Leadership lessons from Moses: Don't let my patients go

The Bible is so rich in stories that took place thousands of years ago. Often, these stories serve as lessons for the present. There's no better example of leadership than Moses, who delivered the Jewish people out of bondage from Egypt to the Promised Land. This article will discuss 10 examples of Moses's leadership and how they apply to modern medical practice.

Moses often became discouraged and distracted. He would pray and consult with the Lord, then be energized, and return to speak to his people. Message: for doctors to stay focused, they may have to retreat, take a breath, maybe even pray, and consult their inner spirit, then return to the task at hand.

It is normal for a physician, office manager, or staff member to become distracted and wander off course or go off message. This is most common when problems in our non-medical or private lives are brought into the practice. That's why one of us (NHB) has a sign in the employee lounge that states, "Tonight is opening night. We need to put on a smile and go out and light up the room." We should never lose our focus that we are in healthcare to serve our patients, and we must leave our problems outside the door when we enter the office and prepare to see our patients.

1. Moses had an effective team. It included his mother, his sister, Miriam, and the Egyptian princess who raised him. In adulthood, Aaron became an indispensable part of his team. Moses' ego was able to accept advice from his trusted team members.

We must be cognizant that we can't do it all and heed the advice of our team members. An effective medical practice must function like a team. We must surround ourselves with a team focused on ensuring each patient has a positive experience in the practice. The team must be cohesive and have an effective communication system so that everyone is on the same page. Often, this can be accomplished through regular staff meetings where problems are identified, solutions offered, and an implementation process created.

I once saw the patient's restroom at the end of the day, with toilet tissue on the floor and a spilled specimen cup in the sink. The staff was asked if they would be comfortable using the restroom, and the answer was negative. At the next staff meeting, we discussed the restroom situation. We found a solution by assigning a different person each day to clean the restroom at noon and mid-afternoon, so that the last patient enjoyed a clean facility, just as the first patient in the morning. We were able to function as a team, and everyone took responsibility for the smallest details.

2. Moses was a good delegator. His father-in-law, Jethro, advised him to delegate by using magistrates and judges to help settle disputes. Perhaps Moses was the first well-known delegator. Moses' ego allowed him to accept advice from his trusted, perceptive father-in-law.

It is not possible to be a good clinician or office manager by micromanaging your staff. An efficient and effective physician should only do what doctors need to do, and all other activities should be delegated to others.

For example, a doctor does not need to take the chief complaint history, record the review of systems, or record past medical history. A scribe with instructions can probably do a better job than a physician and will allow the physician to see other patients while the scribe takes the history. Doctors do not need to remove sutures and change dressings when a medical assistant or nurse can do this. The take-home message is that doctors should work at the top of their license and only do what doctors can and should do.

3. Moses understood the importance of downtime. Moses quickly understood that one day a week was needed for rest and reflection on higher-order things. Doctors and office managers need to help their staff find time for creative problem-solving. This is the purpose of regular staff meetings: the entire staff pulls back from patient care to focus on the problems at hand. This is also why a retreat from the office, free of distractions, can be helpful for long-range planning. Rested and energized staff will be more productive and provide better patient care.

4. Find the willing minority or the one(s) that will be the champions and implementers of your goals and objectives. Only two of Moses' men, Caleb and Joshua, believed that the children of Israel could triumph. Moses found that the willing minority, or these two men, would help achieve their goal and move the group forward.

This also applies to your medical practice. Suppose you are implementing a new program, such as an electronic medical record. In that case, you need a champion or go-to person to head up the project and ensure the implementation process is on track, that deadlines are met, and that the willing minority manages any obstacles or problems.

5. Moses listened and obeyed. God told Moses what to do, and he was willing to do it. Your staff must have that same mentality: when they are told to do something, they must complete the task. For example, a request is given to staff with the intention that the task will be completed; if not, they are to report back why it wasn't done and when it will be. This removes the babysitting function from practice management. You want to be surrounded by a staff that doesn't "try" to accomplish a task but will do it, or at least let you know why they didn't accomplish your request.

6. Moses attempted the impossible. It was not easy to take the entire nation out of Egypt, especially when a cruel Pharaoh was trying to stop them. Moses dared to do the impossible.

We are often confronted with impossible tasks in our practices. Suppose we are merging several practices with physicians of different ages, skill sets, medical cultures, and productivity levels. This can seem like a daunting task. Yet with perseverance and determination, and by agreeing to work for the good of the group instead of being self-serving, the mission of the impossible can be accomplished. After all, merging a few groups is a lot easier than leading the Israelites out of the land of Egypt without food and water!

7. Forgive your staff or fire them. Moses experienced rebellion from his staff and from the Israelites. The rebels were admonished with quick dispatch. Only Miriam and Aaron were forgiven for their evil deeds by scolding. An effective leader decides whether to forgive employee transgressions or fire them. Remember, if you forgive the big transgression, you have set a precedent that will continue to perpetuate itself.

For example, theft of drugs, unauthorized prescription writing, and discussing their salary with other staff members are met with immediate dismissal. Failure to do so only perpetuates such behaviors.

8. Make sacrifices and defer gratification, but not at your family's expense. Moses sacrificed his own life's ambitions and his family for the journey to the Promised Land. The landscape is cluttered with physicians with failed marriages because of not spending adequate quality time with their families. Sacrifice is necessary when you assume a leadership role but find the balance between your family and your profession, and you will be more successful at both.

9. Moses prepared and trained his successor. Moses' equivalent of a chief operating officer was Joshua, whom Moses selected as his successor. Joshua had proven leadership skills and was the obvious successor in the eyes of the Israelites.

Our takeaway message is that a good leader prepares his staff to function when he is absent or upon the leader's retirement. No one can practice forever, and no void should be left when a doctor or office manager is gone or retires.

10. Moses gave the Israelites just a few rules and guidelines. Moses didn't leave the Israelites with an employee manual with more than 100 pages and dozens of rules that no one ever looks at after their few days of orientation in the office. No, he gave them just 10 commandments. This is akin to a mission statement with just a few words to guide the practice. My practice has a brief mission statement or mantra: "Pay attention to the little details because they make a big difference." This one sentence covers all interactions with patients, fellow staff, and doctors. Suppose the staff pays attention to the little details. In that case, every patient will have a favorable experience with the practice, will tell others about it, will complete favorable patient satisfaction surveys, and will write a complimentary online review that affects a doctor's online reputation.

Bottom Line: Moses did finally reach the Promised Land after wandering in the desert for 40 years. The leadership lessons of Moses, which worked for him over 3,000 years ago, can work for you today. Apply his lessons to your practice and your life, and you will succeed just like Moses.

Neil Baum, M.D., is a physician in New Orleans and the author of Business Basics for Creating and Managing a Healthcare Practice (Springer 2022)