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St. Luke’s Dennis Mesaros on FOMO and Other Diseases of the Modern Health Care Executive

By Dennis Mesaros, News and Community
October 17, 2017

Periodically, I’ve had the opportunity in this space to share insights from St. Luke’s team members. Today, St. Luke’s Meridian Administrator Dennis Mesaros tackles plagues of the modern workplace.

Who isn’t overwhelmed by the sheer volume of email received every day? How many are spending more time in meetings than getting things done? If you are frustrated by these time- and energy-draining tasks, I’d invite you to consider Dennis’ thinking.

- David C. Pate, M.D., J.D.

Dennis Mesaros
Dennis Mesaros

Is time sacred?

Given your daily responsibilities, do you have enough time? How do you spend your time?

I have a theory. I believe we have a defined amount of energy (i.e. physical, mental and emotional) in a day. 

This energy keeps us positive and patient with one another, and supports good decision-making. And when the tank gets drained, bad things happen. We snap at our colleagues, make poor decisions and disengage from what is important. 

Given that energy and good decision-making capacity are not endless, how do you spend yours?

On a recent Friday, I logged more than 400 emails having to do with everything from staff issues to surveys and certifications, and dozens in between.

I need to get through them. And I need to spend my time and energy on what makes a difference.

Here’s what I’ve also noticed. Many of the emails I receive have zero relevance to our strategic work. Some are critical, some helpful, others are nice to know and interesting, but many simply aren’t relevant. 

It’s not that I don’t appreciate being in the loop. It’s just that I believe we have limited time and capacity, and that we have an obligation to ensure that we focus on what is important, our patients, and filter out the distractions.  

Email can be an effective form of communication, but not all emails are effective. Here is my modest proposal, one that I believe all of us in health care could benefit from:

  1. Make sure what you are sending is relevant and important to your audience, and keep your audience small; don’t cc Everyone.
  2. No novels! Keep your message brief to improve the chances of it being read and receiving a response. I tend to favor the SBAR format.
  3. Minimize the email distraction by turning off your email alert/notification.
  4. Don’t send an email when a phone call would be more appropriate. Don’t engage in rounds of email when a quick phone call could resolve the question.
  5. Rethink ‘Everyone,’ and use internal, mass-audience platforms for human interest tidbits.

Now that we’ve cut the email deluge by 75 percent, let’s move on to meetings. On this front, both Warren Buffet and Bill Gates have offered a time-protecting strategy. 

Here’s what they tell us. You need to keep your calendar clear if you are going to get anything significant done.

We in health care like to meet. We meet to develop meeting agendas. We meet after meetings to debrief the meetings. Culturally, we are inclusive and try to account for everyone’s input. We believe we all need to be in the meeting to add wisdom and insight. 

But do we all really need to be in the meeting?

True confession here. I suffer from a meeting disorder. Maybe you do, too. There is, in fact, an acronym for this, as there is for nearly everything in health care: FOMO. Fear of Missing Out.

Here’s the thing. Our need for inclusion, regardless of relevance, packs days with inefficiency. Our days start with 6:30 a.m. meetings and often end at zero-dark-thirty. We have double-booked calendars, and we are taking phone meetings in the car, vs. just saying no. We need to organize our time and attend the meetings where our input adds value.  

It’s simple to say and hard to do. As I’ve noted, we are inclusive, and we may individually believe that we need to attend all meetings for fear of being out of the loop. We approach our calendars like a buffet and pile everything on (Initially, it all looked so good, but now that I’m sitting there, not so much ☺.).

Pushing back from the meeting buffet requires self-discipline and trust. Here are some practices I’m finding more and more valuable. 

Trust your team.

I have a great team. My responsibility is to support and coach, but not micromanage them.

Delegate decision-making to those most appropriate (i.e., the subject matter experts) and direct decision-making to the right level of the organization.

Trust your colleagues.

Focus your time and energy on the critical issues that drive the mission, and not the politics.

Focus on what you need to do within your area(s) of responsibilities, span of control and influence.

And here are some questions I’m trying to ask myself increasingly:

Having a seat at the meeting may be nice, but if you are not adding value, are you wasting energy that is needed elsewhere?

Is there a return on investment or opportunity cost of going to the meeting?

I am going to go back my earlier comment about energy and reserving your decision-making capacity to maximize your value. 

President Obama believed the act of decision-making erodes the ability to make later decisions. Psychologists call it decision fatigue, and recommend high-value, low-effort systemization to reduce the number of decisions in a day. 

So while he was in office, President Obama pared down suit choices by only wearing gray or blue suits. He limited menu choices, and perhaps most relevant for us to consider, he responded to numerous written requests from his staff with agree, disagree or let’s discuss.  

I believe the secret to a highly collaborative team – or the cure to disease – will not be found in a meeting, nor will the answer to high reliability be found in email. 

Those trying to lose weight quickly realize there is no magic pill that will replace intentional effort.

Similarly, there is no Imodium product we can suggest in the case of those quick to take to email or those who suffer from FOMO. My intentional effort is to send five fewer emails and trim one meeting per day from my schedule – and to spend the additional time with staff and patients and moving St. Luke’s strategy forward. 

About The Author

Dennis Mesaros is the vice president of Population Health for St. Luke's Health System, based in Boise, Idaho.