Barry's Blog

tag:blogger.com,1999:blog-11542784295311773052012-02-01T03:49:01.219-05:00Barry's BlogThe home for physician leaders.Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.comBlogger291100tag:blogger.com,1999:blog-1154278429531177305.post-72370090521797619992011-11-01T16:26:00.002-04:002011-11-01T16:29:29.471-04:00The Good Journey at ACPE

The journey is coming to an end. Next week I’ll be stepping down as CEO of ACPE to begin the next phase of my life. Let me share some of my experiences for those of you like me, who never quite imagined serving in a CEO role.If you’re an employee in an organization now, you might be thinking to yourself that some decisions don’t make much sense or “I wouldn’t do it that way.” But you never

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com2tag:blogger.com,1999:blog-1154278429531177305.post-56706852715301778662011-10-28T12:20:00.007-04:002011-10-28T12:26:19.788-04:00My Ride

More than three years ago I began two projects, one personal and one professional. I started full-time work as ACPE’s first physician CEO, and I began restoring an old Toyota Land Cruiser. As my last day at ACPE approaches, I’m thinking about the similarities between those projects. Both ACPE (1975) and the old Cruiser (1979) were born about the same time. In geologic time, both came into

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com3tag:blogger.com,1999:blog-1154278429531177305.post-69430701284120556412011-09-21T16:20:00.006-04:002011-09-21T16:30:38.062-04:00The Situation at Pumpkin Springs

On day seven of my raft trip down the Colorado River at the bottom of the Grand Canyon last week, our group came to a popular stopping point called Pumpkin Springs. The rocks just above the hot springs was a place to jump into the dangerous and exciting Colorado River for a cool, refreshing diversion from the hot sun of the mid-afternoon. Our guides noted that the landing here would be

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com1tag:blogger.com,1999:blog-1154278429531177305.post-4943237426510322112011-08-02T11:44:00.004-04:002011-08-02T13:08:53.601-04:00Seeking -- And Finding -- Physician Leaders

One of the more interesting and active discussions in our ACPE Network is about “Why aren’t physicians leading?". You’ll find all sorts of opinions and insight. I want to submit the opposite hypothesis: that physicians ARE leading. And doing it very well!Here are just some of the recent pieces of evidence that demonstrate the effectiveness of physicians when they are in leadership roles:1. The

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com6tag:blogger.com,1999:blog-1154278429531177305.post-66264624415304307932011-06-21T10:59:00.004-04:002011-06-21T11:05:28.199-04:00Disruptive physician or threat to the hierarchy? Watch out for the Kool-Aid

No doubt you’ve been aware of the latest survey on the topic of disruptive behavior in health care. The results of our joint study with QuantiaMD are the same as our ACPE survey nearly two years ago. We physicians still have a lot of work to do in our own house to solve this patient safety issue. We’re making progress. But it’s time to look at another angle of how physicians become labeled as

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com1tag:blogger.com,1999:blog-1154278429531177305.post-51393864882304570782011-05-13T13:29:00.005-04:002011-05-13T13:34:46.434-04:00The Tyranny of Infallibility

Why is it so hard for we physicians to acknowledge that we’re human, prone to mistakes, misstatements, lapses in judgment, fatigue, or failure? I’ve had a most amazing week criss-crossing the country, doing presentations and having discussions with very interesting people. One of those people was Jeff Skiles, co-pilot of USAir Flight 1549 that landed on the Hudson River in January 2009. I

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-34043089804353269892011-04-18T15:56:00.003-04:002011-04-18T16:59:39.926-04:00Notes from the San Antonio Annual Meeting

ACPE's Annual Meeting, held in San Antonio, ended this past week. The participants had an energy, enthusiasm and passion to improve health care that was noticeable to me and the ACPE staff. Here are some comments and observations from the meeting, in no particular pattern, that might be helpful in your daily activities. These thoughts might also help you put the current uncertainty of health care

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-54844282359821821992011-02-17T10:27:00.007-05:002011-02-17T10:43:13.672-05:00The Bus or the Rope?

How many times have you heard leaders talk about “getting the right people on the bus”?I find that analogy in health care to be difficult. It just doesn’t resonate with my experiences or my sense of how we should be thinking of our work on behalf of patients. First, let me outline why the “bus” and its occupants makes me uncomfortable. Then I’ll outline a model that makes more sense to me.Ask a

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-41347262169861909862011-01-31T11:36:00.002-05:002011-01-31T11:38:06.546-05:00Physicians and Disruptive Innovation

Last week, ACPE Vice President of Career Services Barbara Linney hosted a webinar on career options that broke previous attendance records. This one was notable for the number of physicians looking outside the hospital sector for new roles. Consulting, insurance, pharma, or entrepreneurial ventures were mentioned as preferred destinations.I’ve been racking up frequent flyer miles the past few

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-30758557968037521522010-12-13T09:49:00.003-05:002010-12-13T09:56:39.547-05:00My Day at a Free Clinic: The Truth Behind the Rhetoric

