Surgical departments are inherently stressful environments in which uniquely specialized physicians and staff must work in close proximity while using their respective expertise to ensure optimal results for the patient.

Scott Rhine, Whidbey General Hospital chief executive officer, discussed the need for increased teamwork and cohesiveness in the surgical unit at a recent board meeting.

He has recommended to the hospital board and medical staff that leadership needs necessitate the hiring of a part-time physician responsible for guiding and managing the surgical and anesthesia services at the hospital. The physician director would be assisted by key nursing leaders who would help with and assume responsibility for nursing care.

After years of intense schooling and exhaustive training, surgeons are groomed to be “the captain of the ship,” the professionals ultimately accountable to the patients. To shoulder the voluntary burden, the physician must be in complete control.

“When you have 15 surgeons and anesthesiologists each with their own training and perspective, it is sometimes difficult to create an environment where everyone gets along and agrees with the priorities as established by someone else,” Rhine said.

“For many years, surgery departments have been managed by trained and skilled nurse managers. Administration at Whidbey General and hospital administrators across the country are seeing new paradigms with shared leadership and responsibility being delegated to both physicians and nursing leaders.”

Highly trained medical staff must be confident to excel in their duties. And with confidence can come strong egos and conflicting opinions.

“We have found the value of having strong physician leaders in positions of responsibility at Whidbey General,” Rhine added, citing the example of Dr. Lee Roof, medical director for Quality Improvement and Patient Safety. The CEO indicated that installing Roof in the position was one of the best decisions the hospital administration has made in the last nine years.

Dr. Christoper Outlund, an experienced anesthesiologist who currently practices at the hospital, has expressed an interest in the leadership position. Prior to coming to Whidbey General in June, 2001, Outlund practiced anesthesia at Mercy Hospital in Iowa City, Iowa. He feels that with physician leadership, both the surgery department and the viability of island surgery practices can be enhanced. The anesthesiologist is committed to increasing involvement in recruitment and retention of both physicians and nurses, two problems that plague rural facilities.

Some physician and nursing staff members have expressed concern over the proposed change, unsure that a physician leader can step into such a role. Outlund indicated a willingness to obtain additional education, including a master’s degree in health care administration.

The doctor has also raised questions regarding the specific roles under the new structure, inquiring about the level of authority and responsibility he would be given and who he would report to in the organization.

Rhine sees the successful candidate commanding respect from both physician colleagues as well as nursing and surgical department staff members. He told the board he hopes to have the position filled by the first of next year.

Commissioner Holly Schoenknecht indicated that continuing efforts need to be made to address personnel and staff issues.

Dr. Chris Bibby, Whidbey General chief of staff, called the plan an “opportunity to work as a team.”