This is Lab Medicine Rounds, a curated podcast for physicians, laboratory professionals and students. I'm your host, Justin Kreuter, the Bow Tie Bandit of Blood, a transfusion medicine pathologist at Mayo Clinic. Today we're rounding with Robert Michel, editor in Chief of The Dark Report, which is an intelligent service and publication that provides economic and strategic assessment of the clinical laboratory industry. Thanks for joining us today, Robert.
Well, it's a pleasure to be part of this podcast. Oh, well, you know, you and I got to meet several months ago now and kind of maybe foster some of these initial conversations that we're going to have today. I was wondering if you could kind of kick us off with maybe why are laboratory management skills important for laboratory professionals and pathologists? Well, if you think about it, just about everybody working in a laboratory has a certification or an accreditation in something.
The pathologists, the clinical chemists or the PhDs, the medical technologists, histotech, Cytotec. So everybody is very, very skilled in the science of lab medicine.
But as their careers progress and they move up the management ladder there's a whole other discipline that's well established in terms of management, finance, marketing, sales and those are skills that are necessary to oversee an organization that's going to effectively deliver a high quality service in a financially sustainable manner.
So more specific to that then is that anyone who is moving up the management ladder should be paying attention to opportunities to learn management skills, management philosophies, management methods. You know, I'm glad you kind of bring this up because I I think that people, I think as we're learning and training into our like you said, you're, we're getting these certifications.
We're learning, we think that, you know, we're going to become you know, a good scientist, a good physician and there are these other skills that are important that you know, we sort of tend to learn them it seems in almost a little bit of a, you know an apprenticeship sort of way. I think it's, you know, wise for us to be mindful of leaders that we are working with.
That's a little bit of an informal way to learn it and I'm glad you're highlighting about keeping our listeners thoughtful of opportunities that are out there to develop these skills. I was wondering, you know, what are a few kind of these laboratory management principles that you see? Because you've certainly done a lot of workshops with people over the years, workshops... What are those principles that you see pathologists and lab medicine professionals kind of struggle with the most?
Well, let me, let me set up an answer to that call that question because when you work in a in a professional corporate environment, and I've I've been privileged to be in three Fortune 100 corporations, it's very common for them to spend one to two weeks a year on all of their management levels teaching them some area of management skillsets.
And so this is something that you don't see too much of in, say, large hospitals and health systems where there is a formal program to take someone who's, let's say managing a section in the lab or is managing part of an OR and they come into a week or two a year worth of training in specific areas of management.
So the, the first piece that I want to have people think about is outside of healthcare this is a very common management development pathway that corporations deliberately do because they want to take their best and brightest coming in entry level and prepare them for higher and higher levels of responsibility. Now that said, there's the the thing that I've crossed paths with over the years that was more most meaningful to me is the quality management systems,
QMS. W. Edwards Deming, Joseph Joran were industrial engineers of the fifties, sixties, seventies, eighties who really brought that to the world. The Japanese were the ones who adapted it. Today we learn, we know it as ISO 9001, ISO 15189, lean six Sigma and QMS quality management. So if someone was to infuse themselves with this knowledge they'll get a lot of practical management out of that as well as a system-wide approach to running a lab.
And if the audience needs to think about this you run little factories that are very complex. Take an average size hospital there's probably an in-house test menu of 400-500 different kinds of assays. There may be 1000-2000 tubes a day coming in and you may have several hundred employees that do the 24/7 shift. This is a very complex organization.
And then another thing, Dr. Kreuter, is a typical lab does many things that certain companies only do one of so package pickup and delivery is UPS and FedEx. But a lab has courier and logistics specimen collection with phlebotomists, et cetera. The informatics component for the LIS. and for the billing.
So that the, think of it, if you're into a management career in the clinical lab in anatomic pathology space, think of this as a second important dimension to learn and master just as you did the science of performing an accurate reproducible lab test. You know, I wanted to highlight as you brought up I mean both the fact that you're, you're normalizing this
right? I, well physicians laboratory professionals we're used to thinking about our continuing education and and I hear you highlighting us to think about thinking about learning about, you know, business PR principles leadership principles, management principles. This is another domain that we need to pay attention to.
Well, that's very true and I'll, I'll tell you that over the course of my career, which started with Proctor and Gamble, I've come to recognize if you're going to be an effective manager there's really three legs of the stool. I like to say. One leg of the stool is, call it product knowledge. You have to know what goes on in the particular business you're with. In, in our case it's clinical laboratory testing anatomic pathology services.
The second piece of this is understanding management methods. Your, your Lean six Sigma and QMS quality management systems is a good pathway for that. And then the third thing is is I like to call this a bit of human psychology. And I was blessed about 1989 at a Fortune 100 corporation to be taught the DISC personal styling, dominant, influential, steady, competent.