I just got back from a most remarkable experience: volunteering at a free clinic in Charlotte, NC. Like many of you, each day I read my Daily Digest to be aware of the health care news of the day. The political rhetoric about the work ethic of the unemployed has been awfully harsh lately. Opinions about health policy and the tug of war between the two political parties that appear on the

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com3tag:blogger.com,1999:blog-1154278429531177305.post-10598760110994473262010-11-29T11:21:00.003-05:002010-11-29T11:28:22.563-05:00A Good Death

My friends and family must be outliers from what many physicians tell me about patients’ demands for expensive, and often futile, care.Several friends are facing terminal illnesses. Their concerns are about overtreatment and getting into situations that diminish the quality and dignity of their lives. They tell remarkably similar stories of listening to their oncologists’ recommendations for

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-40421619435175541852010-10-27T14:09:00.004-04:002010-10-27T14:15:16.738-04:00Arrogance

The word came up in two separate conversations, from two very different people. Every two weeks, we ask someone associated with ACPE to spend 45 minutes sharing his/her insight on the trends occurring in health care. Both people are nationally known, one a recruiter, the other a physician leader. With the number of physician leadership roles growing rapidly in the past few months, I want to

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com1tag:blogger.com,1999:blog-1154278429531177305.post-59256521310155339172010-10-05T16:44:00.003-04:002010-10-05T16:51:07.205-04:00Notes from the road: An optimistic view of the future

Physicians are preparing to lead health care change across the country. This is perceived by some entrenched interests to be a threat. To patients and their families, and to physicians’ co-workers, this is a very positive development. I think whoever is closest to patients and consumers will be in the best position to impact change.Crisscrossing the country over the past few weeks, here’s what

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-56177080434812438052010-08-04T09:09:00.005-04:002010-08-04T09:17:56.098-04:00Dog Sleds and Teamwork -- Or How a Team of Huskies Made Me a Better Manager

Years ago, before beginning my management career in health care, I trained our four Siberian/Alaskan huskies to pull a dog sled. My motivation was to allow our toddlers to enjoy the winter wilderness with a smile on their faces. Kids love dogs, and a down sleeping bag wrapped around them makes for a nice trip in the back country. Now this is going to be dangerous: I’m going to share some

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com1tag:blogger.com,1999:blog-1154278429531177305.post-18075636715334552362010-06-23T17:27:00.004-04:002010-06-23T17:34:22.564-04:00McChrystal's Downfall

How have you been perceived as a leader lately? What’s fascinating about the uproar over General Stanley McChrystal's conduct is that it's not focused on differences over the war strategy in Afghanistan. Instead, it's about a leader’s behaviors. General McChrystal’s situation has a lot to teach us about leadership! First, it demonstrates the fragility of titles, positions and roles of authority.

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com2tag:blogger.com,1999:blog-1154278429531177305.post-25373564470588587512010-05-11T10:26:00.004-04:002010-05-11T10:41:05.460-04:00Lessons from ACPE's Annual Meeting

It always takes me a few days to unwind from the intensity and new ideas coming out of our Annual Meeting. This year's meeting in Washington, D.C., and that's me in the picture with my wife, Janet, and an actor who portrayed one of the "founding doctors" during our induction ceremony for Fellows and Certified Physician Executives.At the meeting, we heard from Dave Snowden about Complexity Theory

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-12486073587906286732010-03-29T09:56:00.002-04:002010-03-29T09:58:37.256-04:00A Good Friend at CMS

The Obama Administration is set to disclose that Donald M. Berwick is its pick for administrator of the Centers for Medicare & Medicaid Services, according to a report from the Bureau of National Affairs. Members of ACPE are quite familiar with Don’s work and writing as a physician, CEO of the Institute for Healthcare Improvement, and one of the authors of the Institute of Medicine’s landmark

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-27254575393910298402010-03-01T13:28:00.003-05:002010-03-01T13:33:05.059-05:00Physician Leadership: The Next Generation

I’ve had a couple of really great weeks. I had lunch the other day with several physicians who are here in Tampa for the Certified Physician Executive tutorial. Almost all of them were in their thirties. Last week I was at a meeting with CMIOs, many of whom were in the same age group. This is a very energetic and determined group of physicians who have a whole different set of challenges than

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-80817681122331532432010-01-28T11:12:00.004-05:002010-01-28T11:19:41.485-05:00The Blunt End vs. The Sharp End

Clinician leadership. Integrated health system. Accountable Care Organization (ACO). These are the concepts and words being discussed, debated, and defined at our Winter Institute in Naples, FL over the past few days. They’re the same words and issues I heard last week at one of the nation’s premier MHA programs. We’re talking about strategies, structures, compensation methodologies, alignment

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com1tag:blogger.com,1999:blog-1154278429531177305.post-40519521499571455182009-11-24T16:37:00.003-05:002009-11-24T16:47:36.693-05:00Lessons from Tucson

Our Fall Institute in Tucson, Arizona, finished last week. Here are some quick “ahas” from our Board, our members and me that I thought would interest you at this time of chaos and change in health care. Tossed in this mix is a joke from 10-year-old Anastasia, which put a smile on our faces and made us more creative. “If you don’t like change, you’ll like irrelevance even less,” Mike Wirth,

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-57539701737917184362009-10-28T14:52:00.004-04:002009-10-28T14:57:50.170-04:00Health Care and Aviation: Zero Tolerance for Sub-Par Performance?

