Stepping stones across a pool, Fiji

Unless you have been living under a very large rock, you know that our workplaces are undergoing big changes. Things we hoped would change are changing (yay!) and things we thought were givens are changing too. Despite knowing that swift and continual change has become “the new normal,” many people have not yet taken this in.

Recently, a busy California clinic began using the electronic health record (EHR) for patient visits, rather than writing chart notes by hand. Within this clinic, Doctor 1 became a super-user, learning all of the ins and outs of the EHR. Doctors 2 and 3 became proficient, not knowing all of the details that the super-user did, but still using the EHR successfully for each patient visit.

But Doctor 4 is using post-its and his memory to “chart” because he has not accepted the EHR and will not commit to becoming proficient at it. Doctor 4’s resistance is risky; his lack of electronic documentation could endanger his patients’ care. Doctors 1,2, and 3 are becoming very worried about the liability this creates for patients and for their clinic as a business. As a result of Doctor 4’s resistance, the clinical environment has become vulnerable and tense.

Considering the change that the EHR presents, it is important to note several facts. (If you are not in medicine, stay with me, this will come back around to non-doctors in a few paragraphs!)

-In 2013, according to the Centers for Disease Control, 78% of office-based physicians used an electronic health record (EHR) system, up from 18% in 2001.*

-The EHR is intended to remove serious obstacles to patient safety and good patient outcomes. Being able to access a patient’s medical records without relying on the office being open or the doctor being there is key. Being able to read the record, rather than trying to decipher a doctor’s hurried scrawl, prevents medication and diagnostic mistakes. When many different clinicians can access the record, they can coordinate their care of that patient, without missing things or providing redundant services.

-The EHR requires that the clinician learn non-intuitive software, which can be time consuming, intimidating, and frustrating, at least in the beginning. Where doctors work hard to create rapport and trust with patients, now they have to figure out how to use the computer while they are with the patient and not lose the patient’s confidence that they are paying attention.

Doctor 4 is resisting technology, for what he thinks are good reasons. He studied long and hard to accrue a high level of medical expertise, which he wanted to use in service to patients. Today, he is well-liked by patients and well-respected by his peers, a success on his own terms.

However, the role of doctor has changed since he entered the profession. It is no longer solely about “doctoring” but also about using computers to document what happened in the patient visit. If Doctor 4 does not use use the EHR, his fitness as a contemporary physician is called into serious question.

All of this presents Doctor 4 with a dilemma. Should he continue to fight the EHR by being a nonparticipant? If he does so, what is the impact on his patients and colleagues? Should Doctor 4 leave this clinic and try to find one of the few that is not using the EHR?  Should Doctor 4 leave medicine altogether because the practice of it now involves the EHR? Should Doctor 4 accept that the EHR is now a part of any medical practice, and get himself trained?

This example is not an isolated one. If you have not already, it is very likely that you will be faced with changes on the scale of those presented to Doctor 4, and you too will have your own dilemmas to examine.

Regardless of your profession, there are some basic realities about change that the contemporary worker must face. Among them are:

-The industry you are in is morphing, and the job you were hired into will morph accordingly. Technological advances, along with business concerns about financial and environmental sustainability, are impacting workplaces in an unprecedented manner.

-No one is guaranteed a job. Just because you have held the job for a long time–and maybe even performed very well–does not mean you will always have the job, nor that you will be able to exit on your own terms or timing.

-Lifetime employment is waning, even in countries like Japan, where it has been a given. One should not expect, nor is one entitled, to be in the same job or organization for an entire career.

-Bottom line:  if your team or your organization is not changing, it is probably dying. And if your team and organization is changing but you are not, you may well lose your job.

Make no mistake, many of today’s workers welcome and champion change. Those who are curious and fluid with change are the effective leaders, followers, and thought partners in this “new normal.”

Please understand that I am not suggesting you go with every change that is presented in your workplace or profession. Good changes are able to withstand discussion and critique, so if proposed changes seem ill-advised, by all means argue against them. However, if the change happens anyway, ask yourself how you can support it. And if you cannot, leave.

Although it may sound harsh to those who are very resistant to change, the reality of the “new normal” is this: rapid, ongoing change is here to stay. You may not have a choice to stop it, but you certainly have a choice about how to meet it.

*http://www.cdc.gov/nchs/data/databriefs/db143.htm