It's easy to find the footprints of this on the internet but it helps you understand that everyone in the world has, is, is got a a primary perspective on how they deal with the world. There's four of those dominant, influential steady, competent for those in the audience who have done discs. And what happens is, as a manager you begin to understand that if pathologists look at the world is, is very detail-oriented very analytical and very predictable in that pathway.
The salesperson for the lab is a very socially gregarious person who's probably got an idea of the week that's their style. And then as a manager if you understand these four different styles it allows you to be more effective in how you get the organization aligned and achieving and exceeding its goals. That's a great resource and for our listeners to ping on to and learn more about.
One thing I also wanted to go back to that you mentioned you're highlighting taking the in the business world least it's it's keying onto entry level. There are gems that are entry level and developing them further.
Because that's something that's, you know, happened, you know for recently for me here at, at Mayo Clinic where, you know there was a call out for a large leadership position and I was like, well gee, you know I don't know if I have enough gray hairs yet for for putting my name in the hat for that kind of thing. And you know, people say that, no, no, no, this is you know, this is what we want people, you know at your stage to be putting their name in the hat for and to start working towards.
So I think that's something else for our listeners to consider. Whereas I think for a long time I hampered myself thinking about, you know this is my business and my work now rather than looking at taking that step forward. Well, that's a good point. And at, at one tour in my career I had started at a company entry level and they opened up a management position and wanted and and allowed anybody to apply.
And I didn't know at the time, but we showed up one night there were four or five of us aspiring to this management position and we we all did a presentation on how this was going to come out. And I, I was successful in that, but I learned later on they called it a management bake off.
And, and part of their, part of their goal was to identify anybody who aspired to a higher level of management so they could go back and then work with those individuals to prep them for the next opening that would become available. And for all of you out there listening to this podcast you in your mind, you have a career trajectory.
And so as I noted earlier, you've been very good at at preparing for the science of lab medicine you want to be equally forward looking on how you acquire these management skills that allow you to understand finance to understand the psychology of motivating a team and keeping creating a culture within your laboratory. All of these things are actually management and there's many resources that teach them.
And I, I constantly hear the chairs of pathology tell me over the years, there's no time to teach management because they have so much to teach during the during the pathology residency that they never get to the management piece. And they know that.
You know, I think, you know, you're really highlighting I hope this episode is really resonating with our learners across the, the age spectrum of those of us that are more senior thinking about, you know are we cultivating those young entry level gyms in our community and for the older or for the younger folks in our group to be thinking about how are we working towards, you know a future where I can step up and and take these kinds of positions.
Along that line, I was curious about, is there a common pitfall that you see when people are trying to take those correct steps towards developing their, their lab management skills but maybe they go in a a wrong direction? You know, if you go back to my example that most well run corporations do deliberate management training for all of their team every year. And that's not quite as common in all the hospital health systems and not for profit institutions.
Partly because they're, they're they're overstressed as it is. So then to answer your question, nobody's going to look out for you better than you look out for yourself. And what you want to do, we haven't talked about this yet is you want to find a management mentor.
You want to find somebody within your organization in particular who you admire for their ability to manage effectively and for their ability to create a lot of comedy with the team of folks and approach them and talk to them and say how can you help me develop my skills? And that's a very good way to compliment your skills in science and lab medicine with skills in management. Hmm. I like that I idea. Cause that's, that's another aspect that I haven't thought
about. You know, formally, I think informally I think about who do I look up to and oftentimes you know, when I'm, you know, working on my own development I sometimes am reflecting on situations, meetings I've seen them work in, and how they have managed that meeting. There's a couple of stories that I got in my teaching case for that. But I think that you highlight about you know, maybe as a challenge to our listeners consider making that a more formal component.
If you're more junior doing exactly like Robert's suggesting is reaching out to identify that mentor. And. I think if you're a more senior thinking about making yourself available or reaching out to somebody who's more of a gym and and offering to take them on Well you're, you're hitting the nub of a very interesting principle of management.
And many of you may be familiar with the Pareto principle P-A-R-E-T-O, which is also known as the 80/20 or the 20/80 ruled 20% of any population distribution is 80% of the impact. Well this works with human resources as well. In your lab, 20% of the staff are 80% of your go-getters and, and those 20 percenters of the ones that just innately step up to do what needs to be done without being told.
So in a management model, you want to be looking, as you come up your career in your management level, stage by stage you want to find those mentor types at each level that can guide you because they are already at that level of being a contributor. You could call it an outsized contributor. Organizations always recognize somebody who gets the job done.
And I had a management mentor years ago tell me if you see something that needs to be done go fill that need because invariably somebody will assign it to you later on. And, and his point was you can get promoted without any permission if you see certain things and you take them on and you start to do them confidently and sooner or later somebody higher in management recognizes, oh well we've solved that problem. It's, it's his, his or her responsibility now.