Some aviation-related events and conversations this week prompt this post. Two pilots have their licenses revoked by the FAA for overflying the Minneapolis airport, being out of radio contact for more than an hour, and lacking situational awareness. No one was hurt. No alcohol or drugs were involved. By all accounts, the pilots are nice people without any previous disciplinary issues. Did the

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com2tag:blogger.com,1999:blog-1154278429531177305.post-54649565960128799192009-10-06T09:52:00.002-04:002009-10-06T09:55:15.667-04:00Celebrating the Passing of Time on a Train

When I was an oncology fellow many years ago, two other residents/fellows and their significant others joined my wife Janet and me for a ride on an old, narrow-gauge steam train that chugs up and down the Rockies on the Colorado-New Mexico border between Antonito, CO and Chama, NM. Every year since then, we’ve marked the passages of our professional and personal lives, and prepared for the

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-82342562110594089012009-09-02T11:27:00.003-04:002009-09-02T11:33:53.917-04:00Dx: Sick health system; Rx: Physician leadership

Heated emotions in town hall meetings. Partisanship in Washington reaching new levels of acrimony. The stress, uncertainty and hunches in the health care industry about what reforms will take place has sparked a new concern: we need more – and more effective – physician leaders to get us through this crisis. This is like watching a sick patient arrive in the ER with worrisome vital signs, and

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com2tag:blogger.com,1999:blog-1154278429531177305.post-39618107083013921362009-08-12T13:39:00.008-04:002009-08-12T13:55:34.615-04:00Climbing Mt. Kilimanjaro

After leaving ACPE faculty member Eric Berkowitz and Charles Cudjoe and the other Guild of Medical Directors staff in Abuja, my African vacation began with a solo journey through Nairobi, Kenya. Next I crossed the border by “tourist bus” into Tanzania, where I finally met my wife and daughter in Arusha at the central bus station.After a day of rest and preparation at Hotel Marangu, we began our

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-17521883252579378002009-07-13T14:57:00.003-04:002009-07-13T15:03:55.850-04:00Out of Africa

ABUJA, NIGERIA -- ACPE faculty member Eric Berkowitz and I have just finished a two-day course for physician leaders in collaboration with the Guild of Medical Directors (GMD) at the Protea Oakwood Park Hotel in Lagos. Tomorrow we do it here in the capital city of Abuja.Charles Cudjoe, a member of the College for several years, is the force behind this first-ever OnSite on the African continent.

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-84824732680335703242009-05-20T11:38:00.002-04:002009-05-20T11:42:03.093-04:00What I Believe

A personal mission statement. It’s not easy, but the end result has been very powerful for me. In the process, I was able to define what’s important to me – and what isn’t. It applies to my family, friends, professional colleagues, and the counter help at Dairy Queen. Without it, it’s too easy to wander down the wrong career path or spend time on unproductive leisure activities. It takes courage

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-3525022188393367142009-05-20T11:35:00.004-04:002009-05-20T11:38:37.541-04:00Drawing Inspiration from Hospitalists

The Society of Hospital Medicine concluded a very exciting, high energy meeting last weekend in Chicago. A major focus was improving quality, safety, and reliability on a system level through the key roles that hospitalists play at the center of hospital care. The passion that these young physicians have for making a difference in their own hospitals, and sharing those improvements far and wide

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com0tag:blogger.com,1999:blog-1154278429531177305.post-56031128467834582382009-04-30T17:08:00.002-04:002009-04-30T17:15:55.489-04:00The Journey Toward Self-Actualization

Our Annual Meeting in Chicago just ended. Amidst the leadership and business curriculum of the meeting, a key message that lingers is the importance of knowing who you are, and what matters to you. Pete Athans, the soft-spoken, introspective Everest mountaineer, used the term “self actualization” to describe an important ingredient of rising to a challenge. Barbara Linney asked participants in

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com4tag:blogger.com,1999:blog-1154278429531177305.post-71206697330059923722009-04-08T16:04:00.009-04:002009-04-14T15:27:29.054-04:00What Dropping a Truck Bed Taught Me About Patient Safety

Four years ago an accident in my shop gave me a new perspective on errors and mistakes in health care. I have my son, a commercial pilot and A & P (airframe & power plant) certified mechanic, to thank for helping me find that different perspective, and making me curious about what we could learn from mechanics, pilots, and industrial safety engineers that could apply to health care. I’ve been

Barry Silbaugh, MD, FACPEhttp://www.blogger.com/profile/00694694119262225075noreply@blogger.com4