Category Archives: Radiology

Authority Or Responsibility?


A few weeks ago during a question and answer session of a speaking engagement I was asked the following question: “What happens if I do not have the authority to make those decisions?”

I love this question, so I figured I would share my take on it with the broader audience.

People are often waiting to be given the “authority” or the power to make decisions. This is often used as an excuse, or a way of letting ourselves off the hook for not making a decision, making a change, or performing a task.

I do not have the authority, so I do not have to do anything about it.

Authority in many organizations resides at the top and cascades down. This structure allows for decisions to be made and for workers/people to be compliant to follow those decisions.

As long as we follow the decisions and directions, we keep our jobs.

Few of us will ever have the “authority” or be close enough to the top to make decisions in which people must comply with in order to be paid.

Forget about authority. Seek responsibility.

Responsibility is abundant. There is more than enough laying around for any of us to pick up and take.

Each of us has an opportunity on a daily basis to do something that requires us to be accountable, answerable, and responsible for doing something. It can be writing a letter, it can be guiding a patient to a waiting room, it can be answering a phone, it can be changing a workflow, it can be staying late to help transition care between shifts.

No one is asking us to do it. No one told us we must do it. It may not be written down in a job description, or a process improvement, or in a manual. It may not have been done before. It may not be something that we are paid to do. It may be risky. It may be weird. It may be odd.

It may also be the one thing that changes the perception for a patient. A family member. A physician.

Each of us has the ability to take responsibility. To do something.

If it succeeds, spread that acknowledgement around. Share it with others on your team. Commend others for the success. If it fails, stand up and take accountability for your decisions to act. Claim ownership for trying something different.

The more times we take responsibility the more people will realize that we are here to lead.

Leadership is not about a title , or the top of the organizational chart, or having authority.

Leadership is about taking responsibility.

I take responsibility at the N of 1.

As always you can feel free to email me at or follow me on Twitter @cancergeek


Computer Assisted Medicine

Photo courtesy of Washington Post Nov 5, 2015

Photo courtesy of Washington Post Nov 5, 2015

Why is a healthcare leader writing about the weather, again?

Simple, because I want to discuss my own experience and interpretation with IBM Watson during my vacation in Florida and Hurricane Matthew and its implications to Healthcare.

According to the data, the historical indicators, and the predictive modeling the initial projection of Hurricane Matthew was that it was going to miss the coast of Florida.

I noticed that the weather channel also sent reporters to the southern islands where the hurricane was striking. At first I thought this was to have first hand accounts. However, what I realized is that the weather modeling needs feet on the streets to be able to provide additional inputs to update the models.


Because hurricanes are an act of nature. As much as we want to believe that natures acts a specific way, takes a specific course, and that we can effectively predict its patterns….the reality is that nature is not always predictable.

Nature doesn’t follow rules.

Many times the best we can do is inform on possible paths, but not actually predict the entire course.

The question to healthcare is do we believe that we can truly predict the best possible course of care, the best treatment, in order to get the best outcome?

People do not always follow the rules. People are not always predictive or rational. People still have a lizard brain which at times forces us to do things that we shouldn’t do because of our instinctual flight or fight response.

I agree that the math makes sense:

Genome + Zip Code + SDOH = Precision Medicine

However, as much as we all want to focus on the technology, the artificial intelligence, the cloud, the data, the analytics, and the promise of being predictive we need to first remember that this all begins and ends with people.

People as patients do not always act in a predictable, rational, or rule based manner.

Many times due to physicians, clinicians, nurses, technical staff, and front line workers dismissing a patients feelings of anxiety or stress it leads to unpredictable actions.

At times because we do not pause to take the time to understand and listen to a patients problem it leads them to leave and do something that doesn’t help them get the care or follow up they really need or want.

Technology is sexy. Technology enables our ability to connect faster, quicker, and more cheaply than ever before in history.

Yet technology only follows the rules.

In a enterprise whose product is people, in this case healthcare, technology will enable the world of computer assisted medicine.

The technology will know the rules, but it is the physicians, clinicians, nurses, and technical staff that will recognize the anomalies, the outliers, and the exceptions of our patients.

The future of healthcare is a transition to computer assisted medicine. Technology will enable the people working inside of healthcare to have more time, to build more meaningful connections with patients, and to provide the attention needed to build trust.

The future of healthcare is performed by people enabled by technology to deliver care at the N of 1.

As always you can feel free to email me at or follow me on Twitter @cancergeek