're lazy, or inefficient--it’s just that productivity, as defined by the systems they work for, doesn’t feel all that productive.

A good mise en place is the first (and some would say most important) step in cooking a great meal.

When there’s a spot open on our team, we all dream of filling it with a unicorn. Then, the actual applicants show up, and we hire a real live imperfect human and hope for the best.

Our hardwiring causes us to make the same kinds of mistakes and miscalculations over and over again. By understanding those glitches in our behavioral software, we can sometimes overcome them, or at least compensate for them.

Sometimes, incremental change isn’t enough. There are elements of some cultures that are so toxic that they represent an existential threat to a team or organization. These have to be addressed immediately and decisively, or we run the risk of falling to a point of no return.

People in a hierarchy tend to rise to the level of their incompetence. 

Every healthcare organization would love to do the same three things: deliver better quality, care for more patients, and reduce costs. It’s the Holy Trinity of health system goals. It’s also a bit of a trap.

“If only the rest of you performed like our superstars, we’d be just fine.”

We don’t have to start prescribing herbs and magical tinctures to learn a thing or two from our alternative medicine colleagues. We just have to develop the skill that’s actually at the heart of their practice: creating trust.

Some work offers a lot of responsibility. Some work offers a lot of control. The best work offers both.

Sometimes we get enamored with our grand strategies and plans, and we forget that, in the end, we still have to G. S. D. (Get Shit Done).

When we talk about becoming a “healthcare home” we don’t mean that we’re going to build a clinic with bedrooms and a big family room with a pool table and an entertainment center. We mean that we want to create a place that feels like a home--a place that feels like family.

So here’s the question: what keeps humans interested in what they’re doing?

In our culture, we’re really good at assigning blame.

Since we are good, evidence-based practitioners, we accept that healthcare inequity and bias must exist. What we often deny, though, is that we are part of the problem.

What does it mean to earn someone’s trust? Once we have it, does it grow or diminish with time? When do we give our trust to others, and why? What do we expect in return?

Medicine has always had more than its share of pain and tragedy, but we never used to think of it as joyless. It isn’t the human sadness and the loss that have robbed our profession of joy--it’s the daily grind.