Switching Gears: Adapting to Leadership in Civilian Surgical Services
In our July survey, we asked members of our community who served in the U.S. military to discuss their experiences working in both the military and civilian sectors of surgical services. Many expressed having a short learning curve that heightened how different military life can be from civilian life. However, the comparisons are not about claiming one way of leading is better than the other. Indeed, there is much a Director of Surgical Services with a military background can contribute to the civilian OR and vice versa.
In addition to highlights from our survey, Rick Coffman, who enlisted in the U.S. Navy as a hospital corpsman the day he turned 18, talks about how his military background enriches his leadership.
Differences Between Civilian and Military ORs
“One major difference is that there is a lot of organization in the military. You are trained on what to do, when to do it, and how to do it. I was cross-trained in all operating room areas, including central sterile supply and materials management. I could basically work as an LPN in the military. Everyone thoroughly understands everyone else’s jobs, and things get done.
Also, in the military, hospitals try to be identical. It’s very standardized and predictable. It doesn’t matter where you go around the world; you’ve got the same policies, expectations, and documentation. In civilian medicine, I can go to two hospitals, and they will practice entirely differently from one another. As a leader, I have to gear up for something different when I come to a new hospital.”
“Communication really is a big part of that. Sometimes nurses feel they are the only person responsible for patient care in that room. That’s what we do as nurses. We take a lot onto our shoulders. But when you’re on a team, that mindset can hinder us. In the military, we’re taught to delegate and incorporate those who are part of the team into the care of the patient. I don’t think delegation is taught as much as it should be in any realm of healthcare.”
“One of the things I had to change was the understanding that in the military, everyone strives to do the utmost, and that is not always true in the civilian sector.
Anonymous Survey Highlights
Perspectives That Need to be Let Go in Civilian Sector
“One of the things I had to change was the understanding that in the military, everyone strives to do the utmost, and that is not always true in the civilian sector. Often, staff just want to come to work, do their 8 or 12 hours, punch out and go home. The military doesn’t have set hours and breaks like the civilian sector. We worked until the job was done.”
“In the military, everyone was required to be ready to do any job: scrubbing and circulating, mopping and materials managing, packing and transporting the equipment. Whatever was needed. It’s more siloed in the civilian sector, and I had to let go of that expectation that everyone does everything.”
What to Consider Before Entering the Civilian Healthcare Sector
“Get ready for the Wild, Wild West, and very little structure. Flying by the seat of your pants a lot.”
“Take your time to try to find the right cultural fit.”
“In the civilian world, leadership is considered transformational, not from the top down. Some leaders with military experience may have difficulty understanding and utilizing transformational leadership, as well as working in a Union-driven environment.”the top down. Some leaders with military experience may have difficulty understanding and utilizing transformational leadership, as well as working in a Union driven environment.”
“That people have unlimited choices in the private sectors. Long-term succession planning is nearly impossible.”-term succession planning is nearly impossible.”
“You won’t be used to your request being questioned. Directors must realize this and adapt their approach to the civilian setting and understand that they may hear a ‘no.’”no’.”
“Adjust yourself to the change of leadership style that will be required for your new role. Today’s workforce needs to be inspired in an environment of scarcity. There are no shortcuts to buy in.””
Surgery in U.S. Space Force
“I optimistically believe the Space Force will be another branch of the military that will recruit healthcare providers, as is the practice in other branches. We provide surgery on ships at sea, in deserts, jungles, and other remote locations. If we are conceptualizing surgery in space, new technology will need to be developed to accommodate the effects of gravity. Surgery in microgravity (low gravity) is possible and has already been carried out, just not on humans yet. Microgravity environments slow wound and fracture healing and accelerate bone loss, muscle loss, and certain aspects of aging. I’m a Trekkie and believe life will imitate art.”Trekkie and believe life will imitate art.”