Late to the party, but as always, I find the unique structure/flow to RadOnc creates bizarre dynamics.
With a few exceptions, the vast majority of the staff I work with have a near superhuman ability to attain "clock in/clock out" mentality.
"Near superhuman" because they seem to dedicate almost ZERO brainspace to remembering...anything. Which is a problem when therapists rotate machines every few weeks, so when everyone has done a complete cycle, I basically am stuck in real-life "Groundhog's Day".
There's one therapist in particular who manages to forget anything I've ever said, so when she returns to staffing the CTSIM, I literally always have to re-educate her on my default setup preferences. I'm talking like, whether I use a slant board or not. It's crazy.
But healthcare has evolved to make us fairly toothless right now. With decades of direct supervision requirements, we had limited flexibility in where we could be and when. Because of capital requirements, most of us have either been on professional contracts or employed, meaning staff and equipment are not "ours", so we're not anyone's "boss" in a classic sense.
But we're still "the doctor". So we're often perceived as "the boss" - without authority - and carry ALL liability.
We're also the only ones who need to interact with each type of person in the department to get the job done, so we have infinite possibilities for strife and no neutral allies. The front desk secretarial staff has very limited interaction with dosimetry staff, for example. So if there's a "problem dosimetrist", but there's a "work friendship" between a secretary and dosimetrist, you're at risk for creating multiple sources of conflict if the secretaries think you're being unfair "to their friend". This is complicated by the fact that radiotherapy is almost like speaking a foreign language to those without formal training, so issues don't even make sense.
Sprinkle in that everyone loves to waste time at work, and we're the ones on the hook to make sure nothing gets dropped, so lunch meetings with free food and no point are beloved by staff.
It doesn't have to stay this way and hopefully we can improve cultures over time. But I find the natural dynamics which arise in Radiation Oncology to be incredibly strange...and no one talks about it.
Culture is very interesting. A lot of times, we can’t control it, particular if we are the new guy.
What I found on the 4th try (!), is to embrace the one that exists and nurture that. We currently have a staff that has known each other almost from inception of the clinic (3 people here about 30 years) and two “new” people (6 years with us, more with the hospital). ESE’s version - I’ve seen that one and tried to change it with ultimately poor results. The other 3 - they were more like the current situation.
We do very short, informal “meetings”. Lunch is bought once a week, and you can eat wherever you’d like, but we all usually eat together anyway, even when I’m not buying. “Chart rounds” is a couple times a week, and it’s quick, no doses, just updates - we are constantly chattering throughout the week.
Hospiyao runs lean, so all of us do more than we would at a busy department. Manager is dosimetry. Nurse is navigator. Front desk and nurse do billing. Therapy is transport. Marketing is hospital marketing. HR stays out of the way, with limited modules and interactions.
The lines are blurred and hierarchy is limited. I am foregoing “director” type leadership and just going with it. They come to with issues and unless it’s safety issue, if it sounds reasonable, I go with it.
As an operation, we are … fine. We are profitable. We are the c-suite’s darling, at least at the moment. I participate in hospital stuff, not because I have to, but because I like the people I work with. That’s personality - because I have a low threshold to like people.
Point is not that I’m doing much right. I’m so hands off. I think my attitude is the best it’s been and I have really embraced curiosity culture and am conservative - no changes unless it’s required. Whimsical changes based on Simul’s feeling are rare. This is a new way for me - I like things My Way, but found that everyone else does, too.
It’s not perfect and we have some personnel issues (anyone want to work as a physicist in a low stress, high pay per patient treated?), but I would say I have changed a lot in 12 years and I think the “me” today is a better teammate than the “me” of 2010. It is working for us .. today.
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