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.
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