Should I Call the Boss?

I got an interesting email from a friend of mine today. It reminded me of how I learned to handle sick patients many years ago as a Surgical SpR…

and how I respond when asked the question:

“When you are asked to see a patient in the middle of the night, when do you phone the consultant on call?”

We know the answers of course – if you are out of your depth, unsure how to manage them, if the patient is very unwell, etc. etc.

Of course, as you get more experienced you unsurprisingly find yourself calling the boss less and less. Yet sometimes you would still hear that little voice in the back of your head whisper “Shall I call the Consultant to let him know what’s going on?”

My advice to juniors was that if you ever hear that little voice, even if you are quite sure you know what is going on with the patient and you are ‘on the case’ with their management – is to call the consultant and let him know what’s going on.

Because your subconscious mind is working away constantly and realizes that he/she will want to know. Either because there are some aspects of the case that necessitate his involvement, or because of his personality – some colleagues genuinely do want to know about everything of potential significance that is happening, day or night.

And that voice is usually right.

Now the worst thing that might happen if you make the 3am call is that your boss thinks you’re really not as self-confident as you could/should be, and he’s pissed off with you.

But if you don’t make the call and you should have, that means Trouble. Either for just you or worse both you AND the patient.

Because when patients are sick, there is a window of opportunity when you’ve got the very best chance of sorting out the problem and saving their lives. Akin to the “Golden Hour” in the management of trauma patients.

And whilst there is no Golden Hour when it comes to your private practice, there is such a thing as an “Opportunity Cost”.

With patients, the Opportunity Cost of ignoring your inner voice may be their lives.

With your private practice, the Opportunity Cost of ignoring that little voice “I really need to put some time towards growing my practice” is loss of income and practice growth. Because some – not all, but some – of the growth strategies you could implement will pull in patients to your practice, and every month you DON’T implement them is another month without that extra income.

Look at it this way – if a marketing strategy you try out nets you only one measly new patient a month worth £1000 to you – well, every month you DON’T implement that strategy is another £1000 not earned – ‘wasted’, in effect – and that’s £12000 a year. £120 000 over ten years…

So Tip #3 is to Beware the Opportunity Cost of Inaction.

If you are serious about growing your practice, start today. Even if that means cutting your clinic for the day and re-scheduling those patients, and using the time to plan and execute strategy.

But what if you don’t know how to promote and grow your own practice? You know it needs to be done but don’t know where to start?

No more excuses. Find someone who DOES.

And get moving.

By Dev Lall FRCS

Meet the Author

Dev Lall

Upper GI Surgeon and expert in growing private medical practices

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