it’ll be 45 minutes before they go in to surgery. Should be 10 minutes max. This is not good—my malpractice insurance is already through the
roof.” She left Alice to imagine what dire things could happen if a patient woke on the operating table.
There was more. The nurses complained that she didn’t listen to them about the timing of surgeries. Instead, she would barge ahead, going from one surgery to the next with no breaks, exhausting herself and her staff. The team would try to guide her into the correct sequence
of surgeries without her knowledge; they would slip things by her and trick her into doing the right thing.
Week 3: Clinical Success, Management Failure
Dr. Yelyuk was not happy with the 360-degree assessment. “I didn’t expect this from my family,” she said plaintively. “We’ve known each
other for years. They come to my house every holiday season for a special dinner. Everybody brings a special dish. They love my cabbage
rolls. . . .”
“Your team is concerned about you,” Alice said. “They want the best for you and for your patients.”
“I don’t think of myself as pushing too hard. I just see it as working hard and doing as much as I can.”
“Your colleagues say they can always count on you to fill in for them or to shadow for them if they need another hand. I wonder if you sometimes do too much because you don’t want to refuse them.”
She sighed. “It’s very hard for me to say no to a colleague.”
Unlike the techs and the nurses, the other surgeons were pleased that Dr. Yelyuk always stepped in when they needed her. They were also happy
with the number of surgeries she performed. The surgeons were part of a group that contracted with the hospital in a fee-for-service arrangement; this meant that the more surgeries performed, the more money would be earned by the group and by the hospital. In the eyes of her colleagues and the hospital administration, Dr. Yelyuk was a top performer. Alice guessed this was one of the reasons they’d proposed coaching to her as opposed to making a referral to the Quality Committee.
The phone rang before Alice could respond. Dr. Yelyuk talked for several minutes about problems with a website and some shipping issues
with the person on the other end. She was frowning by the time she hung up.
“The website for the store is acting up. We’re going to have hire someone to work on it.”
To Alice’s surprise, Dr. Yelyuk had a side job: She ran an online business reselling vintage items from Givenchy, the French fashion line. In
her sparse spare time, Yelyuk took calls from the staff filling orders.
“I wonder if running the store is a bit much in addition to your hospital work,” Alice ventured. “Would it be possible to hire a full-time
“Oh, but I love the products so much! And it’s a nice diversion from surgery.”
Alice struggled to keep from rolling her eyes. Not only was Dr. Yelyuk running the online store, she also had a husband, three kids,
and two dogs—and all this was in addition to her demanding surgical work. An overloaded schedule and inability to delegate were common
challenges for a high-performing executive.
“When you were in medical school, were there any courses in management skills? Courses on teamwork, leadership, delegating
responsibilities, that kind of thing?”
She shook her head. “There were lots of different clinical courses, but nothing on management.”
As Alice had expected. “When you came to this hospital, did you go through an apprenticeship with an experienced surgeon?”
She shook her head again. “No, nothing like that.”
Surprisingly, most medical schools do not include the basics of management in their training. This is beginning to change; some
schools now offer a joint MD-MBA degree. But there had been no such programs in Dr. Yelyuk’s school. Similarly, most hospitals do
not have an apprenticeship program. For Yelyuk, this meant she went from residency and fellowship directly into the hospital operating
She had always kept up her continuing education, and she was an active member on the board of the surgeon’s group. In addition,
she was recognized for her innovation and incorporation of new techniques. She presented at conferences and was a tremendous resource to
other surgeons across the country. But although she was very accomplished on the clinical side, she simply wasn’t aware of her shortcomings
on the management side.