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Minimizing decision ‘uncertainty’ key to successful practice management
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GRAND RAPDIS, Mich. — Successful management in rheumatology practices requires both evidence-based approaches and critical thinking, in order to turn complex health care problems into practical solutions, according to a presenter at the 2019 National Organization of Rheumatology Managers Annual Conference.
“Evidence-based practice is tied to cognitive functions – it’s tied to your intelligence, your cognition, your ability to perceive and to learn,” Frank Cohen, BA, director of business analytics and business intelligence at Doctors Management, told attendees. “However, critical thinking is a whole different animal. It’s about thinking spontaneously and requires adaptability in judgement. And here is where we get into evidence-based management.”
According to Cohen, a good evidence-based manager needs to be able to learn and better perform critical thinking. This, he said, requires “jumping outside” the heuristics on which evidence-based practices is typically dependent. In addition, although evidence-based practice can be taught through repetition, gaining critical thinking in one’s practice at times requires an emphasis on diversity, and hiring a manager who thinks differently than others on staff.
In addition, Cohen said evidence-based management requires evidence, including data, information and sourcing; decision-making, based on analytics, and; problem solving.
However, the problems encountered by health care managers rarely require simple answers, with obvious practical solutions. Cohen contrasted these complex issues to the simple problems of what to do if one wakes up to a burning home, or if a mosquito lands on one’s arm. These are practical problems with practical solutions, he said.
“In our industry, and in what we do as managers, that is not the case for us,” Cohen said. “We rarely have simple problems. We have complex problems that require multidimensional decision-making.”
According to Cohen, managers can use game theory, as well as the prisoner’s dilemma and other exercises and methods, to address these complex issues.
“All I am saying is, taking a practical problem, convert it into an analytical problem, find an analytical solution and then turn it back into a practical solution,” he said.
Cohen also cautioned against the “pitfalls of anecdotal thinking,” in which managers assume they know the nature of the problem without understanding the real issue. This can lead to the assumption that they know how to fix the problem, and then assuming that solution worked without measuring to confirm the result.
However, if managers train their brains in the area of critical thinking and evidence-based management, they will have a much better chance of tackling problems successfully, Cohen said.
“Here is the truth: Not every decision we make is going to work out,” he said. “People make good decisions that end up with a bad outcome, and many people make bad decisions that end up with a good outcome. That’s just life. However, what I try to do, is that by minimizing the uncertainty around the decisions that I make, I have a higher probability that the outcomes are going to be positive.”
“You’re still going to have things that fall through, or don’t work, because health care is a complex system, where there are way too many interdependencies, and you can’t control everything,” he added. “This isn’t a silver bullet. However, by stopping, taking a deep breath, and taking an inventory, we stand a much better chance of making a better decision.” – by Jason Laday
Reference:
Cohen F. Evidence based management. Presented at: National Organization of Rheumatology Managers Annual Conference; Sept. 13-14, 2019; Grand Rapids, Michigan.
Disclosure: Cohen reports no relevant financial disclosures.