That concept has relevance for you as a physician, executive and leader. When starting a new position, whether it is your first job out of residency; a promotion in hospital administration; or a new research project that has been funded, it behooves you to think of your aims for your first 100 days. Perhaps as importantly, when your organization has a new leader, it is important you to learn what their first 100 day agenda is.
Physicians are often caught flat footed with changes in their reimbursement model, schedule, clinical or administrative duties, workflow or more when they aren't in alignment with where their organization is headed. For better or worse, larger strategic initiatives typically come top down in healthcare.
- Prepare beforehand - Just as with any job interview, school assignment or new rotation, you don't just show up. Learn who are the key stakeholders and gatekeepers of influence, both titled and unofficial. What skills do you have but also need to learn? Do you need to do some background reading? Some introductory meetings can help. Hit the ground running. The higher or more mission critical your position, the less forgiveness and time you have to learn the job and execute. In the era of mass resume sending, numerous candidates for your job are only a click away.
- Listening Campaign - When Hilary Clinton was running for New York Senate ,she realized she was vulnerable to criticisms she was a carpetbagger - namely moving to New York simply for political gain. One way she neutralized this was to go on an active listening campaign across the state for months holding town halls and forums and taking notes and really paying attention to what New York residents wanted. Remember, before you can influence you must be influenced first. Before you can lead, you must be led.
- Build Social Capital - You rarely can do anything alone especially in highly matrixed and complex organizations such as those in healthcare. You need to build stakeholder alliance You need people at the top and at the "bottom" to support you and they need to know you support them. Establishing rapport and relationships is essential. Everyone has an agenda for themselves and their role in the company or organization. People just vary in terms of expansive their agenda is and how aggressive they are in pursuing it. Running afoul of these agendas unwittingly is a recipe for disaster. Connect and ally with the people you need to. Example: A physician executive joining a new hospital could arrange meetings with department heads, nurses, and patient representatives to understand their perspectives.
- Culture Talks - We've spent much time discussing how organizations have unique cultures and culture drives team dynamics and performance. Cultural innovation takes time but is paramount. What are the social practices and institutional norms at your organization? How can they be leveraged effectively? Where do they need to respected? Are they any third rails that can't be touched? Know the DNA of the workplace. This requires conversations, shadowing, talking to alumni, and researching the organization.
- Triage your Agenda - You can't achieve everything immediately. For highly motivated and accomplished people like most doctors, this can be a hard pill to swallow. Pick your most impactful action items and pursue those. Balance high ticket items with rapid points on the board with quick wins. This is one strategy employed by Bill Clinton especially in his second term, the so called Rose Garden strategy - named because he wanted to have a press event in the Rose Garden regularly to demonstrate to the public he was getting things done.
- Internal and External Communication - Like it or not, but media and comms is everything in the modern era. Inside the organization, people should know how and how often you will communicate, whether by memos or town halls or 1 on1 sessions. Externally, all communications must be part of a larger brand strategy so being on point and integrated with marketing is key. Recent years have shown numerous examples of corporations killing their bottom line and alienating a more discerning public by communication missteps.
- What are the pain points? What are the rate limiting factors in your organization and how can you bring attention and validation to them? Since you work in healthcare, undoubtedly one of these will be employee morale. Years ago, I worked at an academic medical center who recruited a new chief of medicine. One of his first acts was to secure a small but permanent salary increase for all the DOM attendings. It was a gesture of respect that won converts to his agenda.
- Alley-Oop - This is a move in basketball when someone lobs the ball high up past defenders to allow a teammate to dunk or hit a layup. When done right, this is one of the most athletic and unbeatable moves in the game. Provide an assist for your employees or charges in order to help them get what they need. Facilitation and setting up others for wins is essential.
- Set Expectations - A new leadership means a new way of doing things for the "new guy." Everyone will have eyes on you and be curious to what the new regime change means, no matter how big or small. So use this opportunity to the lay groundwork for any changes you think need to be instituted. Be savvy, pragmatic and diplomatic but clear in innovations you want to achieve.
- Leverage Technology - Integrate technology solutions that enhance patient care, operational efficiency, and data management. Example: A hospital chief information officer could implement telemedicine platforms to expand access to care for remote patients.
By embracing the principles of the first 100 days of an American Presidential administration, physicians and physician executives can lay the groundwork for successful leadership in the healthcare sector. By setting a clear vision, building relationships, prioritizing initiatives, and effectively communicating, these leaders can drive positive change, improve patient outcomes, and create lasting impact within their organizations.
The first 100 days isn't everything, but it is critical because it is your window to establish an agenda, level set expectations, and build trust in the organization. Do this right and you will have fuel for your initiatives. Do this wrong, and well you'll find out soon enough.
