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  • Writer's picturePaul DeChant MD, MBA

Shadowing Physicians: Going Where the Work Is Done

Updated: Aug 15, 2023

Why should senior leaders get out of their office and the admin suite, and instead shadow clinicians on the "front lines" of patient care?


The answer is powerful in its simplicity


Leaders need to go where the actual work is being done in order to make better informed decisions, decisions based on seeing waste with their own eyes and feeling the pain of the caregivers and patients.


We can’t achieve the same level of understanding by sitting with committees in conference rooms reading reports and spreadsheets. Staff meetings are not much more helpful.


When we see and feel for ourselves the pain clinicians experience on a daily basis, our motivation to support the caregivers on the front lines is much stronger.


How do you do this?


We go with respect for the people doing the work and with a goal of simply observing the work to in order to understand the challenges of the workers.

  • We let them know ahead of time so they don’t wonder why a leader that they rarely see is suddenly coming around.

  • We thank them for their good work, and for allowing us to observe.

  • We arrange a debrief meeting within 48 hours so that all parties learn from the experience.


Why it's Important to go to the Clinical Front Lines


Going to the clinical front lines accomplishes a number of things:

  • When we see the pain, unfiltered by reports from others, our commitment to improvement grows stronger, and our urgency increases to move more quickly and effectively.

  • We learn things that we otherwise would not know, things that can make a dramatic difference.

One hospital CEO described his experience shadowing nurses in the ICU and realizing just how poorly designed the unit was for the work the nurses were doing. The next day the leadership team redirected funds from a major capital building project to redesign the ICU.


I accompanied another CEO to a pediatric ward, where he saw nurses risking injury and compromising care due to poorly designed patient rooms and nurses stations. This led him to change course and fund a request from the medical staff to upgrade the facility.


These are both great examples of removing frustrations from patient care.


Is Shadowing Clinicians a Part of Your Routine Work as a Leader?


What have you learned, or how have you changed, as a result of shadowing clinicians while they care for their patients?


Please reply below to share your thoughts on this.


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