The Rad’s Mission Statement

January 10, 2019

You have a mission you’re supposed to do-are you able to see that mission through?

I’ve had occasion to write “mission” and “vision” statements. For those blissfully unfamiliar, these are exercises undertaken on behalf of organizations, often businesses, summarizing their core objectives, intentions, values, etc. My personal takeaway from such experiences has generally been along the lines of, Well, that was a chunk of my life I’ll never get back.

I’ve never bothered writing up a mission or vision statement for myself, because I’m pretty solidly aware of what I’m about and what I’m after. Phrasing it in a tidy little package of words for others to see and (dis)approve of-well, there’s no percentage in it for me. Anybody with whom I’m working will be aware of it, and if we have any differences in opinion on such fundamental matters, they’ll stand out and get addressed far sooner than later.

Related article: The Warnings Going Unheeded

The topic nevertheless comes to my attention when I sense that I’m deviating from my intended course, whether inadvertently by my own hand or as result of outside influences. If the deviation is a very brief, one-time thing, I might not take as much notice. But if it persists, or especially if it recurs, sooner or later I’m going to think, What the heck am I doing, here?

I think that sentiment doesn’t occur and/or get taken seriously anywhere near as much as it should. An awful lot of what folks do while “on the clock” for their professional lives, especially when they aren’t their own bosses, falls under the heading of “mission drift.” Even that phrase is putting it kindly, since it implies that there is still some general relationship between the activity and what the mission is supposed to be. More than occasionally, there’s no real connection there at all.

Long ago, when I still had time to read books, one of Scott Adams’ (the guy who does the Dilbert comic strip) put it in a way that made perfect sense to me. There’s no way I’m going to dig it up now for a perfect quote, but the idea was that pretty much everything you do at work should be directly related to your mission. That is, what you’d say if someone asked you, “What do you do here?” Or, at the most, one step removed from it. Anything more than that, and it’s probably deserving of scrutiny.

Mission drift

So, for instance, what I would say I do in my main gig is read and occasionally protocol diagnostic-imaging studies in the name of patient care. Any time I spend looking at images and dictating reports I’m on the straight-n-narrow, fulfilling my mission.

Some things that would qualify as one-step-removed from that: Getting in touch with referring clinicians (to convey results extra fast, or to get more clinical info). Or with ancillary staff like technologists (to find out other details about studies that have been ordered or done). Researching things relevant to my interpretations, like looking up normal ranges for measurements or doing CME to keep my knowledge-base current. Even doing an addendum requested by a referrer on a fellow rad’s report if the colleague is away and not going to be back anytime soon-because the other rad and I share the same mission, and the referrer needs this timely clarification to treat his patient.

The step between once-removed and more-than-once can be a subtle one, on a very slippery slope. For instance, suppose that addendum requested above was because the tech entered the study-type wrong, and the colleague reported out a 3-view spinal XR as if it were a 5-view. The tech, or someone else behind the scenes, wants the record corrected with an addendum from a radiologist. That compliance will distract me from patient care, just so I can make a regulator happy.

Another example, mentioned in my columns of previous years: Healthcare facilities have processes to ensure that their workers don’t spread infection. Treating and preventing illness is our mission, so it makes perfect sense for docs, nurses, etc. to have annual screening for stuff like tuberculosis. Get a PPD, etc.

Except now there are thousands of docs who exclusively practice telemedicine. They work remotely, and will never set foot in a hospital or clinic to come into contact with any patients whatsoever. So, unless some magical new strain of mycobacteria comes along that can transmit via the internet, it seems pretty pointless to require those docs to go through the same process. Wastes their time, wastes medical resources (like the PPD itself)-so why does it still have to happen? Is it at all related to the teledocs’ mission? Or is it just to make paperpushers and their file-cabinets happy?

A lot of these deviations aren’t even brought up by those whose missions are being impacted. Either because they don’t want to come across as complainers, or they expect little/no action on the part of their superiors in response. Indeed, they might have come to expect disinterest (or even worse, responses) from the higher-ups when taking the initiative to say, “Hey, I think my time/effort/resources are being wasted with this.”

Related article: The Big Impact of Small Mistakes

Which is a shame, because each time the people whose work actually advances the mission sense that they aren’t being allowed to do so to the best of their ability, it takes a toll on their morale. Compounding the inefficiency and waste created by the mission-deviations themselves.

The higher-ups should instead be very interested in hearing what the workforce thinks about this stuff. Not only listening to their feedback and acting on it, but encouraging more of the same. And if such input, once acted upon, does indeed result in better team-focus on the mission, visibly reward it.