Why Your Open Door Has Become a Revolving Door: From “7 Ways to Stop Drama in Your Healthcare Practice”

By Marlene Chism
July 8, 2019


An open door becomes a revolving door because of rescuing behaviors. In Marlene Chism’s new book and audio program, “7 Ways to Stop Drama in Your Healthcare Practice,” she describes a situation with Nadine, a practice executive for an obstetrics practice, who asked about how to change her open-door policy. She stated, “My open-door policy isn’t working. There are regulars who take up too much of my time with their personal lives, career, home life, etc. I want to make a change, but don’t know how to do so without hurting their feelings.”

In essence, Nadine is saying that she is struggling with keeping boundaries because she would rather make sure everyone agrees with her. It is unthinkable to her that she might hurt someone’s feelings. Therefore, she sacrifices productivity in order to appease her physician colleagues and her employees.

Chism headshotWhat’s sad about this is that the employees and colleagues have no idea that this is how Nadine feels. To complicate matters, Nadine knows she is part of the problem because she continues to allow it.

So how do you course-correct if you have been part of the cause of your team’s low productivity?

According to Marlene Chism, “First, I want to change your mind about rescuing. You see, if you are a rescuer, it’s because you believe in your heart that you are helping others, when, in reality, you are ripping them off. Rescuing leads to temporary relief, but it also leads to long-term drama.”

Below is what one of Marlene’s clients said about the long-term results of rescuing and the impact on organizational effectiveness and productivity:

“I’m just about at the end of a year-long process of managing a disruptive physician. This situation ended up with lawyers involved and should reach a settlement today. It has been a long and painful process, as this employee had been tolerated for 18 years. This employee was occasionally talked to, but since he was considered a ‘high performer,’ he was allowed to carry on, hurting patients, families, and staff along the way, as well as creating chaos in his wake of disruption. I work in a healthcare system, and addressing a high performer is very difficult. One thing I have found myself saying is that I would never do this again. I would move away or change jobs, as it has been very negative and unpleasant. The entire process has taken a toll on me, my team, and the employee. I didn’t realize how hard emotionally and mentally it would really be.”

There is a difference between helping and rescuing. In short, rescuing is giving a man a fish, and helping is teaching a man to fish. As the saying goes, when you give a man a fish he eats for a day, but when you teach a man to fish he eats for a lifetime.

There is a two-step litmus test to know if you’ve been rescuing or helping:

First, when you help, you enable growth. When you rescue, you inhibit growth. Imagine a chrysalis in the cocoon flapping its underdeveloped wings against the inside walls as it tries to free itself from the cocoon. Poking a hole in the cocoon seems to be a helpful thing to do in order to free the moth, but in doing so, the moth’s wings never develop, and it therefore never gains the ability to fly. That’s what we do to our employees and colleagues when we take on their issues that they need to work on in order to grow.

Second, the way to tell if you’ve been rescuing or helping is by noting how you feel. If you feel angry, taken advantage of, or resentful, that’s a dead giveaway that you have been rescuing instead of helping. Let’s face it, if you teach a man to fish, but he isn’t willing to go to the pond, bait his hook, and cast his line, then you are going to be exhausted from doing all of his fishing, and you’ll feel taken advantage of when you see him enjoying free time that you don’t have due to all the time you spent “helping.”

Healthcare executives often feel caught in the middle between their physicians and the employees. A common occurrence in healthcare organizations is the manager’s experience of trying to be “the rescuer” without the backing of the doctors. When you rescue your doctors from the realities of people being upset with changes, then you rescue them from growing as leaders. When you fail to address the fact that the doctor doesn’t take your side when employees try to blindside you, then you are rescuing the doctor from stepping up to the plate as the top leader. In addition, you will feel angry and taken advantage of, and later, your anger may begin to show itself in other ways.

Topics: Management

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