Dr. Gregg Adams: Top challenges as surgery chief & why 'needless paperwork' makes his job harder

Gregg A. Adams, MD, chief of surgery at San Jose, Calif.-based Santa Clara Valley Medical Center, told Becker's ASC Review about day-to-day concerns, leadership challenges and solutions he'd like to see for the field of medicine.

Note: Responses were lightly edited for style and length.

Question: What are the biggest challenges you face when managing a team of 130-plus surgeons?

Dr. Gregg Adams: The teams we manage are large, complex and diverse. They are made up of well-trained, intelligent people who have specific ideas about how they would like to practice their craft. One of the biggest issues is rectifying the requirements and desires of the practitioners with the goals and resource limitations of the medical center and the population they serve. Budgets take time to develop, and priorities of an institution can change rapidly. It is important to inspire and support the ideas and projects that are being generated, but also apply a modicum of reality to the workings of the system. In an environment of scarce resources, frustrations can flare as those who do not receive the resources they requested may feel less important.

Medical advances appear at an incredible rate. Keeping up with new ideas and separating the wheat from the chaff can be challenging. Maintaining a sense of professionalism can also be challenging in a world where more and more practitioners are becoming employed by health centers. Demands for productivity and quality can outstrip the available energy of the staff and leave little room for creativity or research.

Q: What are your top concerns on a day-to-day basis? How do you handle those concerns?

GA: Abdication of the definitions of quality and customer satisfaction to those who are not accountable for the results. For example, the surveys sent out to patients following a visit may not have physician-derived questions. Many questions are worded toward productivity measures rather than satisfaction with the interaction.

There are more and more administrative tasks loaded on the clinical staff. These all take time and are often not considered part of the required "clinical workload." Many practitioners are taking their work home with them, depriving them of sleep or valuable family and decompression time.

Q: If you could change one major thing to make your job or your surgeons' jobs much easier, what would that be?

GA: The needless paperwork, off-loading tasks that would be better suited in other hands. A cost-efficient system takes into account that an expensive, specifically trained practitioner is best used performing the tasks for which they were trained, and not filling the compliance and housekeeping paperwork that may be safely and efficiently done by others.

Dr. Adams is the lead author of On Call Surgery, a pocket-sized book and resource guide for on-call clinicians.

More articles on leadership:
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The ASC management strategy that will likely lead to failure — 3 expert insights
Improving ASC patient satisfaction scores — 7 key steps

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