And a lot of time recognition and remuneration follows with that.
You know, as we're talking about being deliberate about cultivating ourselves in this way, you know, our audience, we might be used to thinking about, you know, maybe, you know different domains of our practice, you know, for residents in training, they, we know about the milestones and we can can think about these different components we get evaluated on them, but probably lesser, fewer of us have been evaluated with an eye for leadership
and management. I know to, to be vulnerable to the audience. You know, a lot of times when I'm interviewing people, one of the interview kind of assessments we have is kind of leadership potential, right? But that's whatever that is all wrapped up into one. I was wondering, Robert, if you can kind of help us break that apart and when we are thinking about being deliberate about cultivating ourselves what are those facets of leadership and management that we should think about and reflect upon?
Well, everybody has a different blend of talents to bring to the organization. And so this is the first thing you you started your career in science. I think we could all agree that that's a very common component to people who are found inside an anatomic pathology group or a clinical laboratory. So you started with the science but now different skills are needed for you to be able to deliver that science to physicians, to patients to health insurance companies, the, the customers.
And so that's when you want to find out what is your special niche, what's what what interests you and from a management perspective would allow you to make that kind of contribution. So I see med techs, for example that rise up and they become very effective in the compliance, the QA, QC area. And in some cases those people also become if you will, your your Lean six Sigma process improvement guru.
Because so much of quality at the bench is workflow and process that brings a good a good quality specimen to the analytical phase. But in other places I've seen med techs that say, Hey I'd like to get out of the lab and go talk to the doctors and generate lab outreach business because it applies my skills in a different way. So now you're in a sales in a marketing channel and that's equally valuable for both the physicians and patients they serve as well as the parent lab or hospital.
I really like the way you framed that because I think for those that are listening that might feel that you know, you know, you know, leadership is, you know that's not my bag or you know, I'm not really you really I think are highlighting there's a lot of custom that can be done for this. There's probably some facet of leadership that might be congruent with who you are and what you are interested in doing.
And, and probably that's underlies your recommendation to find a mentor that you kind of look up to. They might help you find that that niche. Well that's very accurate. You know, each of us is, is a unique mix of, of skills knowledge and experience and we have different interests. You know, the course of my career, I always liked figuring out what the problem was and how to fix it. I just had a knack for that.
And so a lot of my management career oriented towards people who needed problems solved. So you're, you're on the right path that everyone has a unique mix of talents but also of interests and motivations. And in the world of lab management there's something for everybody. You know, phlebotomists need to be managed, couriers need to be managed, med techs need to be managed. The lab coding billing collections department needs to be managed.
So it, as all, all of these things are career paths that have a a special skillset in terms of what you're dealing with but require management savvy and acumen to do it effectively.
You know, as we close out this podcast, I wonder is there one or two issues you just want to highlight that maybe our listeners should pay particular attention to that are kind of up and coming, you know when it comes to lab management Oh, for the up and comers, you know, these these are your future 20 percenters that get 80% of things done.
Well, the, the first thing I would like to talk about to this audience is we organized our first executive war college on lab and pathology management in 1996. And, and we'll be meeting in New Orleans April 25th and 26th. One of the things, one of the attributes that the people who come to the Executive War college is they're looking to change their lab and, and bring in innovative things.
And they're also looking to improve their network to find mentors even out of their own organization and be able to bring back these new ideas to their labs. So I would suggest anybody that has that kind of ambition this is a good place for you to be April 25th and 26th. Second of all, don't sit and wait, find a mentor. And there's a lot of resources out there.
I don't know if some of you're familiar with Toastmaster and Toastmasters is something that develops presentation skills not just for public speaking, but for how to present within your management team to be persuasive. And it's very easy to find a Toastmasters group. They meet once a week and there's usually six or eight people and that's a skillset that you can add to your tool set and it helped advance your career.
Wonderful. Both of those are gem resources for our listeners to pay attention to. I know Toastmasters in particular we've recently done a lot of, you know, recommendations for trainees to really cultivate and develop that skillset. Hey Dr. Kreuter, does Mayo have some Toastmaster groups?
We have a whole host, we have a number of of Toastmaster groups at Mayo and we have a number of employees that participate and, and not just participate but also have gone up in leadership of the Toastmaster community here locally. So I, I asked that question deliberately because here's Mayo, a very well run organization and it's it's fostering that kind of personal skills development. Exactly. On that note, I'm going to close out here.
We've been routing with Dr. Robert Michel, thank you for talking to us talking about this real practical knowledge the tools of laboratory management and encouraging us to not sit around and wait. Well, thank you very much for the opportunity and if I can help any of you, you can find me easily on the internet and I'll be most responsive. So best of luck to everybody And to all of our listeners, thank you for joining us today. We invite you to share your thoughts and suggestions via email.
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